CONTINUING DENTAL EDUCATION COURSE

BIOMATERIALS

&

IMPLANT/RECONSTRUCTIVE DENTISTRY

September 14, 2009 to May 28, 2010

University of Toronto Faculty of Dentistry

Course Directors: Dr. J. Lai, Dr. D. Deporter, Dr. Y. Lenga

NOTE: OBSERVER STATUS ONLY APPLICANTS ARE BEING ACCEPTED FOR 2009/2010

Course Objective: This 9 month, full-time (September to May inclusive) observation and participatory (for those

who can obtain a temporary institutional license from the Royal College of Dental Surgeons of

Ontario*) course is intended to provide formal basic education and training for foreign graduate

dentists in the field of Implant Dentistry. It will consist of lectures, seminars, laboratory sessions

and clinical practice* in both the prosthetic and surgical phases of implant treatment. The

didactic core portion comprises seminars and lectures in biomaterials, tissue biology and tissue

engineering; clinical treatment, patient records and preparation; prosthodontic restoration and

follow-up; surgical techniques for implant site development and implant placement; evidence

from clinical trials and special considerations for identifying complex implant-related treatments

not appropriate for treatment by novice implant providers. The clinical portion includes

observation and assisting*; screening and treatment* of straightforward implant patients. The

aim of the clinical training is to familiarize participants with a limited range of basic implant

procedures including: treatment planning, preparation of surgical placement guides, ridge

retention procedures at the time of tooth extraction at sites intended for later implant placement,

and both the surgical and prosthetic procedures associated with the placement of implants in

single tooth, short-span partially edentulous, indirect sinus elevation and implant-retained

mandibular overdenture situations. Two categories of clinical participation are offered, those

being observation only or full clinical participation. Participants in the full clinical will be the

only participants allowed to treat patients and who must obtain temporary licenses. Further, since

the department does not actively seek patients for implant treatment, it cannot guarantee that all

full clinical participants will be assigned patients with every type of implant treatment discussed

in the didactic portion of the program. Certainly, more complicated treatment methods such as

autogenous block grafting and open sinus augmentations will not be assigned to full clinical

participants as these are beyond the scope of this basic training program. Full clinical

participants can however assist periodontic residents in performing these more advanced patient

treatments.

All course participants will partake in weekly literature review presentations to the teaching staff

and Graduate Residents in Periodontology. In addition, at the end of the program, all

2

participants may be asked to prepare (written and/or oral presentation using PowerPoint) a final

presentation relating to issues covered in the course. Participants will also prepare a digital

dossier of patient treatments as a series of case reports including photographic records of

treatment provided.

* Please note that any participation in actual patient treatment (either as a surgical

assistant or surgeon) is subject to temporary licensing of course participants by the Royal

College of Dental Surgeons of Ontario (RCDSO). The granting of this license is not under

any jurisdiction of the University of Toronto, either directly or indirectly. A major

component in determining whether a license is granted is based on English competency, to

be assessed on TOEFL test results. Participants must apply directly to the RCDSO with all

necessary documentation including TOEFL test results to obtain temporary licenses. The

minimum qualifying TOEFL score is 537. Participants should apply for their

temporary licenses as soon as they are accepted into the program as the committee

reviewing the applications meets on an infrequent basis and it may take several months for

a decision to be reached by the committee. Upon acceptance into the program participants

will be provided with license application information. Until a temporary license is obtained

participation in the clinical aspect of the course will be limited to observer status. The

University of Toronto Faculty of Dentistry does not guarantee that participants will receive

a temporary license and failure to receive this license is not justification for a tuition refund

or reduction.

Didactic Core Course Outline

Module I: Biomaterials, Tissue Biology and Tissue Engineering

Mechanical properties and interpretation of stress/strain considerations in implant treatment Bone and its cells. Optimizing bone healing around dental Implants. Session I.

Bone and its cells. Optimizing bone healing around dental implants. Session II.

Biomaterials used in dental implant fabrication. The past, present and future.

Early healing events around dental implants. How surface geometry affects outcomes.

Bone quality and implant design considerations.

Growth factors and optimizing dental implant treatment.

Coronal bone remodeling and implant design.

Barrier and graft materials used to promote optimal bone healing around dental

implants: A Periodontist’s perspective.

