Nagoya Japan MaxiCourse Curriculum

The 8th Nagoya Japan MaxiCourse®
From April 2023 to November 2024 one or two weekend a month
2 days: Saturday and Sunday

Saturday:14:00‐19:00 (5 hours)
Sunday:  9:00 – 17:00 (7 hours)

2023
12/16-17
2024
1/13-14
2/17-18
3/9-10
4/6-7
4/20-21
5/11-12
5/25-26
6/8-9
6/22-23
7/6-7
7/20-21
8/3-4
8/24-25
9/7-8
9/22-23 
The schedule in November has been changed to September 22nd and 23rd.
9/28-29
10/12-13
10/26-27
11/9-10
11/23-24

Total 40 days and 60 hours Webinar

Training place; AICHI IMPLANT INSTITUTE meeting room
(Next to Hotta Dental Clinic)
13, Morimaki-cho, Moriyama-ku, Nagoya, 463-0073 Japan
Tel; +81(JP) 52-794-8188
Fax;+81-52-792-3425
E-mail; hotta-dc@ff.iij4u.or.jp
Home Page; https://www.hotta-dc.com

Course tuition ; 2,000,000 Japanese Yen
(20 months), payable in 20 instalments of 100,000 Japanese Yen. (pay as you attend)
Cancellation can be made at any time.
However, no refund will be made under any circumstances after payment has been made.

(Lecturers)
Director and Main lecturer; YASUNORI HOTTA, DDS, PhD, FAAID, DABOI/ID
・Director of AICHI IMPLANT INSTITUTE (Center)
・Diplomate of ABOI/ID
・Fellow of AAID
‣Fellow & Certified Educator of the Japanese Society of Oral Implantology (JSOI)
・Visiting Professor of Asahi University, School of Dentistry, Division of Oral Implants Japan (until March 2019)
・Part-time lecturer of AICHI GAKUIN University, School of Dentistry, Division of Oral Implants, Japan(untill March 2022)

Co-director and Assistant lecturers;
1. HIROSHI MURAKAMI, DDS, PhD
・Professor of AICHI GAKUIN University, School of Dentistry, Division of Oral Implants, Japan
‣Fellow & Certified Educator of the Japanese Society of Oral Implantology (JSOI)
・Associate fellow of AAID

2. KOJI ITO, DDS, PhD
・Fellow of AAID
‣Fellow & Certified Educator of the Japanese Society of Oral Implantology (JSOI)
・Part-time lecturer of AICHI GAKUIN University, School of Dentistry, Division  of Oral Implants, Japan

3. TAKASHI SAITO, DDS, PhD
・Fellow of AAID
‣Fellow & Certified Educator of the Japanese Society of Oral Implantology (JSOI)

4. SHINICHI KOMATSU, DDS, PhD
・Associate fellow of AAID
‣Fellow of the Japanese Society of Oral Implantology (JSOI)
・Part-time lecturer of AICHI GAKUIN University, School of Dentistry, Division of Oral Implants, Japan


Invited Lecturers;
1. Dr. Shankar Iyer, DDS
Fellow, American Academy of Implant Dentistry
Diplomate of AAID/ID

2. Dr. Akitoshi Katsumata
Professor and Chairman, Department of oral radiology
Asahi University, School of dentistry, Japan

3. Dr. Kuniteru Nagahara
Professor for Division of Oral Pathogenesis and
Diseases Control, Department of Implantology, Japan

4. Dr. Nobuo Yoshinari
Professor and Chairman in Department of Periodontology, School of Dentistry, Matsumoto
Dental University, Nagano, Japan

5.Dr. Jiro Takahashi (Medical doctor)
Department of Acute Medicine, Kawasaki Medical School Staff Physician, Emergency and Critical Care, Kawasaki Medical School Hospital, Japan

6.Dr. Yuji Kamiya
Department of Oral and Maxillofacial Surgery, Tosei General Hospital, Chief, Japan

7. Dr. Hatsuhiko Maeda
Professor at the Department of Oral Pathology, School of Dentistry, Aichi-Gakuin University, Japan

8.Dr. Yayoi Ikeda
Professor at the Department of Anatomy, Aichi-Gakuin University School of Dentistry, Japan

9. Tatsushi Kawai DDS. Ph. D.
Professor of Dental material Science, School of Dentistry,Aichi-gakuin University
JAPAN.

10. Dr. Toshihiro Hotta
Department of Acute Medicine, Kawasaki Medical School Staff Physician, Emergency and Critical Care, Kawasaki Medical School Hospital, Japan

11.Mrs. Keiko Ikeda (Lawyer)
IKEDA Law Office, Nagoya, Japan


CURRICULUM AND COURSE OUTLINE
GENERAL COURSE OBJECTIVES
To impart the understanding of the diagnostic and treatment modalities necessary to properly treat patients who are candidates for dental implant therapy. The interdisciplinary approach utilizing case based learning methodology will include lectures, demonstrations, interactive seminars, hands- on sessions and relevant review of literature emphasizing evidence based clinical approach.
To provide an intensive overview of the state-of-the-art in implant dentistry
Provide live surgical and prosthetic demonstrations on patients.
To aid the participants in the preparation for the AAID Associate Fellow/Fellow membership examinations and JSOI examination for qualifications.
* * * * *
Nagoya Japan MaxiCourse® ADVANTAGE
1. Over 300 hours of comprehensive lectures, live surgeries, demonstrations and hands-on sessions.
2. In-depth review of surgical and prosthetic protocols.
3. Non-commercial course covering wide spectrum of implant types and systems.
4. Certificate of Completion from Nagoya Japan MaxiCourse and Aichi Implant Institute accredited by JSOI.

Practice schedule of various implant systems SPI-Tomen, ANKYLOS & ASTRA –DENTSPLY, ITI-Strawman.
The model practice of each system is done by a separate schedule.
Note: This course does not receive any funding from any of the above-named implant manufacture.
This course contains live on-site practical surgical observations of a range of implant procedures.


【 the 1st module】
The exciting world of Implant Dentistry.

This module will feature examples of some ideal results achieved with implant dentistry and will provide numerous pre and post op cases from start to finish. This is intended to expose the audience to the scope of treatment that can be achieved through Implant Dentistry.

Introduction and basic study of implants. ・History of dental implants ・Necessary basic science for implant treatment
・Patient management guidelines
《 Practice 》
・ Preliminary medical examination by interview
・ Safe sterilization practices, disinfection methods and handling apparatus.

1.The Expanding Scope of Implant Dentistry – An introduction about the objectives of the course.
Objectives:
• To provide an overview of the discipline of implant dentistry as it relates to mainstream practice of dentistry.
• To emphasize the necessity of considering implant dentistry as an adjunct to overall patient treatment planning rather than predominantly focusing on corporate driven concepts.

Outcomes:
• The students will be able to consider implant dentistry as proven mainstream dental therapy.
• Be able to identify the discipline as part of their scope of treatment.

