{"id":2349,"date":"2019-06-07T08:00:48","date_gmt":"2019-06-07T13:00:48","guid":{"rendered":"http:\/\/www.quintpub.net\/news\/?p=2349"},"modified":"2019-08-26T10:09:05","modified_gmt":"2019-08-26T15:09:05","slug":"challenging-scientific-paradigms-zero-bone-loss-concepts","status":"publish","type":"post","link":"https:\/\/www.quintpub.net\/news\/2019\/06\/challenging-scientific-paradigms-zero-bone-loss-concepts\/","title":{"rendered":"Challenging Scientific Paradigms: Zero Bone Loss Concepts"},"content":{"rendered":"Reading time: <\/span> 8<\/span> minutes<\/span><\/span>

\"\"<\/a><\/p>\n

With today\u2019s scientific advancements, it\u2019s hard to appreciate the hygiene practices that help us avoid life-threatening illnesses. We forget that for the majority of human history, lifespans weren\u2019t nearly as long as they are now. It\u2019s equally difficult to imagine how people once believed foul odors, evil spirits, astrological arrangements, and bathing could cause disease epidemics. Bloodletting, the popular treatment practice used to purge the \u201cbad blood\u201d believed to cause infection, is simply horrifying to think about. These ideas may sound outrageous today, but people in the Middle Ages accepted them just as fervently as we rely on our hand sanitizers, personal hygiene, and food and waste safety measures of the 21st century.<\/p>\n

Continually testing and challenging these scientific paradigms is a cornerstone of scientific advancement.<\/p><\/blockquote><\/div>\n

In the 1800s, germ theory replaced the centuries-old miasma theory of dangerous air clouds. Thanks to the discoveries of John Snow, Louis Pasteur, and Robert Koch, we now know that microscopic organisms\u2014bacteria and viruses\u2014are the true causes of illness. Armed with this knowledge, we have developed ways to treat and prevent their invasion into the body, thereby contributing to longer, healthier lives.<\/p>\n

A hundred years from now, people may be just as quick to dismiss germ theory in favor of new scientific breakthroughs, but that\u2019s the beauty of progress. Continually testing and challenging these scientific paradigms is a cornerstone of scientific advancement. Dr Tomas Linkevi\u010dius, DDS, Dip Pros, PhD, set out to do just that with\u00a0Zero Bone Loss Concepts<\/a><\/em>, his revolutionary new book on implant dentistry. His research has uncovered breakthrough treatment practices to prevent bone loss, has examined the multitude of factors that contribute to it, and has determined that multidisciplinary clinicians are uniquely positioned to treat it.<\/p>\n

Zero Bone Loss<\/h2>\n

\u201cThe concept that bone loss is unavoidable should be abandoned.\u201d<\/p><\/blockquote><\/div>\n

Crestal bone loss has accompanied implant treatment for so long that it has historically been considered the natural result. In fact, this \u201cnorm\u201d has been codified. When Dr Linkevi\u010dius was a postgraduate resident of prosthodontics, almost 15 years ago, he was met with this existing paradigm.<\/p>\n

\u201cMore experienced colleagues explained to me that this bone loss\u00a0is considered\u00a0to be\u00a0unavoidable and urged me to just accept this fact,\u201d Dr Linkevi\u010dius recalls. \u201cHowever, for me, it was obvious that there must be reasons for it and that those factors should be researched and explained.\u201d<\/p>\n

\"\"<\/a>

Different reactions of crestal bone level to dental implants. (a)<\/i> Zero bone loss. (b)<\/i> Stable remodeling. (c)<\/i> Progressive bone loss. (d)<\/i> Bone growth.<\/p><\/div>\n

\"\"<\/a>

(a and b)<\/i> Crestal bone stability 7 years after augmentation and placement of implants without platform switching or a conical connection. The 7-year follow-up shows bone growth and intensive corticalization of bone.<\/p><\/div>\n

He and his team began digging deeper into the interworkings of unavoidable bone loss and soon made discoveries that proved otherwise. Their results dared to challenge the existing paradigm, dismissing the old standards of implant dentistry where 1 mm of bone loss is considered normal.<\/p>\n

“The concept that bone loss is unavoidable should be abandoned,\u201d Dr Linkevi\u010dius explains.<\/p>\n

Zero bone loss<\/em>, defined as long-term crestal bone stability, plays an important role in implant function. Bone stability is one key factor toward a good esthetic outcome, leading to patient satisfaction. Dr Linkevi\u010dius\u2019s research stresses that the goal should always be prevention of bone loss, especially in two major situations that require bone levels be as stable as possible: implants in the esthetic zone and the use of short implants. The shorter the implant, the more dangerous the same amount of bone loss.<\/p>\n

\"\"<\/a>

Remineralization of crestal bone around implants (V3, MIS). (a)<\/i> Delivery day. (b and c)<\/i> After 1 year.<\/p><\/div>\n

