Gérard M. Scortecci, DDS, PhD
Title: Prosthodontic implant dentistry: How basal disk-type implants combined with the patient's own stem cells can make the difference for immediate fixed teeth in extremely atrophic jaws
Synopsis: In difficult clinical situations, prosthetically-driven implant treatment planning allows anticipation of potential esthetic and functional problems before implant placement. Autologous bone grafting, biomaterials, invasive techniques, lengthy procedures, etc. are often necessary when traditional axial implants (screws, cylinders) are selected to reach the therapeutic goal. In Europe, beginning in 2000, we developed an innovative, minimally invasive surgical approach based on activation of the osteogenic cascade involving the patient's own stem cells using a matrix Osteotensor® 90 days pre-op. This preparatory phase is followed by the placement of Diskimplants® with a large base maintained by osteosynthesis screws and conical Fractal® implants allowing a Fractal sinus lift procedure. Combined with biomaterials and platelet-rich fibrin (PRF), this approach makes it possible to equip sectors that were previously untreatable with other implant techniques. Patients are fitted with an immediately functional, screw-retained fixed prosthesis within 48 hr. The final ceramic-bonded-to-metal or ceramic-bonded-to-zirconium restoration is fabricated starting 6 mo. later after the occlusion, phonetics, esthetics, and maintenance have been checked. The results of a study of 1234 patients operated on between 2001 and 2008 reveal the validity, the safety, and the excellent cosmetic outcome obtained with this protocol, which is also applicable when bone grafting has failed or has proven insufficient.
1. Introduction to basal implantology, i.e., placement of implants in the dense cortical skeletal bone using a lateral insertion procedure as opposed to axial osteotomy.
2. Introduction to osteogenic activation: the minimally invasive flapless protocol described invoves activation of the various components – periosteum, endosteum, bone matrix, vascular walls and bone marrow– implicated in bone repair and remodeling.
3. Introduction to the Monobloc flat connection platform: the combination of an external hexagon protected by a rim providing a conical seal permits the fabrication of screw-retained frameworks guaranteeing a passive fit, in particular when used with machined prosthetic components, even for multi-unit restorations with divergent implants axes.
Bio: Dr. Scortecci obtained his DDS (1969), Certificate of specialization in prosthodontics (1976), Certificate of specialization in periodontics (1979), and PhD in odontology (1988) from the University of Aix-Marseilles School of Dentistry. Currently, he is Scientific Chairman, Basal Implantology Program, Dept. of Maxillo-facial surgery, University of Nice-Sophia Antipolis School of Medecine, France; a Visiting Professor, New York University; and a Clinical Professor of Periodontology, University of Southern California. He has been in private practice of implantology and prosthodontics since 1970. His Government appointments include Medico-legal expert in odonto-stomatology (Aix-en-Provence Court of Appeals), and Medico-legal expert for the French Social Security System. He is a member of the American College of Dentists, International College of Dentists, International College of Oral Implantologists, and the European Association for Osseointegration. Dr. Scortecci lectures internationally and has authored over 200 publications in French and English. He has conducted research in implantology at the Experimental Surgery Center in Marseilles, France and at Boston University. He was the founder and first president of the Nice-Côte d'Azur International Dental Congress (1975), today one of the largest dental meetings in southern Europe. He holds several patents, in particular for the Diskimplant, Fractal and Structure implant systems.