October 18, 2010

Dr. Michael Norton

Understanding the BioManagement Complex (BMC)
and its Impact on Clinical Outcomes

Today Osseo integration is considered routinely achievable ensuring a functional prosthetic result on dental implants should be within easy reach. The same cannot be said for achieving esthetics, with difficulties in implant design that do not conform to anatomy and of course the difficulties that arise with early bone loss and consequent loss of soft tissue architecture and papilla form.

The widespread acceptance of an initial adaptation of the marginal bone down to the first thread has recently been challenged by the hypothesis that so-called platform switching accommodates an increased volume for the biologic width and thereby avoids bone loss.

In reality the maintenance of marginal bone is a more complex process than the accommodation of the connective tissue compartment. Rather it depends upon creating ideal conditions for bone to attach itself at the top of the implant, by means of the application of surface topography, through a biomechanical rationale for distribution of functional load through the implant, by eradication of unfavorable microbial leakage, by the creation of space for the connective tissue compartment and by enhancing the bone bonding properties of the implant surface.

Ultimately the concept of prosthetically guided healing for soft tissue sculpting remains the key issue for esthetic success. The surgical options of staged versus immediate approaches also denote a choice between having to regain lost architecture versus maintaining an architecture that is already present. These issues will be discusses in depth, with appropriate examples.

This presentation will focus on the BMC and explain how this multivariate complex can help ensure true long-term maintenance of marginal bone as well as to help the clinician deliver optimal esthetic results with dental implants in particular when utilizing an immediate temporization protocol.

Biographical Sketch

Dr. MICHAEL NORTON is a graduate of the University Of Wales School Of Dental Medicine. He runs a dedicated implant practice in Harley Street, London. He is a specialist in Oral Surgery and in 2007 he was awarded the prestigious Fellowship of the Royal College of Surgeons, Edinburgh for his contribution to the field of implant dentistry. Dr. Norton is both board member & Fellow of the Academy of Osseointegration (AO) and is Past President and the current Scientific Chairman of the Association of Dental Implantology, UK. He is the immediate past editor of the AO’s Academy News and is currently Associate Editor of the International Journal of Oral & Maxillofacial Implants. He also serves as a referee for a number of other peer-review journals.

Dr. Norton lectures internationally, and is widely published in the literature including one of the earliest Quintessence textbooks on the subject published in 1995. He is joint owner and editor of the journal Dental Implant Summaries.