Biocreative Orthodontic Strategy (BOS) point of view on Complicated Cases correction

• The era of Mucointegration in implantology
• The use of modern implants and orthopedic structures
• Osseointegration. Mucointegration
• Planning the emergence profile around dental implant

Orthopedic integration and achieving a stable result
The prosthetic treatment plan must allow an ideal integration of esthetics, biologics and functional requirements on natural teeth and on implants. In case of implants the prosthetic treatment is usually more challenging due to the inevitable soft tissues changing after teeth extraction. In this sense the prosthetic components assume an essential role in order to idealize the prosthetic integration and simultaneously achieve reliable and stable prosthetic results. Nowadays, it is well known that the biological integration and stability around implants, can be significantly influenced by the correct use of modern implant and prosthetic components.

Mucointegration
Implantology has reached the era of the Mucointegration. In this sense implants and prosthetics components should allow to get a restoration integrated at each level achieving restorations osseo-integrated and muco-integrated at the same time. On this object to tailor an ideal surface at each level, to meet biological needs, working on roughness, morphology and surface chemistry is a crucial advantage that can give us the opportunity to achieve a restorative system osseo-and muco-integrated at the same time. In this sense the use of not-removable prosthetic components allows to idealize the soft tissues healing and management around implant with significant advantage from a biological, biomechanical and clinical point of views. This approach offers an undisturbed mucosal seal with many advantages for both surgeons and restorative clinicians.

Planning the emergence profile
On this field assumes a crucial value also the management of the implant of the emergence profile of the restorations that is strictly correlated to the vertical position of the implant and the position of the platform. Lecture is aiming to point out which the latest innovations in all this topics.

• Minimally invasive orthopedic structures: simple crowns, bridges, full mouth rehabilitation
• Minimally invasive preparation and adhesive preparation techniques
• Modern restoration materials
• Making decisions to create the perfect treatment plan
• Aspects related to the treatment of aesthetic areas, with a focus on:
- diagnostic and orthopedic protocols
- surgical methods
- soft tissue management
- work with temporary restorations
- impression technique and the perfect selection of restoration procedures

Tooth-based prosthetics
The prosthetic treatment plan must allow an ideal integration of esthetics, biologics and functional requirements on natural teeth and on implants. In the last 15 years the technology, the new components and the new materials have revolutionized the traditional approaches, introducing steadily new digital instruments year after year: Cad/Cam technology, guided implant surgery and innovative digital tools for diagnosis, planning and treatment. All these innovations have influenced significantly the clinical and technical workflow both in case of teeth-supported and implant-based rehabilitations. Concerning teeth supported prosthesis the key point is the minimal invasive prosthetic approach and its integration with a digital workflow. Minimal invasive prosthetic procedures can be performed not only in case of full mouth rehabilitation but also considering simple crowns and bridges. In fact today with a correct preparation technique is possible to preserve sound tooth structure and also enamel in many clinical situations. This procedure combined with adhesive bond and a correct selection and use of the restorative material allows to achieve excellent result in term of integration and reliability of the final prosthetic outcome.

Implant prosthetics In case of implants the prosthetic treatment is usually more challenging due to the inevitable soft tissues changing after teeth extraction. In fact, the soft-tissue management around implants represents a crucial aspect and must be considered also from a prosthetic point of view in order to conclude the therapy with excellent outcomes. In this sense the prosthetic components assume an essential role in order to idealize the prosthetic integration and simultaneously achieve reliable prosthetic results. Clinical situations require specific evaluations in terms of implant connection, temporary abutments, definitive abutments and restorative materials and approaches. Nowadays, it is well known that the biological integration and stability around implants, can be significantly influenced by the correct use of modern prosthetic components. This lectures is step by step aiming to describe the decision making process in order to define the ideal prosthetic approach for all clinical situations, considering the single tooth replacement, the treatment of partial edentulous areas and the full-arch implant-supported rehabilitation. Special considerations and aspects will be introduced speaking about the treatment of the esthetic areas, focusing the attention on the diagnostic and prosthetic protocol, surgical techniques, soft tissues management working with the temporary restorations, soft-tissue based impression technique and the ideal selection of the restorative procedures. Also the selection of the restorative material will be evaluated considering both the monolithic and the layered approaches and pointing out the indications, the advantages and the drawback of each approach. All the topics covered during the course will be aiming to describe how to achieve an excellence integration of the restoration idealizing in the same time the reliability of the prosthetic outcome.