PennWell and OnlineOralSurgery have partnered to bring you the first program of Practical Oral Surgery for the Practicing Dentist. We begin with “Basics of Oral Surgery”, which covers some fundamental concepts involving the surgical removal of erupted teeth. In dental school, there is time to teach only very simple exodontia. Many dentists are faced daily with patients who need more advanced surgical treatment, yet do not have the option of sending their patient to the oral surgeon. They must treat the patient in their own practices, even though they do not feel totally qualified to do so. This course consists of five modules that cover topics that will help the course participant improve their competence and confidence when performing basic oral surgery procedures.

This course is intended to provide the dental clinician with an overview of the considerations and steps involved in determining the requirement for site preservation prior to implant placement. Topics discussed include socket and site assessment for bone grafting, ridge preservation, site preservation based on site morphology, and the advantages and disadvantages of bone grafting prior to implant placement. The target audience for this course is dental clinicians.

Dental implants are a well-accepted treatment for the replacement of missing teeth. An estimated two million implants are placed annually, and it can be anticipated that an increasing number of implants will be placed and need to be maintained in the coming years. The intraoral environment and overall health of an individual patient influence patient selection/implant candidacy and the outcome of implant therapy. Factors affecting the intraoral environment include the patient’s heath status, medication use, level of oral hygiene, and habits such as smoking and drinking. Oral hygiene is an important determinant of implant success, as it is with the health of the natural dentition. Brushing and flossing are also critical success factors, requiring considerable patient education and motivation, and adjunctive therapy may be considered. With careful patient selection and patient commitment to oral hygiene measures, the potential for long-term success and implant health is excellent.

It has been estimated that more than 40 million teeth were extracted in 1999. An atraumatic extraction technique, together with ridge and site preservation, is important for function and esthetics following tooth replacement. This is particularly true if an implant is being contemplated for the extraction site. Atraumatic tooth extraction using the least-invasive procedure possible is the first step. Current techniques used for ridge and site preservation include the use of bone graft materials and/or resorbable membranes. Ideally, at the end of the process the area will be filled with vital, mineralized bone. A combination technique using deproteinized bovine bone grafting material and a resorbable collagen membrane has been found to produce a consistently preserved alveolar ridge at the site. The addition of a temporary ovate pontic helps to preserve and develop soft tissue contours during healing. Use of an appropriate technique preserves alveolar ridge anatomy, facilitates prosthetic management, optimizes function and esthetics, and enables the patient to be treated in a shorter time and with fewer surgical procedures.

Case acceptance, especially for those patients facing complex procedures such as implant dentistry, is a major factor for many dental health professionals. However, the failure of patients to carry through with a recommended course of treatment is not an insurmountable problem. Through a discussion of the various issues involved in case acceptance, this course addresses how the dentist can increase the odds of patient retention over time. This course includes analyses of patient readiness, psychological contributors from the patient’s point of view, and ways in which the dentist’s perception of the patient can positively or negatively influence case acceptance.

Lateral window sinus elevation is a preprosthetic procedure that can increase the success rate for posterior maxillary implants. An evidence-based decision process is required so that appropriate decisions can be made that will lead to the most positive patient outcomes.