2. Examples of cases where the patients’ needs and desires could not have been met without implants.
Objectives:
• To illustrate the end result of various cases that have been successfully treated.
• To provide basic reports of cases from simple predictable situations to varying advance levels.
• Display examples of significant changes in the quality of life produced through the benefits of implant dentistry.

Outcomes:
• This will instill confidence among participants that they too can plan for treatment of predictable cases.
• They will be able to have a perspective early in the course as to identify various approaches that practitioners could take and have an overall understanding of the multimodal approach.

3. How implants work?
• History of Implant Dentistry
• Materials used in the fabrication of dental implants
• Biomechanics
• Manufacturing of dental implants
• Wound healing around dental implants

4. Evolution of Modern Implant Dentistry
Objectives:
• To provide a chronological sequence of events that has led to the professional acceptance of implants as part of mainstream dentistry.
• To emphasize the importance of understanding previous designs and configurations and their pitfalls.
• To provide an overview of the corporate strategies that changed the practice of implant dentistry.
• To elaborate on regulatory standards that govern the sale and distribution of dental implants.

Outcome:
• This presentation will enable the participants to compare the present implants systems as they are being constantly modified and help them in deciding if there may be any validity in the changes.
• They will also understand that their practice would have to be patient centered rather than a “one implant system” practice.


【 the 2nd module 】
12 hours
Why are there several implant systems?
• Implant modalities, companies and the market
• Choosing an implant system that will work for me
• What to look for in an implant system
• Evaluating manufacturers claims

1. Review of Current Implant Modalities - Systems – Configurations, Surface Treatments and Enhancements
Objectives:
• To review the salient features of some of the popular implant systems.
• The corporate influence in the practice of implant dentistry.
• Review of literature about valid scientific evidence.
• To provide an overview of Evidence based dentistry.
• To help a reader to critically evaluate articles published in peer reviewed literature.
• Evaluate and verify if the results from one system can be extrapolated to another
• Review of various surface modifications including – coatings, coined, acid-etched, small/large grit blasted, diffusion bonded microspheres and other interface enhancing technologies.
• Factors to consider in choosing the appropriate implant systems.
• Prosthetic complications.
• Mechanical problems.
• Excessively inclined implants.
• Difficulty in obtaining passivity of fit of prosthesis.
• Broken abutment screws, migrating interlocks, etc.
• Loss of fixture integrations.
• Prosthesis design guidelines for different clinical situations.
• Protocols for single tooth.
• Protocols for quadrant restorations protocols for removable prosthesis (over denture and inserts).
• Laboratory procedures in implant dentistry.
• Completion of prosthetic rehabilitation of clinical cases.
□Alternative concepts in implant treatment planning: use of Morse Tapers vs. Screw vs. Cement retained abutments.

Outcomes – The students will be able to:
• Have a broad knowledge of the various commercially available implant systems
• Compare benefits and risks associated with each of the systems
• Evaluate manufacturers’ claims of efficacy and safety in an analytical manner
• To judiciously utilize features that claim rapid and better integration

2.Biomaterials and Biomechanics
Objectives:
• To teach concepts of passivity, corrosion, metallurgy and biomaterials
• To elaborate on the influence of biomechanics, design features, configurations, factors of force, force transfer on the longevity of implants
• To explain the various types of loads sustained by the prosthesis and the resultants fatigue induced into the implant/prosthesis unit
• Understanding the principles and results of immediate vs. delayed function of implants and to prognosticate the type of tissue support
• Help validate the response of bone to various surface textures.
3. Peri-implant Tissue.
Objectives:
• To help students in the understanding of soft tissue healing around dental implants.
• To review whether attached gingiva is essential around dental implants.

Outcomes – The students will be able to:
• Learn the principles of soft tissue healing around dental implants.
• Compare the attachment mechanism between natural teeth and implants.
• Plan for adequate soft tissue architecture that is conducive for maintenance of implants.
• Relate the surface treatment margins of implants, polished collars and abutment/implant interfaces to the soft tissue/bone interfaces of implants.
• Plan for proper prosthetic design features to promote soft tissue health.

4. Office Emergencies. Lecture and practice.
・ Management practice of overall medical status
Sphygmomanometer, blood test, and urine test, etc.
Intravenous instillation
Actual directions of patient monitor (medical monitor) before and during operations
Automatic sphygmomanometer, electrocardiogram, and pulse oximeter.
* Actual method of making PRP and PRF.
Demo: blood draw and monitor set up
・ Evaluation of patient’s overall medical status pre-surgery and office emergency (BLS)
IV sedation.
・ How to use patient monitors (medical monitor) before and during operations
・ Evaluation of RPP
PRP (Platelet Rich Plasma) and PRF (Platelet Rich Fibrin)
Objectives:
□To learn BLS
Outcomes – The students will be able to:

□perform BLS


【 the 3rd module】
12 hours
* The surgical practice using pig’s mandibular jaws for implant surgeries.
(Both Saturday and Sunday will be spent on practice)
1. The participants will learn about the incision line and the suture as a basic surgical method (practice).
2. They will also learn about the basic and necessary periodontal surgeries for the implant operations.
《 Practice 》
・The above-mentioned operation method is practiced using 3 pig's mandibles

Surgical Phase

Objectives:
• Knowledge regarding the usage of various types of scalpels.
• Learn how to make an incision in the soft tissue and make a flap.
• Learn various suturing techniques.
• Knowledge about how to perform a Free Gingival Graft (FGG).
• Learn about conventional periodontal flap surgery.
• Learn how to perform the closing of the surgical sight through vertical incision and releasing of the periosteum.

Outcomes: The student will be able to:
• Perform appropriate incisions.
• Suture using various techniques.
• Make a full or a partial sickness flap.
• Preform FGG.
• Perform conventional flap surgery and appically positioned flap surgery.
• Close the flap without any tension.


【 the 4th module 】
・ Practice of root form implants with plastic model. 2 hours or more. Faculty: KOJI ITO, DDS, PhD (Fellow of AAID)
TAKASHI SAITO, DDS, PhD (Fellow of AAID)
SHINICHI KOMATSU, DDS, PhD (Associate Fellow of AAID)

1. Diagnostic Radiology – Periapicals, CT Scans, Tomograms.
Objectives:
• To teach how to interpret various forms of radiographs including periapicals, panoramic, CT scans and MRIs.
• To discuss the advantages and disadvantages associated with each of them.
• Evaluate and quantify available bone, identifying vital structures and mapping out possible implant sites.
• To teach application of implant planning software (Simplant).
• To teach fabrication of radiographic stents.
• To teach about the radiation dose emitted by various machines.
• To teach about the limits of exposure to radiation dose for patients.

Outcomes – The students will be able to:
• Prescribe the appropriate radiographs necessary for a given situation.
• Make a preliminary determination of the available bone, and have a basic understanding of the anatomic configuration of potential implant sites.
• Fabricate radiographic stents for CT scans and later on modify the same as a surgical stent.
• Explain the radiation dosage of various machines.
• Prevent overexposure of the patient to radiation.

