Saving Teeth in the Age of Implants (American Academy of Dental Science)

In this day and age, dentists are routinely confronted with the same dilemma: To extract or not to extract? As dental implants continue to rise in popularity, this question has become more important – and complicated – than ever before. Join the American Academy of Dental Science for this day-long symposium featuring a series of distinguished lecturers representing a variety of specialties and backgrounds whose research seeks to help answer the question: 'to extract or not to extract?' 

I. Bruce J. Paster, Ph.D., Professor of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA; Director of Molecular Genetics of the Oral Microbiome, Forsyth Institute, Cambridge, MA 

The Oral Microbiome and Its Relation to Health and Disease
The oral microbiome is incredibly complex; the average adult harbors between 50 and 100 billion bacteria in their oral cavity, which represent approximately 200 of the 700 predominant bacterial species found in the human body. In his lecture, Dr. Paster will shed light on the essence of the oral microbiome, such as:

• The abundant number and types of bacteria that exist within the microbiome
• The molecular methods used to rapidly determine bacterial associations
• The site specificity of the host, the associations between oral health and disease
• Bacteria's ability to serve as a biomarker for non-oral diseases
• The potential use of oral microbial profiles to assess disease risk
• Increased understanding of the oral microbiome leads to increased understanding of bacterial-host interactions, which, in turn, help doctors to determine when and when not to extract a tooth.

II. Giuseppe Intini, D.D.S, Ph. D.,. Assistant Professor of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA. 

Role of Post-Natal Skeletal Stem Cells in Bone and Periodontal Homeostasis and Regeneration: Harnessing Their Potentials for Clinical Success.
In his lecture, Dr. Intini will explore the research, past and present, that has led to the identification of post-natal skeletal stem cells in craniofacial bones and in the periodontium. Attendees will develop a deeper understanding of the biology of autologous stem cells, their location and the molecular mechanisms that control their activity during tissue homeostasis and regeneration. Using a series of clinical cases in which these cells have been successfully harnessed, Dr. Intini will present the clinical tools that are currently available to clinicians and can be used to achieve success in bone and periodontal regenerative therapies. 


III. Thomas E. Van Dyke, D.D.S. PhD, Chair, Department of Applied Oral Sciences Center for Periodontology; Vice President for Clinical and Translational Research, Forsyth Institute, Cambridge MA 

Inflammation in Periodontitis: The Link That Ties Periodontal Regeneration and the Host Response to Systemic Disease
Recent studies have suggested a relationship between oral infection – particularly periodontal disease – and systemic diseases. Periodontal disease has been identified as a risk factor for the development of cardiovascular disease and stroke, as well as diabetic complications including glycemic control. It has become clear that periodontitis is an inflammatory disease linked to dysbiosis of the oral microbial biofilm, implying that it is the host response to the biofilm that destroys the periodontium in the pathogenesis of the disease. As our understanding of pathways of inflammation has matured, a better insight into the molecular basis of resolution of inflammation, which is distinct from pharmacologic anti-inflammation, has emerged. Resolution of inflammation is a well-orchestrated, active, receptor agonist-mediated return of tissue homeostasis, not inhibition of proinflammatory pathways. The isolation and characterization of endogenous lipid mediators of resolution has opened new doors for managing periodontitis and systemic inflammatory diseases. In his lecture, Dr. Van Dyke will review:

• Resolution of inflammation in the context of periodontal disease
• The role of inflammation and its control in bone regeneration
• The link between periodontal inflammation and inflammatory systemic diseases, particularly type 2 diabetes
• The rationale for periodontal medical approaches for bone regeneration and the potential benefits to systemic health therein

IV. Allen Ali Nasseh, D.D.S., MMSc., Postgraduate Faculty, Department of Endodontics, Harvard School of Dental Medicine, Boston MA 

Saving Teeth in the Age of Implants
Over the past twenty years, implant therapy has been established as the best alternative for replacing missing teeth. But what is the status of saving endodontically compromised teeth? What is the success rate of endodontics, and how successful is it compared to implant therapy? Furthermore, are there any philosophical arguments for saving teeth or is a success rate comparison enough? In his lecture, Dr. Nasseh will discuss the challenges of endodontic therapy, its current success rate, and some of the recent innovations, surgical and non-surgical, that have helped improve both the efficiency and efficacy of root canal therapy in order to extend the lifespan of endodontically compromised teeth. 


V. Hans-Peter Weber, D.M.D., Professor and Chairman, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA. 

Are Dental Implants a Panacea or Should We Better Strive to Save Teeth?
Dental implants have become an important and desirable treatment alternative to replace missing or “hopeless” teeth in many clinical situations. However, over the last few years, implants have begun to be recommended over and instead of treatment geared towards saving compromised teeth, particularly by less trained and experienced clinicians. This trend is of serious concern as it has become evident through clinical and scientific evidence that implants can suffer from biological and technical complications, such as peri-implantitis, which often necessitates complex treatment decisions. Although dental conditions, such as advanced caries or periodontally-diseased teeth, exist in which a practitioner must declare the tooth “hopeless,” the assumption that implants yield a better long-term prognosis is not universally true. This assumption has been disproved in several comparative studies and systematic reviews, which have instead shown that even teeth compromised by periodontal disease or endodontic problems may have a longevity that substantially surpasses that of the average implant. Hence, it is time to revisit the long history of successfully preserving teeth and the natural dentition instead of rushing to extract teeth and replace them with implants. In his lecture, Dr. Weber will highlight the “good and the bad” of dental implants in oral rehabilitation.

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Refunds

Full tuition refund or credit will be given for cancellations received at least two weeks prior to course date. Refunds or tuition credit will not be issued for participant no-shows.