Dr Linkevi\u010dius and his team have developed four ways to increase vertical soft tissue thickness, which is one of the critical surgical factors for ensuring zero bone loss. These are outlined in the book with a chapter devoted to each method.\u00a0<\/strong>The text also looks a step further than bone loss prevention\u2014there could even be remineralization or bone growth.<\/p>\n

\"\"<\/a>

Different methods of vertical soft tissue augmentation. (a and b)<\/i> Flattening of the alveolar ridge. (c and d)<\/i> Subcrestal implant placement. (e and f)<\/i> Tent-pole technique. (g and h)<\/i> Vertical augmentation.<\/p><\/div>\n

Crestal Bone Loss: A Multifactorial Issue<\/h2>\n

Now that the concept and cause of bone loss can be better understood through the text and through Dr Linkevi\u010dius\u2019s worldwide lectures, a common focus of readers and attendees is to pinpoint a single cause.<\/p>\n

\u201cCrestal bone loss is a multifactorial issue, and there is no single most important factor.\u201d<\/p><\/blockquote><\/div>\n

\u201cWhen I hear lecturers talking about the most important factor, or\u00a0audience\u00a0members asking to name one, I\u00a0immediately\u00a0perceive a lack of deep understanding of the subject,\u201d Dr Linkevi\u010dius says. \u201cI want readers to understand that crestal bone loss is a multifactorial issue, and there is no single most important factor.\u201d<\/p>\n

To demonstrate this in the text, he describes an apple metaphor.<\/p>\n

\u201cImagine a basket of apples,\u201d he says. \u201cEach apple represents a separate factor that influences crestal bone stability. The purpose of research is to take one apple out of the basket and study it alone, eliminating other confounding factors. Clinical studies must be designed so that the factor in question\u2014the single apple\u2014can be studied as objectively as possible. The difficult part is that after research is complete, the apple must be returned to the basket, meaning that in clinical reality all factors operate simultaneously.\u201d<\/p>\n

\"\"<\/a>

Basket of apples metaphor<\/p><\/div>\n

The Value of the Multidisciplinary Clinician<\/h2>\n

Dr Linkevi\u010dius was trained as a prosthodontist, and for the first 5 years of his professional career, his practice remained limited to prosthetic work. This seemed to work for a while, until he hit a wall.<\/p>\n

\u201cI soon realized that without the proper surgical knowledge and techniques, I simply could not deliver the results that my patients deserved,\u201d Dr Linkevi\u010dius says. \u201cI strongly feel that whenever possible, it is ideal for all treatment to be performed by the same specialist who possesses knowledge of implant design, biology, and prosthetics and can therefore achieve zero bone loss around every implant.\u201d<\/p>\n

\u201cRespecting surgical factors is simply not enough. We need to take prosthetic factors into consideration as well.\u201d<\/p><\/blockquote><\/div>\n

To meet the needs of his patients, he set out to widen his skillset, adding \u201cimplant dentist\u201d to his r\u00e9sum\u00e9. Subsequently, his implant research has benefitted from his personal\/professional journey, and his book reflects those professional practices.<\/p>\n

\u201cIf we want to have crestal bone stability after restoration of implants, respecting surgical factors is simply not enough,\u201d Dr Linkevi\u010dius says. \u201cWe need to take prosthetic factors into consideration as well\u2014they are equally important.\u201d<\/p>\n

Put another way, \u201cA surgeon without prosthetic knowledge and a prosthodontist lacking surgical awareness may never accomplish the most desired results, as both parts are equally responsible for bone stability.\u201d<\/p>\n

From establishing crestal bone stability through surgical factors to maintaining that stability through prosthetic factors, the book combines surgical and prosthetic advice, making it a unique, one-stop resource of clinical procedures backed by solid clinical evidence.<\/p>\n

Impossible Is Nothing<\/h2>\n

Dr Linkevi\u010dius\u2019s goal for Zero Bone Loss Concepts<\/a><\/em>\u00a0is that clinicians thoroughly understand and can practically apply the zero bone loss breakthrough, multifactorial concept, and multidisciplinary value. However, he is all too aware that his research into implant dentistry has only touched the tip of the iceberg on crestal bone loss. While his book presents the latest on the concept to date, the scientific paradigm he has set in motion\u2014away from beliefs of the past 30 years and toward new research\u2014will continue to change and shift over time. The process of compiling his research into this book has intimately shown him how scientific research is constantly evolving in a never-ending cycle. Case in point: New information was being generated while the book was being printed, which will inform future editions.<\/p>\n

Until then, Dr Linkevi\u010dius stands by a favorite saying that \u201cimpossible is nothing\u201d when it comes to improving crestal bone loss levels around implants. He encourages clinicians to discover this for themselves by applying the concepts detailed in the book.<\/p>\n