2. Periodontology
・ Basic knowledge of periodontitis and periodontal surgery.
・ Treatment of remaining natural teeth.

・Biologic width of natural teeth
Objectives:
□ To teach differences between the surrounding tissue of natural teeth and that of implants.
□ To teach the difference between peri-implantitis and peri-implant mucositis.
□ To teach about the healing mechanism of epithelium/connective tissues around submerged and non-submerged implants.
□ To explore the existence of biological width around dental implants – discussion of the microgap.

Outcomes – The students will be able to:
□ Explain surrounding tissue of natural teeth and implants.
□ Explain definition of peri-implant diseases.
□ Compare the attachment mechanism between natural teeth and implants.
□ Plan for adequate soft tissue architecture that is conducive for maintenance  of implants.
□Relate the surface treatment margins of implants, polished collars and abutment/implant interfaces to the soft tissue/bone interfaces of implants.
□ Plan for proper prosthetic design features to promote soft tissue health.

3. Applied Anatomy in Implant Dentistry – Lectures
Objectives:
• To illustrate applied anatomy of the maxillofacial region as it relates to implant dentistry.
• To review the basics of gross anatomy through videos of dissection.
• To teach regional anatomy with all the vital landmarks as it relates to diagnosis and surgical planning.
• Correlation of radiographic images with anatomical structures.
• To teach an anatomic approach to local anesthesia of mandible and maxilla.
• Anatomical spaces of the head and neck.
• Anatomy of the maxillary sinus.

Outcomes:
• The participants will be able to apply the knowledge of anatomy to clinical situations during the administration of anesthesia, trouble shoot during times when anesthesia fails to work, minimize complications of surgery, refine surgical approaches and other related surgical interventions.
• Obtain a three-dimensional relationship of the available bone and apply to modalities and configurations of dental implants.
• Visualize the anatomy of the sinus and correlate with the radiographic information.
• Appreciate the importance of careful surgical techniques to prevent violation of vital structures.
• Recognize variations and abnormal anatomical departures.

4. Statutory requirements in implant treatments.
・ Social dentistry concerning implant treatment; informed consent of patients regarding the terms and conditions of contracts and agreements etc.
Objectives:
□ To teach the basics of informed consent.
□ To teach how to draft agreements for implant treatments.
□ To learn past judicial precedents on the implant treatments.
Outcomes– The students will be able to:
□ Explain pros and cons in implant treatments.
□ Draft agreements for implant treatments and contracts.
□ Explain lawsuits on implant treatments.

《 Practice 》
・ Practice of root form implants with plastic model.

 

【 the 5th module 】
12 hours
・ Practice of root form implants with plastic model. 2 hours or more Faculty: KOJI ITO, DDS, PhD (Fellow of AAID)
TAKASHI SAITO, DDS, PhD (Fellow of AAID)
SHINICHI KOMATSU, DDS, PhD (Associate Fellow of AAID)
1. Implant treatment for senior citizens.
Objectives:
□ To make clear the difficulties in treatment of senior citizens.
□ To explain about the various physical conditions of senior citizens.
□ To teach the kinds of procedures better suitable for a senior citizen.
□ To teach about implant super structures suitable for patients who may suffer from decline in their mental faculties in the future.

Outcomes: The student will be able to:
□ Determine if a senior citizen qualifies for implant surgery.
□ Evaluate the physical conditions of the patient for suitability of implant surgery.
□ Determine which procedure is most suitable for the patient: conventional or implant.
□ Able to give super structure implants that are easy to maintain.

2. Advanced implant surgeries including bone grafting.
Objectives:
• To teach the fundamentals of defect anatomy, wound stability and a review of alloplasts, allografts, autografts and xenografts.
• To review the graft healing principles and to elaborate on growth factors such as BMP -2, BMP -7, PDGF, TGfb, IGF, P-15 etc.
• To review in-depth – autogenous bone grafts - corticocancellous, cortical, membranous, nonvascularized, composite grafts, intra-oral and extra-oral graft sites.
• Instrumentation – chisels, drills, trephines, frames and meshes etc.
• Procedures of harvesting – blocks, chips, slurry etc.
• Graft fixation techniques – screws, ligatures for tissue closure techniques.

Outcomes – The students will be able to:
• Have an overall knowledge of the various graft materials, their composition, and their inductive and conductive properties.
• Choose the appropriate graft materials for the situation indicated.
• Become familiar with the techniques of bone harvesting and learn the protocols for grafting.
• Have a thorough knowledge of the graft healing sequence to predict maturation times, problem avoidance and problem solving.

3. BRONJ/ARONJ
・Biphosphonates (BP) may cause ‘bisphosphonate-related osteonecrosis of the jaw’ (BRONJ)
・BRONJ is similar to osteonecrosis and is usually identified by the appearance of exposed bone in the oral cavity
・BRONJ is difficult to treat. If patient is diagnosed with BRONJ, advice and cooperation with the whole dental and medical rehabilitation team is critical
・The term ARONJ (Antiresorptive drug related osteonecrosis of the jaw) is now used instead of BRONJ.

Objectives:
□ To teach definitions and classifications of ARONJ.
□ To teach bisphosphonate therapy.
□ To inform the patient about the probability of the occurrence of ARONJ/BRONJ
□ To teach about the various difficulties in treatments.

Outcomes: The student will be able to:
□ Explain the definition and classifications of BRONJ.
□ Explain about (BRONJ) or (ARONJ).
□ Evaluate the probability of BRONJ/ARONJ occurrence caused by certain drugs taken over a long period of time.
□ Refer the patient to specialists in hospital.

4. Physiology of Pain: Theory and Management.
Objectives:
• To teach principles of pathophysiology of pain and neuronal transmission.
• To be able to distinguish character, type, origin, and theories of pain such as the Gate control theory of pain.
• To teach various types of infiltration and block anesthesia.
• To teach the basics of sedation.
• To teach principles of pain management.
• To teach pharmacology of pain control.

Outcomes – The students will be able to:
• Understand the mechanism of pain generation.
• Be able to appropriately prepare patients for pain control.
• Distinguish between neuralgias, myofascial pain, odontogenic pain, neuropathies dysesthesias, paresthesias, etc.


