Continuing Dental Education

Graduate Prosthodontic Symposium

TERMINAL DENTITION…Where do we draw the line???; Single-Tooth Implant Esthetics: A Diagnostically-Driven Protocol; Fixed Prosthetic Solutions for the Edentulous Patient; Minimally Invasive Restorations

Ricardo Mitrani, DDS, MSD, Keynote Speaker; Dana Buglione, DMD, 3rd Year Resident; Jack M. Keesler, DDS, 3rd Year Resident; Bree Hsu, DDS, MSD, 3rd Year Resident

lecture icon Lecture

TERMINAL DENTITION…Where do we draw the line???

Ricardo Mitrani, DDS, MSD

For over a decade, the term “Terminal Dentition”, has unquestionably gained a lot of traction in the dental community, and it implies that there is a need to remove a patient’s remaining dentition. But how do we reach such stage or conclusion? Does it mean the same to everybody?

The reality is that the term Terminal Dentition is actually a “dentist made term”.

Of the same token, until this day, there seems to be confusion among dental practitioners as to what is the ideal prosthetic solution for these patients.

This presentation will discuss a linear though process that allows the treating team to decide when to choose to give up hope on the remaining dentition and how to decide among the different restorative designs available.

Course Objectives

As a result of attending this program you will be able to:

  • Review a simple Classification (LTR Classification) that helps identify the patient´s condition and therefore decide the ideal treatment design for each given patient.
  • Review the different implant assisted/supported prosthetic solutions.
  • Improve communication amongst the treating team.
  • Review a treatment planning algorithm that allows the treating team to follow a linear thought process in assessing the remaining dentition.

Single-Tooth Implant Esthetics: A Diagnostically-Driven Protocol

Dana Buglione, DMD

Replacing a single tooth in the esthetic zone is one of the most technically demanding cases for the dental clinician. Ultimately, the esthetic success or failure of the definitive restoration comes down to case selection. But how do you differentiate between the “successful case” and the “disaster case?” The first part of this lecture illustrates a protocol for case selection based on key pre-treatment diagnostic indicators to help the clinician set anterior implant cases up for success. The second part of the lecture outlines prosthodontic and surgical protocols (including provisionalization for soft tissue contour, augmentation, flap design, and implant positioning) based on the specific diagnostic findings to aid in predictable execution.

Course Objectives

As a result of attending this course, you will be able to:

  • Complete a pre-treatment diagnostic assessment of the smile, soft tissues, and hard tissues.
  • Select immediate implant placement vs. delayed implant placement, based on specific diagnostic assessment findings for each category.
  • Select appropriate incision / flap design and describe the characteristics of a prosthetically-driven implant position.
  • Describe indications for immediate vs. delayed provisionalization, as well as correctly designing interim restorations for each scenario.
  • Properly select the ideal case for immediate single-tooth implant placement and provisionalization in the esthetic zone.

Fixed Prosthetic Solutions for the Edentulous Patient

Jack M. Keesler, DDS

Despite decreasing trends, edentulism continues to be a significant health care burden, and edentulous patients often wish to pursue fixed prosthetic treatment with implants. This lecture presentation will discuss current trends in edentulism, review morphological changes that occur subsequent to tooth loss, review the importance of osseointegration in providing various treatment options for edentulous patients, and present edentulous cases treated with fixed implant prostheses.

Course Objectives

As a result of attending this course, you will be able to:

  • Understand the significant bone and facial changes that occur following longstanding tooth loss.
  • Appreciate the history and current trends of osseointegration in managing edentulous patients.
  • Be able to recognize appropriate implant treatment modalities for edentulous patients or those with terminal dentition.

Minimally Invasive Restorations

Bree Hsu, DDS, MSD

With the development of adhesive techniques, there are more options for conservative tooth restoration. Let’s explore the rationales behind the transition from full coverage restoration to minimal invasive restoration.

Course Objectives

As a result of attending this course, you will be able to:

  • Learn the key elements of successful bonding.
  • Properly select of restorative materials.
  • Learn the indications of anterior and posterior bonding restoration. (veneer, inlay/onlay)
  • Learn preparation designs for bonding restoration.
  • Learn the treatment of ceramics for cementation.


Ricardo Mitrani is a member of the Spear Resident Faculty, the Executive Director of Spear Digest and a Spear Seminar instructor. He has authored numerous scientific publications and chapters in text books in the fields of implant prosthodontics and esthetic dentistry and has given more than 400 lectures in 26 countries. He holds academic affiliation at the National University of Mexico (UNAM) and serves as affiliate associate professor at the University of Washington. He maintains a private practice limited to prosthodontics and implants in Mexico City.

A member of the American Academy of Esthetic Dentistry, American Academy of Restorative Dentistry and the International College of Dentistry, Dr. Mitrani also serves on the editorial boards of numerous peer-reviewed journals, including the Journal of Esthetic and Restorative Dentistry (JERD), Compendium of Continuing Education in Dentistry and the Journal of Cosmetic Dentistry.

Dr. Mitrani received his DDS degree from the UNITEC University of Mexico City; he then obtained a certificate in prosthodontics as well as an MS in dentistry from the University of Washington, where he served as the graduate prosthodontics program’s assistant director during 2001.

Dana Buglione was born and raised in central upstate New York, as a third-generation dentist. He graduated with a BA in Fine Arts from the College of the Holy Cross in Worcester, Massachusetts, where he also played four years of NCAA Division 1 football (Go Crusaders!). After college, he joined Teach For America, where he had a blast teaching 6th grade in Hartford, Connecticut. He received his DMD from the University of Connecticut School of Dental Medicine, prior to attending the Graduate Prosthodontics program at University of Washington. After graduation, he will be practicing Prosthodontics in Bellingham, Washington. He enjoys backpacking, trail running, cooking (especially the eating part), creating artwork with his wife Lauren, and hauling their two young kids along on their many adventures.

Jack Keesler, a native of Wisconsin, will complete his advanced training in Graduate Prosthodontics at the University of Washington in 2019. Dr. Keesler earned a Bachelor of Science degree in biological sciences from Marquette University in 2012 and completed his DDS in 2016, also at Marquette University. He was awarded the David H. Wands Fellowship in Graduate Prosthodontics for 2017-2018. Dr. Keesler is also an avid painter, guitarist, and fly-fisherman.

Bree Hsu earned her DDS degree in 2010 and MSD degree in Prosthodontics in 2012 from Kaohsiung Medical University in Taiwan. She spent two years working in private practice, then joined the family of UW Graduate Prosthodontics in 2016. She enjoys the beauty of Seattle and the cultural diversity in Washington very much.

Course Logistics

Friday, June 14, 2019

The Mountaineers Club
7700 Sand Point Way NE
Seattle, WA 98115

This course is designed for specialists and dentists; team members are welcome to attend.

This event has been completely underwritten by our generous sponsors and all attendees will receive 7 hours of CDE credit. After you register, we hope you will consider a voluntary donation to Graduate Prosthodontics to support the work of our amazing faculty and students.

Download Course Application Form
Register Online (available until the Wednesday before the course).

Registration and Continental Breakfast: 8:00am – 8:30am
Course: 8:30am – 4:30pm

TUITION – price includes lunch:
Suggested Donation
$200/Hygienist, Dental Assistant, Office Staff
$275/Current Dental Alumni Member

7 hours

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The University of Washington is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

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The University of Washington is a member of the Association for Continuing Dental Education.

University of Washington designates this activity for 7 continuing education credits.