Paul Weigl

Prof. Weigl graduated from the University of Munich Dental School in 1989. Since 1992 he has worked as an assistant professor and director of preclinical studies for the Department of Prosthodontics of the Johann Wolfgang Goethe-University Frankfurt am Main. Dr. Weigl has special focus in the field of prosthetics on implants. He is also a senior specialist at the Dept of Prosthodontics, University of Frankfurt. Additionally he runs a R&D project to develop a fully automatic working CAD/CAM process to manufacture complete crowns and bridges and to develop a new fs-laser based device for diagnosis and minimally invasive therapy of caries. His new Department of Postgraduate Education offers the master course “Master of Science of Oral Implantology”.

Title 1: Brilliant and Sustainable Pink Aesthetics Through Immediate and Minimally Invasive Shaping of the Peri-Implant Soft Tissue.

Abstract 1: Today, about 80% of the implants are placed in a single tooth gap. A therapy concept offered in the dental practice of today must be able to serve the main stream of patients that is predominant: brilliant esthetic results, treatment appointments reduced to a minimum and minimal invasive procedure. These requirements provide anatomic-functional shaping of the peri-implant soft tissue immediately after implant placement or after re-entry of a submerged healed implant. In the so-called soft tissue transition zone, the prosthetic components abutment and / or crown simulate the root portion of the missing tooth and thereby form a nature-identical emergence profile. The therapy concept includes only two treatment appointments and avoids the change of abutments. This sometimes requires new work steps and workflows between surgeon, dentist and dental technology. The therapy concept stands in contrast to a stepwise shaping of the soft tissue [1]. In case of sufficient primary stability, an immediate restoration with a temporary single crown with infra-occlusion is prioritized. In addition to conventional clinical and dental procedures, the following digital workflows are suitable for this:

• The own production of a patient-specific abutment, the temporary and the final crown with a chair-side CAD / CAM system (e.g. CEREC^®)
• The outsourced production and deployment of the patient-specific abutment, temporary crown and ZrO₂ framework of the final crown prior to fully guided implant placement.

References:

[1] Furze D, Byrne A, Alam S, Wittneben JG. Esthetic Outcome of Implant Supported Crowns With and Without Peri-Implant Conditioning Using Provisional Fixed Prosthesis: A Randomized Controlled Clinical Trial. Clin Implant Dent Relat Res. 2016 Dec;18(6):1153-1162.

Title 2: The Socket Chamber Concept: Clinical Outcomes of Immediate Implant Placement and Restoration

Abstract 2: An immediate implant placement has to be combined with a primary wound healing of the extraction socket by a seal with a root-shaped abutment/crown complex. The resulting socket chamber is filled with blood which has a very high potential for healing and for new bone formation. The blood-filled chamber completely ossified without any therapeutic support [1] - the placement of membranes and bone replacement materials in case of a lack of buccal bone lamella loses its dogmatic required application [2]. This kind of immediate restoration simulates a tooth-reimplantation in the transition zone requiring a flapless tooth extraction. It ensures the preservation of the original emergence profile including papillae and long-term esthetics [3]. However, an appropriate implant thread design and osteotomy is mandatory to gain predictable a sufficient primary and secondary stability of the implant at the fresh extraction socket. Additionally, a two appointments work-flow enables an one-abutment-one-time [4] concept preventing mid-facial soft-tissue recession. In addition, a meta-analysis showed that immediate implantation in an infected socket does not increase the risk of failure [5].

References:

[1] Mainetti T, Lang NP, Bengazi F, Favero V, Soto Cantero L, Botticelli D.

Sequential healing at implants installed immediately into extraction sockets. An experimental study in dogs.  Clin Oral Implants Res. 2014 Dec 18.

[2] Sarnachiaro GO, Chu SJ, Sarnachiaro E, Gotta SL, Tarnow DP.

Immediate Implant Placement into Extraction Sockets with Labial Plate Dehiscence Defects: A Clinical Case Series.  Clin Implant Dent Relat Res. 2015 Apr 27.

[3] Weigl P, Strangio A. The impact of immediately placed and restored single-tooth implants on hard and soft tissues in the anterior maxilla. Eur J Oral Implantol. 2016;9(2):89-106.

[4]  Tallarico M, Caneva M, Meloni SM, Xhanari E, Covani U, Canullo L.

Definitive Abutments Placed at Implant Insertion and Never Removed: Is It an Effective Approach? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Oral Maxillofac Surg. 2018 Feb;76(2):316-324.

[5] Chen H, Zhang G, Weigl P, Gu X. Immediate placement of dental implants into infected versus noninfected sites in the esthetic zone: A systematic review and meta-analysis. J Prosthet Dent. 2018 Nov;120(5):658-667.