【 the 6th module】
12 hours
・ Practice of root form implants with plastic model. 2 hours or more
Faculty: KOJI ITO, DDS, PhD (Fellow of AAID)
TAKASHI SAITO, DDS, PhD (Fellow of AAID)
SHINICHI KOMATSU, DDS, PhD (Associate Fellow of AAID)

1. Itemized discussion of root form implants
・History of root form implants in Japan
About Kyocera “Bioceram” ceramics implant
・Concept of Osseo-integration
・Design concept, indications, and pros and cons of various forms of implants
①Screw type: configuration such as ITI・BONEFIT screw and Branemark implant.
②Press fit (cylinder) type (non-screw type): configuration such as IMZ and Integral implant, etc.
③Hollow basket type: configuration of ITI-BONEFIT hollow basket.
④Various connected styles and the pros and cons of implant body and abutment.
・Basic concept of various implants’ surface properties. Indication, pros and cons.
①Titanium surface (Non-HA coating)
Sand blast, acid-etched
② Concept of Bio-integration with HA coating
③Titanium Plasma Spray (TPS) coating
2. Basic ideas of root form implants configuration
・What configuration is preferable? The diameter or the Length?
  ・ The shape of screw, the width of pitch and the depth of groove.
・The relation between the bone quality and the configuration of screw.
・The properties of different implant surfaces and their load carrying ability.
  ・ How to prevent implant neck bone resorption.
・What is the controversy surrounding the stress theory and the periodontal theory?
3. Manipulation of various kinds of implants in relation to bone quality
Diagnosis and indications
・Classification of bone quality
Implant indications of each classification
・Diagnostic imaging and technique
・Panoramic and dental radiograph, CT application for implant treatments.
・Diagnosis and treatment plan using implant simulation software (SIM/PLANT).
・Decision regarding the position and direction of implant insertions.

3. Pre-Surgical Prosthetic Planning:
Diagnosing implant candidates and work-up sequence
・Study casts
・X-rays and CT scans
・Diagnostic wax ups
・Surgical guides
・Trial prostheses and evaluation of final outcomes
・Evaluation of available bone

4. Demonstration of placement of Endosseous Implants
Objectives:
• To demonstrate the clinical setting of inserting dental implants.
• To review sterilization and clean room protocols.
• To review radiographic and pre-surgical planning.
• To review implant insertion protocols.
• To provide an in-depth live demonstration of the actual surgical sequencing and the protocol for endosseous dental implants – root form/plate form.

Outcomes:
• The learner will be able to have some clinical background knowledge that will be relevant when discussing the applied basic science course materials.
• As the students will have first-hand exposure to real life procedures, they will be excited to learn right from the start of the course.
• They will return to their respective offices with a broader perspective regarding patient treatment.
• They will return enthused about future Maxi-Course® sessions, since the faculty will be there to trouble shoot their clinical problems.
□ The student will be able to better understand the nature and validity of suggested treatment options.
• They will learn the mechanics of osteotomy preparations.
• Know how to choose appropriate drilling systems.
• Know their hand piece basics.
• Gain knowledge of asepsis v/s sterility.
• Learn the proper procedures regarding the preparation of the patient.
• Learn about implant handling and transfers.
• Surgical manipulation of available bone.
• Know how to work with stents and establish prosthetic predictability.
• Pre, intra and post-operative medications and care.

6. Surgical Principles – Basic implant surgeries
Objectives: This lecture will review the presurgical evaluation, operatory setup, equipment setup, and surgical techniques for the placement of popular implant systems. It will teach about:
• Instrument care and sterilization techniques.
• Sterility vs. Clean aseptic environment.
• Preoperative preparation – Surgical drapes and equipments.
• Treatment room preparation.
• Surgical field preparation.
• Clinical attire.
• Instrumentation check list.
• Anesthetics and pain control.
• Incision and flap designs.
• Evaluation of the available bone and management of osteotomy sites.
• Implant drilling sequence and protocols.
• Performing surgery with prosthodontic considerations.
• Tissue management and methods of achieving homeostasis.
• Sutures and suturing techniques.
• Techniques of fixture level impressions – when to take them and when not to.
• Impression materials and provisionalization of immediate function implants.

Outcomes: The students will be able to:
• Perform surgical setups and create a clean room environment for implant placement.
• Implement prosthetically driven surgeries.
• Commence prosthetic phases during stage I surgery.
• Identify and manage minor surgical complications.
• Plan for stage II root form surgeries to allow for aesthetic integration of soft tissues.
□Utilize aesthetic and anatomic healing abutments, incorporate emergence profile, aesthetically sculpt and apically reposition flaps to increase keratinized gingival.

《 Practice 》
・ Practice of root form implants with plastic model


【 the 7th module】
12 hours
・ Practice of root form implants with plastic model 2 hours or more.
1. Explanation regarding the fundamental concepts of designing overdentures with various kinds of bars supported by anterior implants in edentulous jaw (especially, mandibular jaw). This includes:
 Knowing how many implants are necessary in the anterior region.
 Identifying suitable implant sites.
 Explanation about the cross-sectional shape, pros and cons of various bars.
 Learning about the Biomechanics and occlusal pattern of overdenture supported by anterior implants.

2. Transplantation of natural teeth:
 History and problems of transplant from another person.
 Teeth autotransplantation (success and ankylosis).

3. Indications and methods of endodontic stabilizers:
・Improvement of the ratio of coronal length to root length in the tooth.
・Problems in blind technique operation.
・About using the direct view operation and its complementary procedure, especially with an apicoectomy.

4. History, the indications, methods, and pros and cons of Blade/Plate Implants: What is the concept of Fibro-osseous integration? In answering this question, the basic idea of the support style will be taught. This includes:
 Case study of long-term cases dating back twenty years or more showing positive results.

5. Subperiosteal implants
・Indication of severe bone resorption.
・Design concept and procedures.
・Support mechanism of subperiosteal implant: Sling theory.
・Various kinds of subperiosteal implants:
 Concept of mandibular tripodial subperiosteal implants.
・The knowledge learnt from a long term (ten years or more) case and excellent passage examples.
・ Explaining why subperiosteal implants are not used in Japan anymore.
・ Difficulties in archiving good long term results about subperiosteal implants and the limitations in their maintenance.

6. Distraction osteogenesis
・Necessary apparatus.
・Various kinds of methods and notes.

7. About GBR (Guided Bone Regeneration) technique in implant treatments
・ Underlying concept of GBR
・Implant placements with GBR technique immediately after same day tooth extraction(s)
・Staged implant placements 6-8 weeks after extraction and GBR
・ Evaluation of various bone substitute materials and the directions for use
・ Kinds and the characteristics of the various membranes as barriers, and their pros and cons, and directions for use
・Non-resorbable membrane (synthetic)
GORE-TEX membrane etc.
・Resorbable membrane (organic)
Characteristic and directions of various resorbable membranes
・ GBR technique with titanium mesh
・ GBR technique as recovery after implant removal
・Repair of bone defect after defective implant removal and implant replacement
・ Autogenous bone graft
・Autogenous bone graft by bone collection from mentum, ramus of mandible, retromolar triangle and tuberosity of maxilla, etc.

《 Practice 》
・ Practice of root form implants with plastic model.


【 the 8th module】
12 hours
1. Immediate placement and immediate loading
・Indications and the risk
・Current thinking concerning HDD (Horizontal Defect Dimension)

Objectives:
□Immediate v/s delayed loading of cases.
□Submerged v/s one stage surgeries.
□Interim Prosthesis.
□Transitional implants.
□Stage II surgical protocol.

