We should aim to minimise bone augmentation

Nathalie Schüller, Dental Tribune International

Wed. 23. October 2024

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Ahead of the European Association for Osseointegration (EAO) congress, Dr Giovanni Zucchelli, who is a co-chair of the scientific committee, spoke with Dental Tribune International about the major areas of discussion at this year’s event. In this interview, he talks about significant advancements in the field of implantology and the value of the event for attendees.

Dr Zucchelli, as a past president of the Italian Academy of Osseointegration and as a co-chair of the EAO congress, what are your thoughts on the significance of this year’s collaboration with the EAO?
I think the EAO congress is a great opportunity for Italian societies as well. The Italian Society of Periodontology and Implantology and the Italian Academy of Osseointegration will be present both to join forces and because the EAO is a very big and important event. The most important speakers in the field are invited, and the topics that will be covered are not only exciting but also the most relevant and challenging topics. We also have a new theme, “Beyond the limits”. The goal is to try to understand what we can do in the future to overcome what have been considered to be limitations of osseointegration treatments to date—an important compass for implant therapy.

Indeed, when we spoke five years ago at the MASTERMINDS²conference in Athens in Greece, you mentioned that implantologists tended to focus on bone augmentation around the implant and less on soft-tissue management, considering it a procedure done only to improve on the outcome achieved with bone augmentation. You believe that, by increasing the soft-tissue thickness and improving the soft-tissue management, the clinician can usually avoid bone augmentation. Have things changed?
I think that many things have changed in the last five years. There has been a growing recognition of the critical role soft-tissue management plays in implantology. While bone augmentation remains important, soft-tissue augmentation often achieves optimal outcomes without the need for additional bone procedures. Managing soft tissue becomes more complex when performing bone augmentation, and for that reason, we should aim to minimise bone augmentation whenever possible.

Historically, the focus was on bone augmentation because it was perceived as simpler to manage. However, especially in the aesthetic zone, soft-tissue management is essential and frequently provides excellent results without requiring bone enhancement. Additionally, bone augmentation can sometimes damage the surrounding soft tissue, further complicating treatment.

Given these considerations, the field of implantology has evolved. No longer is the emphasis solely on the relationship between the implant and the bone; there is now a greater appreciation of the crucial role of soft tissue. A strong periodontics background is essential for effective soft-tissue management, which ultimately enhances overall implant therapy outcomes.

Can you share some key topics or themes that will be highlighted at this year’s EAO congress and explain why these are particularly relevant to the current state of dental implantology?
The traditional topics will be covered, but I strongly encourage clinicians to attend the sessions of the new theme, “Beyond the limits”. These sessions will challenge participants to explore treatments that go beyond what is currently considered evidence-based. Going beyond the limits means achieving clinical results that surpass what is currently documented in evidence-based literature. While evidence-based practice provides a foundation, today, we have the opportunity to achieve outcomes that, although not yet fully reported on in the literature, are indeed possible.

For example, the sessions will explore innovative approaches to treating and managing peri-implantitis, including handling implant failures with advanced soft-tissue management techniques and strategies for dealing with implant extraction due to peri-implantitis. It will be fascinating to learn how far we can go in treating a failing implant, whether through efforts to salvage it with soft-tissue management and prosthetic adjustments or when extraction is necessary, requiring a complete restart of the treatment process.

“In terms of innovation, we must consider the digital impact on implantology.”

From your perspective, what are some of the most exciting advancements or innovations in the field of implantology that will be discussed at the congress?
In terms of innovation, we must consider the digital impact on implantology, such as the enhancement of implant placement with precise guidance using digital tools. This technology allows for implant placement even in areas with limited bone, reducing the need for extensive bone augmentation by utilising the available bone more effectively. Additionally, it enables a more minimally invasive approach, as implants can now be placed with less bone than was required in the past when such guidance tools were not available.

Another significant advancement involves new materials for both soft- and hard-tissue augmentation. These materials help clinicians reduce the invasiveness of surgical procedures, promoting better patient outcomes and faster recovery.

Having been deeply involved in the field for many years, what do you personally hope attendees will take away from this congress?
When attending a major congress like this, it’s important to focus on the key innovations and future directions highlighted by the latest research. This is an opportunity to gain insights into cutting-edge techniques, technologies and materials that are shaping the future of implantology. By understanding these advancements, clinicians can enhance their practice, improve patient outcomes and stay ahead in a rapidly evolving field.

Participants learn more about the latest courses and training opportunities offered by EAO. (All images: Robert Strehler)

Participants exchanging ideas among the dynamic atmosphere of EAO-DGI 2024.

Some of the many booths showcasing world-class industry innovations.

Participants engage with ePosters showcasing new clinical and scientific research in implant dentistry.

Italian Dr Luca De Stavola presents on some key aspects of surgical management.

More than 4,200 delegates from over 70 countries attended the congress. Here are some enthralled by one of the many presentations on offer.

Congress attendees learn more about implant treatment and digital dentistry at the MegaGen booth.

Next year's EAO congress will be held in glitzy Monaco, the home of the most renowned Formula One race in the world.

Industry leaders make the most of the networking opportunities on offer at the congress.

Participants learn more about Dentsiply Sirona's OSSIX® product line, which offers advanced solutions for guided bone and tissue regeneration.

The congress stimualted extensive, free flowing dialogue among participants. Here are some engaged in discussion about the latest in industry trends.

The aesthetically polished booth from leading Swiss dental implant manufacturer, Nobel Biocare.

Congress attendees learn more about implant, regenerative and esthetic dentistry at the Straumann booth.

Participants keep abreast of daily developments at the conference through the DTI Today publication.

Meisinger Implants shares information about its recent developments in the field of dental implantology with interested visitors.

Editorial note:

Dr Giovanni Zucchelli is one of the chairs in the session titled “Beyond the limits of hard- and soft-tissue augmentation: the next level”, which will be held on Saturday, 26 October, from 11:00 to 12:15 at the EAO congress. The congress takes place at the Milano Convention Centre. More information about the event can be found here.

Topics:

Dental Implantology

Tags:

Bone augmentation Dental implantology Digital Implantology EAO congress European Association for Osseointegration Osseointegration Soft-tissue management

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