Ortho Tribune Middle East & Africa No. 2, 2018

E6 ◊Page E5 ORTHO TRIBUNE Dental Tribune Middle East & Africa Edition | 2/2018 at the inferior dental nerve block procedure. Therefore, it is crucial that the operator achieve optimal pain control with minimal episodes of injection with minimal doses of anaesthetic agent. minimise damage to the IDN. The rate of complications after coronec- tomy is comparable to that observed after surgical extraction, except with a signiﬁ cantly low incidence of in- jury to the IDN. The surgery should be planned ac- cording to the information obtained from the preoperative assessment process. The procedure itself should aim to minimise the manipulation around the IDC. Both should include the carefully planned access, tooth sectioning and elevation techniques. In many scenarios, the extraction of the whole tooth may carry an una- voidable risk of injury to the nerve, therefore intentional retention of parts of the tooth was proposed via a planned procedure introduced around 20 years ago called coro- nectomy. This is the removal of the crown of a tooth, leaving the root in situ. It is merely adopted to avoid or It should be noted that both sec- tioning and coronectomy can be performed with a shorter incision, as the amount of bone removal re- quired is minimal, thus minimising the postoperative morbidity. How- ever, it cannot be performed in all cases in which the LM3 is close to the IDC and is certainly contra-indicated when the LM3 is decayed or its roots are associated with a pathology and should be considered with caution in severely inclined mesio-angular and horizontal impaction cases. The author does not recommend distal bone removal or retraction of the lingual ﬂ ap with the intention of protecting the lingual nerve, as these may increase the risk of dam- aging the lingual nerve. It should be emphasised that incision may not extend beyond the distobuccal as- pect of the tooth. The other impor- tant aspect of the dental extraction procedure is the future replacement of the tooth to be extracted. The cur- rent trend of tooth replacement for both functional and aesthetic rea- sons is the placement of dental im- plants. The success of this treatment largely depends on the availability of healthy bone in sufﬁ cient volume. Therefore, it is crucial for the dental practitioner not to compromise the alveolar bone during extraction of the teeth. Changes in the alveolar bone ridge after an extraction are inevitable. After all dental extrac- tions, bone height and width always undergo dimensional changes. Bone does not regenerate above the level of the alveolar crest, that is, its height will not increase during healing. The buccal plate tends to shrink, shifting the crest of the alveolar ridge lin- gually, and often forms a concavity. Such changes are proportional to the amount of trauma to the soft- and hard-tissue during the extraction. 04-05 May 2018 Target Group: GP’s, Orthodontists Venue: Madinat Jumeirah ConferenEe Centre, Dubai, UAE Accreditation: 14 CE Credits | Est. DHA 12 CME | Est. HAAD 14 CME 14 available CME FINAL PROGRAMME >>> CLICK HERE REGISTER NOW >>> CLICK HERE Final Programme 09:00 - 09:15 Dr. Naif Almosa, KSA | Chairman Opening Speech - Introduction to Digital Orthodontics Symposium 09:15 - 10:15 Dr. Francesco Garino, Italy The Digital Revolution with Intraoral Scanner 10:15 - 11:20 Dr. Amar Benaddi, France Introducton to a new 3D concept in vestbular orthodontic treatment thanks to the innovations in materials and digital tools. 11:20 - 12:20 Prof. Ross Hobson, UK Improving Planning and Predictability Using Digital Workﬂows in Ortho-restorative Cases 14:00 - 15:00 Dr. Khaled Hazem Attia, Egypt The Role of CBCT in evaluating Carriere® Motion Appliance 15:00 - 16:00 Dr. Francesco Garino, Italy Clinical Applications of Intraoral Scanners in Orthodontics 16:00 - 17:00 Dr. Jaswinder Gill, UK How to increase case acceptance with the digital workﬂow SUPPORTED BY Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. CAPP designates this activity for 14 CE Credits Round Table Trainings TABLE 1 TABLE 2 TABLE 3 TABLE 4 Turgay Guelal UAE Dr. Khaled Hazem Attia, Egypt Dr. Amar Benaddi France Dr. Jaswinder Gill UK Digital Evaluation with iTero Intraoral Scanner Self Liagation Introduction to a New Orthodontic Workshop with Henry Schein Orthodontics - Carriere® 3D Motion 3D Concept in Conﬁdence & Quality Vestibular Orthodon- tic Treatment ... Cases, CBCT in Orthodontics Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Tel: +971 4 347 6747 | Mob: +971 50 2793711 | E: events@cappmea.com www.cappmea.com/digitalortho An additional unfavourable change that may take place is the slow re- modelling of the bone formed to ﬁ ll up the extraction socket owing to lack of functional stimulation. The presence of poorly remodelled alveolar bone may compromise the stability and function of the future implant. Furthermore, studies show that the stripping and elevation of mucoperiosteal tissue produce a higher number of osteoclasts within the alveolar ridge and hence greater resorption and shrinkage are seen after the classical surgical or the trau- matic extraction of teeth. The preservation of alveolar bone for future implant placement may be achieved by avoiding unnecessary bone removal and stripping of the periosteum during surgery, as well as performing a surgical alveolar bone preservation procedure. Bone removal can be largely avoided or minimised through modiﬁ cation of the traditional extraction technique. The ﬁ rst such modiﬁ cation is the use of dental periotomes and luxato- mes to gently strip the periodontal ligament ﬁ bres and widen the socket without causing cracks or fracture of the cortical plates, as commonly encountered when using dental forceps or the bulky elevators. The use of such gentle instruments also eliminates the need for elevation of mucoperiosteal tissue. However, it should be noted that the safe use of these instruments requires adequate training and should be encouraged during undergraduate clinics. Clot stabilisation through light packing of the socket with collagen sponges may help to minimise clot dislodg- ment, as well as accelerate the heal- ing process and bone regeneration. The second strategy is the alveolar bone preservation procedure. This includes packing the extraction socket with different ﬁ llers, such as osteoinductive or osteoconductive materials, like autogenous, natural or synthetic bone grafting materi- als that support the alveolar socket walls, thus preventing their collapse and shrinkage. It should be noted that this intervention can only slow down the post-extraction changes to improve the success of the dental implant, but cannot stop them alto- gether. Finally, post-extraction care should include an explanation of the heal- ing process and potential symptoms encountered after such procedures. The prescription of medications should be limited to non-steroidal anti-inﬂ ammatory drugs in most cases and imprudent use of antibi- otics or socket dressing should be avoided. Dr Kamis Gaballah Educated in the UK and Ireland, Dr Kamis Gaballah is currently an associate profes- sor and senior specialist in oral and max- illofacial surgery at the Ajman University of Science and Technology in the United Arab Emirates.

Ortho Tribune Middle East & Africa No. 2, 2018

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