Outcomes: The students will be able to:
• Explain pros and cons of immediate and delayed loading of cases.
• Explain how to choose Submerged or one stage surgeries.
• Commence prosthetic phases during Stage I surgery.
• Identify and manage minor surgical complications.
• Plan for stage II root form surgeries to allow for aesthetic integration of soft tissues.

2. About the ridge expansion (Lateral expansion of alveolus bone)
・ Indications, use of apparatus, and notes
・Procedure of split crest technique for cases where bucco-lingual bone width is extremely thin, and case reports of this technique

3. Sinus elevation technique
・History and the method
・Selection of surgical method by the distance between bottom of the sinus and the alveolar crest of ridge
Lateral Window Technique (Lateral approach technique)
Crestal Approach Technique (Socket lift)
Dr. Summers’ Osteotome Technique
・Consideration of selection of bone substitute materials for sinus elevation
・Consideration of superstructure and selection of occlusal contact pattern

《 Practice 》
・Practice of sinus lift using chicken eggs

Summary of JSOI 100-hour course
1. Summary of implant diagnosis and treatment planning
2. Design of superstructures.
Basic concept and summary of natural teeth prostheses and implant prostheses.
・Identification of best occlusal contact pattern.
・Risk of the connection of implant prostheses to natural teeth, and exceptions.
・Pros and cons of screw-retained and cement-retained superstructures.
3. Basic concept and kinds of implant superstructures.
・Operator removable superstructure with precision attachments or telescope system, and their pros and cons.
・ Management of occlusion.
4. Production method of implant superstructure and how to create occlusal contacts
5. Directions of semi-adjustable articulators
・Demonstration of use of face bow, check bite and mounting to articulators in semi-adjustable articulators.
7. Maintenance.

《 Practice 》
・ Case presentation by current course trainees


【 the 9th module & the 10th module】
Crown-Bridge in Implant Dentistry (4 days)
24 hours
Training place; Aichi Implant Center meeting room and Hotta Dental Clinic’s laboratory.
* The implant superstructures that are made in laboratory will be focus during this course.
・Functional occlusal contact pattern
Appropriate occlusal contact pattern for implant prostheses
Configuration of occlusal surface and the pattern and disposition of occlusal contact points
Position and direction of occlusal ridges, and grooves
Position, size and depth of fossa
About long-centric occlusion
・Consideration of implant prostheses configuration
  Relation to implant position
Importance of axial surface of implant prostheses
Relation between implant number and shape of prostheses in mandibular molar region
Harmony of shape between alveolar ridge and implant prostheses
・About centric occlusion
Consideration of both existing natural teeth and implants, and their concept and background
Concept of synchronizing or non-synchronizing occlusal contacts in relation to PDL
Dr. Misch’s Implant-protected occlusion
How to manage centric occlusion in practice
Maintenance of centric occlusion in follow-up, and the procedures of occlusal adjustments
・Consideration of occlusal contact pattern in lateral movement
・Occlusal contact pattern
The change of occlusal contact pattern according to age
How to accommodate the change in implant prostheses throughout a patient’s life
・ Controversy of single-stand implant and connected implants
Consideration of biomechanics
  Pros and cons of each
Relationship of implant option to bone quality
Difficulties of laboratory work in connected implants prostheses
・The connection of natural teeth and implants
Principles and Exceptions
Problems of the connection of natural teeth and implants
Long-term prognosis when connecting them
Possibility of problems when connecting them
・Cement-retained vs screw-retained prostheses
Pros and cons of each
Screw-retained indication for short clinical crown cases
About the use of temporary cement
Dissolution of the temporary cement
・Criteria of implant selection for esthetics applied in maxillary anterior region
Minimum inter-implant distance
Minimum space between the implant and adjacent tooth
Diameter of maxillary anterior implants
Abutment selection for esthetic zone
Pros and cons of immediate loading or placement
Prosthodontic management of emergence profile
Distance from the base of the contact area to the crest of bone with the presence or absence of the interproximal papilla
・Evaluation of platform-switched implants and platform-matched implants
Advantage of platform-switched implants
Decision factor regarding distance from crest of bone to crest of the interproximal papilla
・Occlusal pattern in anterior region
Importance of anterior guidance
Influence of anterior guidance on posterior separation
Determining occlusal contact pattern in full arch implant cases
Disadvantage of anterior deep bite, and how to create proper occlusal pattern
Difficulty of bite raising in relation to a patient’s TMJ
《 Practice 》Setup of articulator and waxing-up of crown
・Proper occlusal contact points to reduce lateral force in implant prostheses
・Configuration of axial crown surface for protection of soft tissue surrounding implant neck
《 Practice 》Making of anterior implant temporary bridge on a plaster model
・Esthetic problems of anterior implant prostheses
・Prosthodontic solution of black triangle

1. Prosthodontic Diagnosis.
Objectives:
• To review the need for obtaining proper diagnostic casts, take face-bow transfer, jaw relation records to mount the casts, techniques of wax-ups and mock cast surgeries.

Outcomes:
• The students will be able to relate the maxillary and mandibular diagnostic casts in an average or semi-adjustable articulator with proper orientation and centric records.
• They will be able to visualize the end result through the wax ups thereby identifying the deficiencies that need corrections.

2. Fabrication of provisional prosthesis and providing template for the final restoration.
Objectives:
• Impression techniques and procedures.
• Effective ways of registering inter Occlusal records.
• Mounting the cases and creating appropriate occlusal schemes.
• Educating the lab about the case and writing appropriate prescriptions.
• Trial of metal frames and obtaining passivity.
• Working with matrices and templates from provisional’s.

3. Prosthodontic Protocols – Presurgical, Provisional and Definitive.
Objectives – to teach the following:
• Evaluation of Patient expectations – avoidance of removable prosthesis: stability and retention.
• Functional requirements placed upon prosthesis.
• Predicting aesthetic outcomes and satisfying aesthetic expectations.
• Creating improvement in self-confidence and self-esteem.
• Therapeutic/surgical concerns – short term success.
• Long term prognoses.
• Evaluations Contradictions: Prosthetic – insufficient inter arch space, extreme jaw relationship, etc. Surgical, Medical, anatomical, etc.
• Prosthetic Design Considerations.
• Evaluation of structures to be replaced by prosthesis.
• Aesthetics – lip support, dento-gingival aesthetics.
• Phonetics.
• Design for hygiene.
• Soft tissue considerations.
• Ridge laps and emergence profiles.
• Opposing dentition.
• Length of edentulous spans, AP spreads cantilevers, etc.
• Parafunctional habits etc.
• Control of biomechanical stress.
• Reduction of forces of occlusion.
• Narrowed occlusal table.
• Minimal posterior cusp height.
• Occlusal materials and design.
• Occlusal schemes for implants.
• Distribution of forces of occlusion.
• Number and size of implants used.
• Angulations of implants and offsets of prosthesis.
• Reduction of cantilevers.
• Prosthesis designed considerations for screw retained and cemented restorations.


