To extract or preserve? That is the question. - by Dr. Marlene Teo, Singapore

We are very often faced with patients who have anterior teeth with guarded prognoses due to periodontal attachment loss. With advances in regenerative therapy, new developments in orthodontic-periodontal relationships, advances in graft materials and implant therapy, dentists have a large variety of treatment options to choose from.

How do we choose the best treatment plan for the patient that will give the best aesthetics, function, and longevity? Do we keep the tooth or extract the tooth and place an implant?

Orthodontic extrusion and/or extraction have also been discussed at length recently. Does this concept really work and is it a feasible treatment option? This lecture will attempt to simplify treatment planning for the patient with a periodontally compromised upper anterior tooth. The rationale for the various modes of treatment will be discussed.

What are the risks involved for periodontal patients with implants - Dr. Jeanette Chua, Malaysia

It has been documented that implants in periodontal patients have a risk of failure ranging from 2 - 47%. Why is there such a wide range? Nonetheless, this is the group of patient that requires the most help from dental implants to restore oral health and function. The big dilemma of whether we should or we should not rehabilitate with implants has been a topic of interest for the past decade.

Are we taking bigger risks when we insert implants in periodontal patients? What are the risks factors? Can we make implants last in periodontal patients? How do we educate patients about the current evidence? How do we mitigate risks involved?

This lecture will discuss the factors to consider, how to diagnose and manage this group of patients prior to introducing them to dental implants.

Implant Treatment Planning for Periodontally Compromised Patients - Dr. Pintippa Bunyaratavej, Thailand

Dental implant has become the treatment of choice for tooth/teeth replacement due to its high success rate. However, treating periodontally compromised patients with dental implant is much more challenging due to the lack of supporting structure, possible future loss more teeth, compromised space, and the higher risk of failure.

Complete periodontal treatment should be performed prior to implant placement in order to minimize the source of periodontal pathogens. Extraction of tooth/teeth adjacent to edentulous space with questionable prognosis should be considered to maximize the longevity of planned implant supported prosthesis. The sequence of treatment is also critical. In some cases, combined periodontal surgery with implant surgery can be performed. Orthodontic treatment may be helpful for space management. Team approach with good understanding between restorative dentists, periodontists and orthodontists can enhance the final outcomes for the patients. Patient’s cooperation and also understanding of the rationale, options, process (time and cost) of treatment and expected outcome are essential to successfully complete the long treatment process.

Optimizing esthetic results around teeth and implants through interdisciplinary dentistry - Dr. Regina Santos-Morales, Philippines

It is the goal of each dental clinician to restore back, if not, improve to its best capacity what was destroyed by dental disease and give their patients the most ideal comprehensive treatment. This can be managed through Interdisciplinary dentistry where all the dental specialities work towards the end goal of giving the patient the most satisfying results that encompasses biology, function and esthetics. Nowadays, when implant dentistry is being pushed sometimes even beyond its limits, we should approach this the most consciencious and most prudent way. We, the dentists who are given the trust and care of our patients, should give back what they deserve and believe that we can truly take dentistry to the next level. And lastly, a brief introduction to LANAP (Laser Assisted New Attachment Procedure) will be presented as a new alternative to traditional periodontal surgery in treatment of Moderate to Advance Periodontitis.