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SCIENCE / CLINICAL RESEARCH logo 39 • the CAMLOG Partner Magazine • November 2016 10 best way of preventing peri-implantitis. Professor Sanz also considers a favorable peri-implant soft tissue architecture as a key preventive factor. This in turn depends on the configuration of the transmucosal zone and hence on the implant-abutment connection. Prof. Katja Nelson (University of Freiburg, Germany) investigated various implant systems for their sealing and mechanical stability in the ring accelerator at the European Synchrotron Radiation Facility (ESRF). According to her results, there is, for instance, no significant difference between conical and flat- to-flat connections with regard to the size of the microgap and the stability of the connection. What can be observed, however, is that thin implants deform relatively strongly and also permanently under load and lead to unfavorable stress applied to the crestal bone. Furthermore, overloading of the implant wall often leads to fractures, particularly in the posterior region. According to Nelson's observations this applies primarily to conical and to a lesser extent to flat-on-flat connections, as the load is passed to the implant shoulder. PD Dr. Dietmar Weng (Starnberg, Germany) views the microgap as a means of entry and exit for microorganisms and thus as a primary cause of peri-implant inflammation. A minimized gap, which he attributes to primary conical connections, may therefore be more important for bone stability than the horizontal offset in Platform Switching. The battle – heated discussions on controversial topics The highlight of both days of the congress was the closing session. Different opinions were hotly discussed in "debates". The audience had the opportunity to pose questions at any time via app, which were then addressed in the panel discussions. For example, PD Dr. Markus Schlee (Forchheim, Germany) cast doubt on the etiologic leading role of the biofilm. Other speakers evaluated this similarly in their contributions. Often it was unclear why some patients suffer from peri-implantitis and others don't. As the available therapy methods would have an uncertain prognosis, Schlee prefers explantation and, where appropriate, repeated implantation in many cases. Prof. Dr. Frank Schwarz (University of Düsseldorf, Germany) contested this in that there has yet to be a study published in which bone decay without biofilm- induced inflammation could be detected. From a therapeutic standpoint various methods have been proven to be successful. Depending on the situation, implant surfaces need to be smoothed with rotary instruments. All speakers agreed that a whole series of factors favor peri-implant inflammation, including periodontitis, quality and quantity of soft tissue, implant position, cement residues in the sulcus (remedy: the use of floss) and the surface properties of the implant, abutment and restoration. The etiological role of host factors, such as systemic diseases, immunology and genetic disposition, is less well researched. In case of doubt, Professor Myron Nevins is of the opinion that implants should be avoided and a bridge placed where possible. Digital Dentistry pre-congress A pre-congress was staged for the first time in advance of the International CAMLOG Congress, and was devoted entirely to the topic of Digital Dentistry. Implantation and prosthetics can be planned on the computer in new dimensions, standardized methods and material quality allow improved predictable outcomes. But this only works with the suitable technology and sound knowledge, as experts from universities, practices and laboratories showed in Krakow. The future is open and digital Where does the digital path lead? For instance, will we only work with virtual models in the future? Moderators Prof. Dr. Irena Sailer (University of Geneva, Switzerland) and MDT Christian Hannker (Hüde bei Diepholz, Germany) received differentiated answers in lectures and panel discussions. The team of Dr. Peter Gehrke and Carsten Fischer (Ludwigshafen and Frankfurt am Main respectively) were convinced that "analog work steps will stay with us for a long time". The digital future clearly belongs to open systems with unadulterated STL files. The first closed systems have already disappeared from the market. Those who combine components should however know all providers and partners and communicate with them competently. In the view of Prof. Dr. Florian Beuer (Charité Berlin, Germany), all participants should overcome their mental blocks in order for digital techniques to proliferate. Copying analog processes digitally does not lead to the desired objective. In Krakow, many examples showed how analog and digital complement one another and open up completely new possibilities. Despite all visions, at the end of the congress Professor Sailer formulated an understated conclusion: "Digital technology has come on a long way, but we haven't arrived yet." PD Dr. Markus Schlee Prof Frank Schwarz Prof. Irena Sailer