【 the 11th module & the 12th module】
Complete Overdenture in Implant Dentistry (4 days)
24 hours
Training place; Aichi Implant Center meeting room and Hotta Dental Clinic’s laboratory.

These modules show live on-site practical observations of a full range of denture making procedures.
《 On-site practical observations 》
・Impression taking, adjustment of individual tray, pressure control, muscle trimming, final precision impression taking
・Bite registration
・3D gothic arch
・Denture space
・Trial of wax denture
・Setting of provisional denture
・Impression taking for relining
・Completion of dentures
《 Laboratory work 》
・Making plaster model
・Making record block for bite registration
・Setting up gothic arch tracer
・Remount the model to articulator
・Preparing table for record of mandibular movement
・Provisional arrangement of maxillary artificial teeth
・Making tray (keel) for taking denture space
・Making buccal and lingual plaster cores
・Evaluation of neutral zone and determination of position for arrangement of artificial mandibular teeth
・Polymerization
・Selective grinding on articulator
・Polishing
・Polymerization after relining
《 Practice 》
・Trainee record each other’s gothic arches and set up articulators
・Selective grinding on articulator to understand the difference of occlusal contact pattern
between natural dental arch and complete denture


【 the 13th ~20th module】Advanced Implant Course

Models 13-20 present a more in depth discussion of procedures and techniques, and prevention of complications.

On site live implant surgery observations where possible, supplemented by viewings of a comprehensive list of a wide range of different un-edited video surgeries by the course director.


【 the 13th module】advanced implant course session 1
12 hours
The preparation necessary for the AAID examination.
Objectives:
□To properly document all of the necessary information such as oral photographs, CT, panoramic X-rays, periapical X-rays in preparation for the AAID examination.

Outcomes: The students will be able to:
□Meet the AAID requirement and standard for documentation.

1. Clinical Examination.
Objectives:
• To review a sequential way of performing clinical examination, including extra-oral, intra-oral, soft and hard tissue exam, periodontal and Occlusal evaluations.
• To make a preliminary assessment of the patients’ chief complaint, identifying aggravating and contributing factors.

Outcomes: The students will be able to:
• Examine their patients as a whole rather than focusing on just the problem.
• Gather clinical data related to the patient’s oral health.
• Create a problem list that will further outline the probable interrelationships of the various contributing factors.

2. Introduction to Diagnosis and Treatment Planning.
Objectives:
• To help understand the diagnostic and treatment modalities necessary to properly treat patients requiring implant dentistry.
• To meet the patient before meeting the mouth (determining the patient’s needs, desires, motivations and goals).
• To provide an organized approach to examination, taking records, patient evaluations, obtain appropriate tests and radiographs and formulate a clinical decision-making tree (vertical treatment planning).
• To recognize and incorporate an interdisciplinary approach to treatment planning.

Outcomes: The participants will be able:
• To provide medical evaluation of implant patients.
• To diagnose and incorporate criteria for recognition of basic predictable cases as opposed to more complex forms of treatment.
• To understand the indication and contraindications for implant modalities and therapies.
• To learn how to determine whether they should treat or refer a case based on their degree of training and experience.
• Incorporate DeVans axiom “preserve what remains rather than meticulously replace what is missing.”
• Will be able to consider comprehensive treatment planning. 


【 the 14th module】advanced implant course session 2
12 hours
3. Developing Treatment Plans
Objectives:
• To teach principles of vertical treatment planning by creating a decision tree for implant modality selection preferred choices etc.
• To help organize the data gathered from the initial interview to the wax-up and create the appropriate treatment plan that fulfills the patient’s needs and satisfies their wants.
• To teach how to customize the treatment plan for every individual.

Outcomes – The students will be able to:
• Integrate all the diagnostic information gathered from their patients and provide for a comprehensive treatment plan.
• Provide for optional plans and contingencies in the event that an ideal plan cannot be achieved.
• Consider implant therapy as part of the overall treatment plan for patients.

4. Medical Assessment and Pharmacology – Review of tests, values and evaluations of the medically compromised patient. Review of basic pharmacokinetics and pharmacodynamics.

Objectives:
• To review a sequential way of performing clinical examination, including extra-oral, intra-oral, soft and hard tissue exam, periodontal and occlusal evaluations.
• To make a preliminary assessment of the patients’ chief complaint, identifying aggravating and contributing factors

Outcomes: The students will be able to:
• Examine their patients as a whole rather than focusing on just the problem
• Gather clinical data related to the patient’s oral health
• Create a problem list that will further outline the probable interrelationships of the various contributing factors
5. Bone Biology
Objectives:
• To teach the basics of bone biology.
• Responses to function – Wolfe’s law.
• Adaptation, modeling and remodeling (RAP – concepts of Regional Acceleratory Phenomenon) etc.
• To understand the biological basis for bone healing, resorption, and related bone changes.
• To define and describe osseointegration, osseopreservation, fibro-osseous integration for bone support around dental implants.
• To teach and describe micro-anatomy – light microscopic and ultra microscopic levels.
• To teach levels of bone injury resulting from osteotomy preparations, heat generation with various drills speeds, aseptic thermal necrosis, appositional and undermining restorative patterns of osseous healing in osteotomies.
• Evidence through animal models and correlation of sigma cycles of bone healing.
• To teach at the microscopic level the bone response to surface modifications and enhancements of the implant interface.

Outcomes:
• This overview will provide for a sound biological basis for preserving bone as a vital tissue.
• Appreciation of gentle handling of bone during osteotomy preparations, reflection of mucoperiosteal flaps and maintenance of homeostasis during surgery.
6. Basics of Surgery – Introduction to immunology and wound healing
Objectives:
• To teach basic principles of wound healing.
• Day to day sequence of osseous healing around dental implants.
• Soft tissue healing around implants –submerged and non-submerged.
• Healing sequence of one stage and two stage implants.

Outcomes:
• The students will be able to understand the pathophysiology of bone healing in extraction sockets.
• The students will learn the basic wound healing mechanism that is initiated following insertion of dental implants and correlate it with functioning and non functioning implants.
They will be able to apply immunological principles that govern wound healing to the systemic conditions that may impair normal responses.


【 the 15th module】advanced implant course session 3
12 hours
7. Fundamentals of Sinus Graft, Symphyseal Grafts, Ramus Grafts
Objectives:
• Learn how to perform pre-surgical planning and assess the maxillary sinus prior to surgery
• Be introduced to the surgical techniques and armamentarium to perform a crestal sinus window approach
• Be introduced to the surgical techniques and armamentarium to perform a crestal sinus lift using osteotomes
• Learn how to use the piezoelectric device to access the sinus
• Be introduced to the techniques necessary to perform the Balloon sinus lift procedure

Outcomes:
• Gain knowledge in anatomy and physiology of the maxillary sinus and augmentation surgery.
• Come to understand the concept of prosthetic guided bone graft surgery.
• Gain knowledge on how to avoid and manage sinus complications and learn when an ENY specialist referral is appropriate.
• Come to understand the histologic behavior of graft materials used in sinus.

