The challenge of missing teeth and facial growth – under the spotlight at Perio Master Clinic 2023

The challenge of dealing with the combination of missing teeth and facial growth will be tackled in one of the sessions at the EFP’s Perio Master Clinic 2023, which takes place in Antwerp on March 3 and 4.

The session, which takes place after lunch on the first day, will be chaired by Belgian periodontist Selena Toma, and begins with a presentation by Nicole Winitsky (Sweden) on implants and passive eruption.

Dr Winitsky, a senior prosthodontic consultant, will highlight how, in younger people, skeletal development, maturation, and the passive eruption of adjacent teeth mean that single anterior implants tend to end up in infra-position. Her presentation, based on her own long-term research on single anterior implants, will explore three key questions:

• How much infra-position can we expect?
• What are the patients’ reactions to this phenomenon?
• How do we plan our treatments to minimise the risk of making this a problem for our patients?

This presentation will be followed by a “duo lecture” — an innovative feature of Perio Master Clinic 2023 — in which France Lambert and Amelie Mainjot (both from Belgium) will provide different perspectives, from periodontology and prosthodontics, on managing and preventing implant infra-position.

Their lecture will address the complications that can arise after placing dental implants because of continuous facial growth – notably in young patients – which can lead to implant infra-positioning and impair both function and aesthetic outcomes. They will show how a team approach combining periodontology and prosthetic dentistry can manage such complications in the aesthetic zone by combining prosthesis and soft-tissue interventions.

Prof Mainjot and Prof Lambert (respectively professor in dental biomaterials and professor of periodontology at the University of Liège) will also discuss alternative treatments using a cantilever bonded bridge combined with muco-gingival surgery and will use clinical cases to discuss the pros and cons of the different management and prevention strategies.

The session will be rounded off with a clinical case presentation by Dick Barendregt (Netherlands) on autotransplantation as a viable option for patients of all ages.

Dr Barendregt will explain how the principle that supports the success of autotransplants – a vital periodontal ligament – was established more than half a century ago. The presence of this ligament provides a normal development of surrounding tissues and adaptation to the patient’s natural growth and remodelling. “This is in sharp contrast to dental implants, which fail to have the same characteristics and are therefore not applicable to adolescents and young adults or adult patients having a high remodelling rate,” he observes.

His presentation will report on the success he has achieved with autotransplantation, highlighting the importance of optimal endodontic treatment, early functional loading, and infection control, and concluding that “autotransplants have become an indication at all ages and, if possible, a more predictable treatment option than dental implants.”

Dick Barendregt, who has his own periodontology and implantology clinic in Rotterdam, was interviewed about autotransplantation in the latest issue of the EFP Alumni magazine Perio Life.

Perio Master Clinic 2023, on “The Perio-Ortho Synergy”, takes place at the Flanders Meeting & Convention Centre in Antwerp, Belgium, on March 3 and 4. 

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