David Nisand

Dr. David Nisand (FR)

Speaker: Delayed implant placement/Delayed Temporization

Dr. David Nisand (FR)

Dr. David Nisand received a DDS degree from the University of Paris 5 along with a specialization in Periodontology and Implantology from the University of Paris 7.
He is a guest lecturer in the Department of Periodontology, University of Paris 7, elected president of the French Society of Periodontology and Oral Implantology, and co-editor of the European Association of Osseointegration magazine (Inspyred). He also serves as reviewer for the French Journal of Periodontology and oral Implantology and as chairman for the EAO congress in Paris in 2016.
His primary scientific interests include the field of periodontal reconstructive surgery, and periodontal and implant therapy. He is in a private practice limited to periodontal therapy and oral implantology in Paris.

Lecture

Achieving optimal long lasting esthetic outcome in the esthetic zone with implant supported restoration remain a challenge in daily clinical practice. This challenge is mainly associated with the loss of bundle bone and the related remodeling of the soft tissue contour. Several therapeutic options have been proposed to overcome this issue from immediate implant placement to early implant placement with or without immediate loading. All these therapeutic options might be successful from an esthetic point of view as long as there are correctly selected and meticulously performed. As such, immediate implant placement should mainly be selected when thick gingival biotype and intact buccal bone wall are present. Nevertheless, the surgical procedure has to take into consideration the unpredictability of the buccal bone remodeling over the first weeks and attempt for overcorrection using connective tissue graft. Although early implant placement might be less appealing in terms of number of surgical sessions and treatment time, its use in daily clinical practice offer many advantages from healed soft tissue contour to favorable condition for guided bone regeneration with three wall bony defect and increased soft tissue volume especially in thin gingival biotype. Early implant placement involve implant placement with guided bone regeneration 4 to 8 weeks after atraumatic tooth extraction followed after three to six months by a connective tissue graft. Provisional restoration should be installed at the time of uncovering four to six weeks after connective tissue grafting. The aim of the lecture is to focus on the decision making process in order to elicit the best therapeutic option in the esthetic zone and to describe in details the early implant placement procedure with delayed temporization. This lecture will also emphasize the importance of effective guided bone regeneration and soft tissue grafting and stress the impact of adequate temporization to achieve immediate and long term esthetic outcome.

Learning Objectives

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