8. Extra Oral Grafting.
9. Implant Periodontics and Aesthetics.
10. Advanced Implantology- Immediate loading principles and techniques.
11. Long-term Validation of Principles and Techniques – Predictable implant sequencing.
12. Advanced Restorative and Esthetic Strategies in Implant Dentistry.
13. Identifying failures and managing complications.
14. Pathophysiology of Implant Failures – Mechanical, Biological, Chemical and Surgical.
15. Presenting cases and Patient management in Implant Dentistry: Marketing the Implant Practice.
Objectives
• Presenting implant therapy to patients.
• Presenting implant cases to peers.
• Establishing fees for implant cases.
Outcomes: The students will be able to:
□Explain implant therapy to patients.

□Present their own case professionally.
□Understand and explain the fee structure for implant cases.
16. How to document cases and present at National and International symposia.
17. Medico-Legal considerations.
18. Preparation for the Associate Fellow/Fellow exams of the AAID.


【 the 16th module】advanced implant course session 4
12 hours
Summary of review (made from JSOI)
Ⅰ.Ethics required of a specialist
GIO:
Acquire knowledge and attitudes about significance of medical ethics, which is important to be a respectable specialist of oral implantology.
SBOs:
The learner will be able to;
1 explain ethical problems related to life and death,
2 establish the trustful relationship with a patient through implant therapy,
3 provide a patient with appropriate explanation on possible troubles and complications associated with implant therapy,
4 handle patients equally with different personal and/or social backgrounds,
5 recognize and cope with diverse value systems of patients in a flexible manner,
6 explain to a patient what is deemed best for him/her,
7 list legal obligations of a dentist.

Ⅱ.Knowledge of basic medical science
GIO:
Acquire knowledge of basic medical science in order to grasp concepts of oral implant therapy
SBOs:
The learner will be able to;
1 explain historical backgrounds of implant therapy,
2 explain anatomy (histology), physiology, biochemistry, bacteriology, and social dental science, which are required for implant therapy,
3 explain properties of biological materials which are used in implant therapy,
4 explain osseointegration which takes place around the implant body,
5 explain soft tissue responses around the implant body,
6 explain the anatomical structures including major vascular vessels and nerves in the maxilla-facial region.

Ⅲ.Medical safety
GIO:
Acquire knowledge and skills in order to perform implant therapy in safety

SBOs:
The learner will be able to;
1 perform standard precautions,
2 take appropriate actions for needle stick injuries,
3 explain preventive measures of medical accidents,
4 perform safety measures in implant therapy,
5 explain infection control manual of the institution to which one belongs.

Ⅳ.Medical interview
GIO:
Acquire knowledge, skills and attitudes required for having basic communication in order to establish a trustful relation between the patient and the dental care provider and to obtain accurate information on the patient

SBOs:
The learner will be able to;
1 interview a patient with appropriate appearance, speech, and polite manners,
2 explain basic communication skills required in medical interview,
3 obtain the patient’s history (chief complaint, current and past history, and family history),
4 extract and summarize the patient’s problems in consideration of his/her physical, psychological and social sufferings,
5 record the obtained information in the patient medical record in the format of POMR (problem-oriented medical record),
6 have consideration for protection of patient’s privacy,
7 understand significance of duties to protect patient’s information and information delivery to the patient,
8 Implement protection of the patient’s private information and provision of information to the patient,
9 explain to the patient the outline and prognosis of implant therapy and prognosis.


【 the 17th module】advanced implant course session 5
12 hours
Summary of review
Ⅴ. Systemic examinations and tests
GIO:
Acquire knowledge and skills required for basic examinations and tests to understand the patient’s systemic conditions and identify risk factors of implant therapy
SBOs:
The learner will be able to;
1 explain examinations/tests needed to grasp the systemic conditions,
2 perform examinations/tests needed to grasp the systemic conditions,
3 know the reference values of various clinical tests and explain the meanings of significant abnormal values,
4 refer the patient to a medical doctor upon necessity,
5 explain the relationship between the patient’s medications and implant therapy,
6 record systemic findings obtained with examinations/tests in the patient record,
7 explain systemic risk factors of implant therapy,
8 perform accurate placement of a monitor of vital information.

Ⅵ. Local examinations/tests
GIO:
Acquire knowledge and skills about basic examinations and tests in order to grasp local conditions and clarify treatment policy
SBOs: 
The learner will be able to;
1 explain examinations and tests of mandibular functions,
2 perform examinations and tests of mandibular functions,
3 explain examinations and tests performed in the mouth,
4 perform examinations and tests in the mouth,
5 explain examinations and tests for occlusal conditions,
6 perform occlusal examinations and tests,
7 explain the status of missing teeth,
8 explain examinations and tests needed for esthetic areas,
9 perform examinations and tests needed for esthetic areas,
10 explain tests conducted with study models,
11 explain radiological tests,
12 record local findings obtained from examinations and tests in the patient record,
13 explain local risk factors related to implant therapy.

Ⅶ.Treatment plan

GIO:
Acquire basic knowledge for making treatment plans in order to make safe and secure implant treatment plan

SBOs:
The learner will be able to;
1 explain the treatment plan needed to treat caries, periodontal disease, and occlusion, etc. for preparation of the oral environment before start of implant therapy,
2 explain difference between implant therapy and other prosthodontic options for tooth replacement,
3 explain prosthetic-driven implant therapy,
4 explain the surgical plan related to implant therapy,
5 explain selection of implant bodies,
6 explain the treatment plan and points to note with simulation that is constructed based on information obtained from CT images,
7 explain the design of super-structure,
8 explain the informed consent for the final treatment plan.

Ⅷ. Peri-operative management
GIO:
Acquire basic knowledge and skills of peri-operative systemic management, psych-sedation methods and local anesthesia in order to perform safe implant surgeries for a patient with systemic disease or of old age.

SBOs:
The learner will be able to;
1 explain systemic conditions of the patient,
2 explain the features, purposes and kinds of psycho-sedation methods,
3 explain indications, contraindications and medications for inhalation sedation,
4 explain indications, contraindications and medications for intra-venous sedation,
5 explain the purpose of local anesthesia,
6 explain classification of local anesthetics and their modes of actions,

7 explain factors which affect actions of local anesthetics,
8 explain purposes of use, kinds, features and precautions in clinical use of vasoconstrictors,
9 explain complications associated with local anesthesia,
10 take appropriate measures for complications associated with local anesthesia,
11 Perform appropriate peri-operative monitoring, 
12 explain innervation which required for performing local anesthesia.


