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CE - Micro-Diagnosis 7/16/09

PART I                                             MICRO-DIAGNOSIS

7/16/09                                        Its relation to localized defects, prognosis
and the decision to treat or extract.
PART II    08/13/09                          MINIMALLY INVASIVE MICROSURGERY,  
                                                              Minimally Invasive Implant Placement and  Implant Site Preparation
                                                              Using Risk Analysis Theory to decide whether to place an implant or bridge
                                                             Utilizing small diameter implants and computer precision guided placement
                                                             in limited spaces such as the lower anterior and laterals

    Kenneth Abe, D.D.S.

 2.5 units     Hilton Garden Inn, 840 East El Camino Real, Mt. View CA 940405


Do you have patients who have localized problems that do not seem to respond to therapy? Have you had a patient who has had periodontal or endodontic procedures that have failed, have had compromised outcomes or have relapsed a couple of years later? Do you know why this has happened?  We were taught that plaque is the primary cause of bone l
oss along with general host factors. This does not explain localized problems, however. Why does bone loss occur selectively on only one surface or around one particular tooth? Does plaque "decide" to grow on a particular surface or tooth and not others? Was this taken into account in determining treatment? Factors that will help avoid these problems or allow you to predict them more reliably will be reviewed.Most periodontal therapy was developed for more generalized forms of disease. At that time, most disease patterns were generalized. Improvements in our understanding of periodontal disease and preventive care have resulted in an epidemiologic shift from more generalized involvement to more localized areas of bone loss. Traditional approaches to treatment need to be changed to reflect the new realities of periodontal disease. The surgical microscope has been used in periodontics to improve esthetic outcomes in soft tissue grafting and flap surgery. Its use has been shown to result in faster healing with less trauma and discomfort. There is more to microsurgery, however:  How many times have you heard "I treated the defect?"  Emphasizing treating "defects"addresses the result of the disease rather than the cause.  Many of us focus on treating defects because we can’t see the cause. If you don't see it, you won't treat it.  This will result in ineffective treatment causing decreased success rates or relapse.  Micro-Surgical Diagnosis allows us to detect problems that are normally overlooked because they are not visible to the naked eye or simple loupes. This has resulted in a Diagnostic and Surgical Paradigm Shift in treating Periodontal Disease. Before treating the result of the disease (the defect), we address the etiology of the disease (the local cause). By treating the etiology, we can improve success rates, predictability and avoid problems, such as relapse, later on. Localized defects are due to localized problems. Localized problems such as micro-fractures, micro-cementum, dentin and enamel defects, micro-accessory canals, micro-leakage, micro-grooves etc. will be reviewed.    In addition, I will review new strategies that have been developed to treat the microscopic problems detected. Any problem that affects the periodontium macroscopically also affects it microscopically. How these microscopic problems affect the long term prognosis of teeth as well as the determining factors that go into the decision of saving or sacrificing a tooth or teeth will be addressed.

Come explore the world of microscopic dentistry which will change the way you approach patient treatment and improve your ability to predict treatment outcomes for your patients.