\u201cThe definition of \u2018best\u2019 treatment is not permanent,\u201d he stresses.<\/p>\n

He is determined to continue making new versions of that \u201cbest\u201d treatment possible for practicing clinicians for years to come. Clinicians may get an inside look at the latest treatment practices in October at his upcoming workshop<\/a> at the Dr H.W. Haase CE Center in Batavia, IL.<\/p>\n

\"\"<\/a><\/p>\n

\n

\"\"<\/a><\/strong>Tomas Linkevi\u010dius, DDS, Dip Pros, PhD,<\/strong> is a professor at Vilnius University in Vilnius, Lithuania, where he completed his postgraduate studies in prosthetic dentistry and obtained his prosthodontist specialty. Dr Linkevi\u010dius received his dental degree in 2000 from Kaunas Medical University in Kaunas, Lithuania, and defended his doctoral dissertation at Ri\u012bga Stradins University in R\u012bga, Latvia, in 2009. Dr Linkevi\u010dius has authored dozens of publications in international peer-reviewed journals. He has also contributed to several books, including Cementation in Dental Implantology <\/em>(Springer, 2015) and Implants in the Aesthetic Zone<\/em> (Springer, 2019). During the course of his research, Dr Linkevi\u010dius developed zero bone loss concepts<\/em>, an evidence-based clinical protocol that demonstrates how to achieve and maintain crestal bone stability around dental implants. He lectures internationally on this topic and is an active member of several professional organizations, such as the Academy of Osseointegration and the European Academy of Osseointegration. Dr Linkevi\u010dius maintains a practice specializing in prosthodontics and implant dentistry and continues to study zero bone loss concepts at the Vilnius Research Group.<\/p>\n

 <\/p>\n

\"\"<\/a><\/strong>Zero Bone Loss Concepts<\/a><\/strong>
\nTomas Linkevi\u010dius<\/em><\/p>\n

Bone loss is still a major issue that dentists encounter, but it is a complication that can be prevented. By combining clinical experience with peer-reviewed scientific evidence, the author of this book has put together a guide that any implant specialist will find invaluable to prevent bone loss in their patients. Different strategies are presented that can be used to achieve zero bone loss years after treatment. Because successful treatment depends on both the surgical and prosthetic components, the book is divided into two parts, each focusing in depth on what must be done in each phase to promote bone stability. Case presentations detail many types of clinical situations, implant choices, and prosthetic solutions, all backed by evidence-based clinical studies that have proven success.<\/p>\n

304 pp; 1,231 illus; \u00a92019; ISBN 978-0-86715-799-4 (B7994); US\u00a0$198<\/strong><\/p>\n

Contents
\n<\/em>Developing Crestal Bone Stability \u2022 Implant Design \u2022 Implant Depth \u2022 Vertical Soft Tissue Thickness \u2022 Subcrestal Implant Placement \u2022 Flattening Bone \u2022 Tent-Pole Technique \u2022 Vertical Soft Tissue Augmentation \u2022 Attached Tissues \u2022 Cement- and Screw-Retained Restorations \u2022\u00a0Individual Abutments \u2022 Fixed Partial Dentures \u2022 Angulated Abutments \u2022 Emergence Profile \u2022 Prosthetic Materials \u2022 Subgingival Materials \u2022 Supragingival Materials<\/p>\n

\n

This article was written by Sarah Mondello, Quintessence Publishing. <\/em><\/p>\n

\u00a92019 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY.\u00a0NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.<\/p>\n","protected":false},"excerpt":{"rendered":"

Reading time: <\/span> 8<\/span> minutes<\/span><\/span> With today\u2019s scientific advancements, it\u2019s hard to appreciate the hygiene practices that help us avoid life-threatening illnesses. We forget that for the majority of human history, lifespans weren\u2019t nearly as long as they are now. It\u2019s equally difficult to imagine … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":289,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[8,210,34,35,43],"tags":[432,429,63,76,430,431],"class_list":["post-2349","post","type-post","status-publish","format-standard","hentry","category-books","category-feature","category-implant_dentistry","category-multidisciplinary","category-prosthodontics","tag-alveolar-bone-loss","tag-crestal-bone-loss","tag-dental-implants","tag-implant-dentistry","tag-tomas-linkevicius","tag-zero-bone-loss"],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p8oYan-BT","jetpack_sharing_enabled":true,"jetpack_likes_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/posts\/2349","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/users\/289"}],"replies":[{"embeddable":true,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/comments?post=2349"}],"version-history":[{"count":62,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/posts\/2349\/revisions"}],"predecessor-version":[{"id":2558,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/posts\/2349\/revisions\/2558"}],"wp:attachment":[{"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/media?parent=2349"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/categories?post=2349"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.quintpub.net\/news\/wp-json\/wp\/v2\/tags?post=2349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}