【 the 18th module】advanced implant course session 6
12 hours
Summary of review
Ⅸ. Implant placement surgeries
GIO:
Acquire basic knowledge and skills required for performing the safe and secure implant placement surgery and the secondary operation

SBOs:
The learner will be able to;
1 measure pre-operative vital signs and grasp systemic conditions of the patient,
2 select and perform anesthetic methods suitable for the patient’s systemic conditions,
3 explain the order of steps of implant placement surgery,
4 perform surgical hand scrubbing, use sterile gloves, and wear a gown,
5 determine clean and unclean areas and perform disinfection of surgical field as needed,
6 perform appropriate incision and dissection to secure surgical field,
7 explain the features of drills for implant placement (length, diameter, rpm and water irrigation),
8 perform appropriate placement of implant body (precise implant bed osteotomy with appropriate use of a surgical guide plate, selection of appropriate drills, handling of implant body, use of a rachet trench, placement torque, initial stability, wound closure, etc.),
9 explain post-operative conditions of implant body based on radiographic findings,
10 explain post-operative precautions to be noted,
11 explain post-operative clearing, cleaning and sterilization of devices and materials,
12 explain healing process of surgical wound,
13 explain the order of steps of the secondary operation in the 2- stage implant system,
14 perform the secondary surgery (removal of cover screws, placement of healing abutments),
15 grasp the post-operative systemic conditions of the patient,
16 grasp the post-operative local conditions of the patient,
17 implement post-operative measures of infection control..

Ⅹ.Implant therapy-related surgeries (Bone tissue management: bone grafting, GBR, maxillary sinus elevation, bone distraction, split crest procedure, collection of autogenous bone, mandibular alveolar nerve repositioning; Soft tissue management; free gingival grafting, free connective tissue grafting, vestibuloplasty)

GIO:
Acquire basic knowledge and skills in oral surgery in order to perform safe and secure implant therapy-related surgical procedures

SBOs:
The learner will be able to;
1 explain kinds and contents of implant therapy-related surgical procedures,
2 explain the order of steps of implant therapy-related surgeries,
3 perform surgical hand scrubbing, wear sterile gloves and a gown,
4 explain instruments/devices used for implant therapy-related surgeries,
5 determine clean and unclean areas for securing the surgical field,
6 select and perform anesthetic method suitable for the patient’s systemic conditions and surgical procedures,
7 perform disinfection inside and outside the mouth needed for the surgical field,
8 perform appropriate incision and dissection needed for securing the surgical field suitable for surgical procedures,
9 use instruments/devices needed for implant therapy-related surgical procedures,
10 select implant therapy-related surgical procedures suitable for the individual case,
11 explain the healing process of surgical wound,
12 harvest autogenous bone in safe and precise manner,
13 harvest autogenous tissues in a safe and precise manner,
14 use artificial materials in a safe and precise manner,
15 apply regenerative medicine in a safe and precise manner,
16 prepare the recipient bed of a graft in a safe and precise manner,
17 apply graft materials to the recipient bed in a secure manner,
18 explain post-operative conditions of implant therapy-related surgery with the radiographic findings,
19 explain post-operative precautions,
20 explain clearing, cleaning and disinfection of instruments/devices after surgery,
21 grasp the patient’s post-operative systemic conditions,
22 grasp the patient’s post-operative local conditions,
23 perform post-operative infection control measures


【 the 19th module】advanced implant course session 7
12 hours
Summary of review
Ⅺ. Implant prosthodontic procedures
GIO:
Acquire basic prosthodontic knowledge and skills required to fabricate the appropriate super structure in implant therapy

SBOs:
The learner will be able to;
1 explain kinds of impression taking methods for implant treatment,
2 take impressions for implant therapy,
3 explain fixation methods of implant super-structures,
4 explain the purposes of provisional restorations,
5 explain selection of abutments for fixed superstructures,
6 explain kinds and features of attachments for removable superstructures,
7 explain and select from, kinds and features of materials of superstructures,
8 explain fabrication of abutments and superstructures with use of CAD/CAM technology,
9 explain design of superstructures that can avoid prosthodontic troubles,
10 perform secure delivery of superstructures.

Ⅻ.Maintenance of implant therapy
GIO:
Acquire basic knowledge and skill required for long term maintenance of oral functions which are restored by implant therapy

SBOs:
The learner will be able to;
1 explain difference in surrounding tissues between implants and natural teeth,
2 explain association of peri-implant mucitis /peri-implantitis with periodontal disease,
3 explain peri-implant mucitis/peri-implantitis and its prevention,
4 explain periodic examinations and items to be tested in implant therapy,
5 perform periodic examinations and tests in implant therapy,
6 explain cleaning instructions for implants,
7 provide cleaning instructions for implants,
8 explain procedures of Professional Mechanical Cleaning (PMC) for remaining teeth and implants,
9 perform procedures of professional mechanical cleaning (PMC) for remaining teeth and implants,
10 explain treatment methods of peri-implant mucitis/peri-implantitis,
11 explain CIST (cumulative interceptive supportive therapy).


【 the 20th module】advanced implant course session 8
12 hours
Summary of review
ⅩⅢ.Troubles and complications
GIO:
Acquire basic knowledge and skills to appropriately cope with troubles and complications associated with implant therapy

SBOs:
The learner will be able to;
1 explain success criteria of implant therapy,
2 understand and take appropriate measures to troubles and complications which are associated with implant therapy,
3 take appropriate measures to intra-operative and post-operative infection which could occur in surgery,
4 take appropriate measures to various nervous injuries which could be incurred during surgery,
5 make accurate diagnosis and measures to sinusitis which occurs after implant therapy- related surgical procedures,
6 take appropriate measures to erroneous insertion of implant body or a related instrument in the maxillary sinus,
7 take appropriate measure to abnormal bleeding during and after surgery,
8 make accurate diagnosis and measures to post-operative abnormal pain,
9 explain erroneous swallowing, aspiration or breakage of instruments,
10 take appropriate measures to erroneous swallowing, aspiration or breakage of instruments,
11 explain troubles associated with implant bed osteotomy,
12 take appropriate measures to troubles during implant bed osteotomy,
13 grasp and appropriately cope with troubles or complications that occur after treatment,
14 explain fracture of implant body or abutment,
15 take appropriate measures to fracture of implant body or abutment,
16 take appropriate measures to screw loosening, damage or fracture,
17 explain fracture of superstructures,
18 tale appropriate measures to fractured superstructures,
19 explain esthetic problems of superstructures,
20 take appropriate measures to esthetic problems of superstructures,
21 explain risks of residual cement in cemented superstructures,
22 take appropriate measures to residual cement in cemented superstructures,
23 explain peri-implant mucitis and peri-implantitis,
24 take appropriate measures to peri-implant mucitis and peri-implantitis,
25 explain implant body dislodgement,
26 take appropriate measures to dislodgement of the implant body,
27 explain fracture or wear of the occluding teeth and bone resorption,
28 take appropriate measures to fracture or wear of the occluding teeth as well as bone resorption.