Barrier and graft (autograft, allograft, xenograft and alloplastic) materials used to promote

optimal bone healing around dental implants: An oral surgeon’s perspective.

Bone growth inducers and implant dentistry: What does the literature tell us?

Ridge preservation, Novel approaches using “old” principles.

Implant designs and surface geometry in promoting efficient and optimal implant integration as

well as long-term stability of the bone-implant interface.

Esthetic Concepts and developments in dental implant design.

3

Module II: Clinical Treatment: Records and Preparation

Patient history and record collection in preparation for implant treatment.

Prosthodontic planning for successful implant dentistry.

Pharmacologic considerations in implant treatment.

Preparation for digital format case presentations. A suggested template.

Management of periodontal and other dental diseases prior to implant treatment.

Radiography for Implants.

Module III: Prosthodontic Restoration and Follow-up of the Implant Patient

Prosthodontic management of the mandibular implant-retained overdenture.

Prosthodontic management of the maxillary implant-retained overdenture.

Fixed restorations of implants: implant placement guides, types and management of temporary

partial prostheses, impression-taking, and laboratory procedures.

Castings, indexing/soldering, porcelains and prosthesis design including mechanics of

implant components and splinting vs. no splinting.

Prosthodontic, esthetic, laboratory and occlusal issues relating to the single tooth implant.

Implant patient maintenance.

Recognizing and managing peri-implant complications with porous-surfaced dental implants.

Prosthodontic, esthetic, laboratory and occlusal issues relating to the multiple implant fixed

implant supported restoration.

Minimizing and dealing with prosthodontic complications.

Prosthodontic maintenance for implant patients.

Introduction on different types of implant retained/supported overdentures and a detailed

clinical and laboratory procedures of milled-bar overdenture.

Common clinical situations a general dentist may encounter with implant treatment and their

prevention and solution.

Module IV: Clinical Treatment: Surgical Techniques for Implant Site

Development and Implant Placement

Surgical technique with threaded implant designs followed by a live or video demo.

Techniques for augmentation of the edentulous ridge with block grafts of autogenous bone.

Surgical technique with porous-surfaced dental implants.

Osteotome techniques for dealing with the maxillary sinus and dental implant placement.)

Sinus grafting in preparation for dental implants.

The maxillary sinus. A medical perspective on risks, complications and their management.

One–stage vs two-stage implant placement with porous-surfaced implants. Optimizing

treatment outcomes.

One-stage vs two-stage implant placement with threaded implants. Optimizing treatment

outcomes.

Immediate implant placement with threaded implants. Optimizing outcomes.

Clinical advantages with porous-surfaced dental implants.

4

Optimizing soft tissue esthetics around dental implants.

Immediate implant placement with porous-surfaced implants. Optimizing outcomes.

Immediate implant function. Rationale and scientific background considerations.

Immediate implant function. Clinical outcomes reported to date.

Immediate loading of threaded implants in the esthetic zone.

Tooth-in-an-Hour™ (Nobel Biocare Procera Software Program and Nobel Guide Surgical

Procedure).

Module V: Evidence from Clinical Trials

Clinical trial outcomes with threaded implant designs.

Clinical Trial outcomes with bullet-shaped implant designs.

Clinical trial outcomes with sintered porous-surfaced implant designs.

Risk factors and causes of dental implant failure.

Module VI: Special Considerations for the Complex Implant Treatment

Transitional implants and treatment delivery.

Dental implants in facilitating orthodontic treatment.

Issues relating to the ethical, safe and effective practice of implant dentistry in a private

practice setting.

Tuition Fees: Observer Status - $25,000 CDN.

Clinical Participant * - $30,000 CDN.

Please note: Payment of $25,000 must accompany the completed registration form.

Cancellation Policy for the course of 2009/2010:

Cancellation received after June 30, 2009 – no refund

Cancellation received between June 1 and June 30, 2009 – 50% refund

Cancellation received on or before June 1, 2009– 100%

Successful completion of this course will result in the participant receiving a Certificate of Completion

of the Biomaterials and Implant/Reconstructive Dentistry Continuing Dental Education Course from

the University of Toronto, Faculty of Dentistry. This Certificate does not confer specialty or advanced

degree status.

* Limited openings available for this program.