• University of the Republic Montevideo, Urugay -Doctor of Dentistry, Oral Implant Surgeon - Smile Design

• since Nov 2010 Chief Medical Director - Clínica Odontológica Digital Lhasa
• March 2002 - since KOL Formlabs/ KOL 3shape/ KOL Pascal/ KOL Diashine/ Hass Ambassador Lhasa Digital Dentistry Clinic
• Since March 2022 President of the Uruguayan Digital Dental Society

According to the available data, millions of implants are placed annually. The number of implants already placed globally is enormous. Lots of patients have accepted implant therapies andthis population is growing dramatically. Despite the high survival rates of several implant protocols, failures do exist, and biological complications are the pivotal reason for implant loss. All epidemiological studies have shown that irrespectively of the criteria used to define peri-implantitis, the prevalence of this destructive disease is high.

28%-56% of the implant patients suffer from peri-implantitis and 12%-43% of the implants exhibit bone loss related to peri-implant pathology. Similarly to what is observed in periodontal diseases, peri-implantitis is the evolvement of a reversible inflammatory condition, restricted only in the soft peri-implant tissues. This disease is called peri-implant mucositis. Interestingly, in peri- implant mucositis cases, where the disease was not properly treated because the patients did not enroll in an individualized maintenance program, the situation aggravated, and the incidence of peri-implantitis reached 44%.

It is therefore obvious that since peri-implant mucositis as well as peri-implantitis are inflammatory diseases of primarily microbial etiology, treatment and prevention must be based on an effort to decrease periodontal pathogens during therapy of peri-implant pathology and on a regular basis, during maintenance therapy.

In the light of recent data presenting the side-effects of mechanical debridement of implant surfaces, because of the titanium particles and the corrosion that occurs, the need for a safe and harmless approach for implant surface decontamination becomes crucial.

The Cumulative Interceptive Supportive Therapy Protocol, introduced in the late 80’s, may be used as the basis of the clinicians’ effort to prevent peri- implant pathology and provide successful therapies to patients in need.It is therefore obvious that since peri-implant mucositis as well as peri-implantitis are inflammatory diseases of primarily microbial etiology, treatment and prevention must be based on an effort to decrease periodontal pathogens during therapy of peri-implant pathology and on a regular basis, during maintenance therapy.

In this course, a modification of the classical CIST protocol will be presented. Guided Biofilm Therapy is the principal step for every cumulative procedure aiming to treat peri-implant infection, and is advantageous for prevention, for non-surgical and for surgical procedures. The biofilm disclosure offers both clinicians and patients benefit beyond any doubt. Air Flow and Perio Flow with Erythritol are not only successful for the removal of the microbial deposits but also harmless to the implant surface, in contrast to all other methods used for implant surface decontamination, as shown in our own data from electron microscopy. Therefore, it is not proper for Air Flow with Erytrhitol to be included in the term “air abrasives”, since abrasion, by definition, means the loss of tooth or other material structure, by mechanical forces. EMS technology promotes biofilm removal without scratching or removing particles of the material per se. An explanatory nomenclature for “Airflowing” might be “air debriding decontamination”.

The dental professionals must be aware of the importance of harmless biofilm removal from dental implants and familiarize themselves with GBT, for the prevention and treatment of peri-implant pathologies.

Modern day dentistry allows us to leverage the full power of digital technology to improve our predictability, efficiency and accuracy in smile rehabilitation cases. In this presentation we will discuss preparation techniques for true minimal invasive dentistry and touch on new workflows in relation to CAD CAM and 3d printed restorations.