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ePaper created 2015-03-10, 11:16:47 | version 1.33.01
32 — issue 1/2015 Advanced Implant Aesthetics Interview INTERVIEW with — Professor Dr. Tiziano Testori Q: Immediate loading is probablyone ofthe most important innovations in the modern eraoforalimplantology.Inyourexperience, why is this approach so beneficial? A: Immediate loading has a number of ad- vantages for the patient compared with conventional loading: return to function in fewer visits, there is no need for a re- movable prosthesis, improved soft-tissue healing, and less pain and discomfort. Since it is cost-effective, a much wider section of society can afford it. Q:Whatdoyouconsiderthemostimportant aspect professionals wishingto performthis clinical procedure should bear in mind? A: Appropriate training to apply the method is essential. Professionals should be able to obtain adequate primarystabil- ity regardless of bone quality, since this is a prerequisite for clinical success, and fol- low an efficient prosthetic protocol that allows them to be cost-effective. Q: In your opinion, what are the most suit- ableimplantsystemsforimmediateloading? A: Any implant system that has clinical peer-revieweddocumentationonits pro- tocolcanbeused.Manydifferentsystems exist on the market that can meet this re- quirementandmanydifferenttypesofim- plants are available. I prefer using tapered implants, since it is easierto achieve good primary stability with this implant type; however, I still use cylindrical implants in dense bone. Q: What are common complications of im- mediate loading, and how can they be man- aged effectively? A:Eventhoughimmediateloadingisasafe protocol in many clinical scenarios, there are clinical situations in which it is advis- able to follow a conventional protocol. Cases requiring bone regeneration or maxillary sinus lift or very esthetically de- manding cases should be evaluated with caution. Soft-tissue management is more diffi- cult in immediate loading, since the clini- cian does not have an uncovering phase during which to increase or correct the soft tissue. One of the most common complications is soft-tissue recession and this can be a problem especially in cases in which esthetics is significant. There could be an increased failure rate in some clinical indications, such as post-extrac- tion implants in the maxillae. Q: Maxillary sinus floor augmentation has many different components, such as en- doscopy,radiology,andanesthesiaandcon- scious sedation techniques. Do you think that this kind of surgery can be performed by all dentists or is it a specialist discipline? A: Performing maxillary sinus surgery needs specific training because knowl- edge, skills and clinical experience play an important role in the final outcome. Q: What are the main benefits of conven- tional and novel techniques for sinus lift for both clinicians and patients? A: Maxillary sinus lift surgery is evolving toward a less invasive approach, such as the crestal sinus lift, in which the flaps are less extensive and the morbidity of the procedure is lowered. Q:Couldyoupleaselistandexplainpossible alternativestomaxillarysinusflooraugmen- tation? A: The possible alternatives are short im- plants,tiltedimplants,orimplantswithdis- tal cantilevers, for which the implants are placed in native bone without anysinus in- volvement. Q: What does the Clinical Masters Program inAdvancedImplantAestheticsoffercourse participants? A: The course is not only theoretical but consists of live surgerysessions and prac- tical workshops, in which the participants learntheprocedurestaughtintheorystep by step. The participants learn how to progress from theory to practice. Q: What isthe overall aim ofthe course, and how does it differ from other courses? A: The overall aim of the course is to help participants achieve a high level of com- petence in diagnosing and treating pa- tients, from the easiest to the most diffi- cult case. The main difference is the education path, moving from theory to practice in a very cost-effective way. Q: What are the main challenges in esthetic dentistry today? A: The main challenge is maintaining the clinical outcome achieved in the long term. The diagnostic phase is of utmost importance and requires objective meth- ods to classify the level of complexity, since complex cases require a multidisci- plinary approach. „A performing maxillary sinus surgery needs specific training because knowledge, skills and clinical experience play an important role in the final outcome.“