Held in Florence from 1 to 3 October 2015, the Symposium strived to provide answers to the greatest clinical questions concerning modern regenerative dentistry, highlighting how essential it is to provide clarification regarding the data of scientific evidence and current knowledge for correct application of treatments in daily practice.
Thursday, 1 October, started with the highly valuable contributions of Cristiano Tomasi and Maurizio Tonetti, who alternated in an intense discussion on the treatment of patients suffering from periodontitis: the focus was on case histories and communication with the patient to understand the importance of oral hygiene and periodic check ups.
A very interesting event held in the afternoon, the Expert Forum on the Diagnosis and treatment of peri-implantitis, was attended by almost a thousand participants: Expert coordination by Mario Roccuzzo allowed balanced and punctual participation by the 7 speakers who examined and presented the various aspects of the state-of-the-art regarding peri-implant disease (Marco Aglietta, Tord Berghlund, Denis Cecchinato, Emilio Maschera, Mauro Merli, Stefan Renvert, Tiziano Testori). The main conclusions of the forum included confirmation by experts of the possibility of the treatment of peri-implantitis - albeit with certain limits, such as mal-positioning of the implant, the presence of minimum keratinised tissue and adequate periodontal conditions. Nonetheless there is still no commonly validated, accepted protocol.
There was also high attendance at the theory-practical workshops of the Osteology Foundation which dealt with soft tissue management and aesthetic success in post-extraction sites (Daniele Cardaropoli/Paolo Casentini) and the management of periodontal and peri-implantar soft tissues (Raffaele Cavalcanti/Roberto Rotundo). The workshops of sponsor companies with Anton Sculean and Filippo Fontana were also sold out.
After the inaugural message from the scientific Chairmen Pierpaolo Cortellini, Myron Nevins and Massimo Simion, on Friday, each session involved a debate between two speakers with great clinical experience. Giovanni Zucchelli and Francesco Cairo presented evidence and results regarding the coronally advanced flap technique, whether associated or not with grafting of connective tissue, in the treatment of single and multiple recessions. The use of the graft was found to be advantageous, but not always indispensable, suggesting the need to analyse the individual anatomical situations – gums, papilla, crown, mandible/maxilla, extent of the defect - in the choice of the most appropriate treatment.
Giulio Rasperini and Anton Sculean debated the treatment options for periodontal regeneration, during which closure of the flap by primary intention and selection of the correct combination of biomaterials on the basis of the severity of the defect were found to be essential factors.
The role of the implant surface on the onset of peri-implantitis was the object of discussion for Tord Berghlund and Giovanni Polizzi. The strengths and weaknesses of the smooth and rough surfaces appeared to be evident; moreover, long-term results are necessary on the correlation between the onset of peri-implant disease and the type of surface.
Mauro Merli and Carlo Tinti were the protagonists of the reports regarding the choice of GBR membranes. Although reinforced membranes have been a common therapeutic solution for extended bone augmentation for at least two decades, resorbable membranes can provide a successful, less invasive alternative, as long as a stable support is used which creates space and stabilises the graft and coagulum, conditions necessary for effective bone regeneration.
On Saturday morning, starting with the Keynote lecture by Myron Nevins, the topic of large bone reconstructions was discussed. Excellent speeches by Matteo Chiapasco and Istvan Urban brought out the comparison of the best situations for using block grafts or GBR with biomaterials. In severe atrophies, the block of autologous bone remains the gold standard, but there are also several clinical situations wherein the correct use of mixtures of autologous bone and biomaterials, associated with resorbable membranes, make it possible to obtain an adequate, stable result. Urban's “sausage technique” is an example of the use of collagen membranes fixed with pins for horizontal augmentation, the volumetric stability of which is ensured by the presence of biomaterials that are resorbed slowly.
Lastly, the moderators of the various sessions emphasised the “Take home messages” resulting from the reports and calling upon the participants to again vote on the treatment options of an illustrative case presented during the Symposium.
Equally important was the Lunch for Learning dedicated to those under 35 which was “sold out” weeks before the start of the symposium: the group of young people worked with enthusiasm in diagnosis and in formulation of treatment plans under the guidance of expert tutors.
The appointment with Forensic Medicine in Dentistry with Stefano Fiorentino was a huge success: it was the occasion for providing clarification regarding standards which regulate the use of medical devices, bone bank, blood derivatives and the possibilities of executing aesthetic medicine interventions.
The winners of the contest for the best posters in the Basic research, Clinical research and Case report categories were Giulia Ghiacci (University of Parma), David Palombo (University of Milan) and Nicola Alberto Valente (University of Buffalo, NY), respectively.
Three intensive days, each providing the participants with clinical advice to be applied immediately in practice, with the aim of optimising the diagnostic phase and the correct approach for each patient: from analysis of the defect to choice of the technique, from evaluation of the implant type to that of biomaterial, from preference for mini-invasiveness to correct information, all in the sole interest of the patient's well-being.
The scientific program can be viewed and downloaded from the www.osteology-firenze.org
See all photos from the event in The Box.