Clinical Realities - Maximizing Aesthetics and Health Using a Closed-Flap ER: YSGG Laser Technique
Hugh Flax, DDS, PC
Developing Optimal Peri-Implant Papillae within the Esthetic Zone: Guided Soft Tissue Augmentation
Osseointegrated dental implants have enjoyed longterm success in the rehabilitation of totally edentulous patients. Every aspect of traditional treatment planning protocols continues to be re-evaluated and updated to better incorporate the benefits of osseointegration into clinical practice. This is particularly evident as dentistry has committed to fully integrating this approach into the more varied and demanding environment of the partially edentulous patient.
Labial Bone Thickness in Area of Anterior Maxillary Implants Associated with Crestal Labial Soft Tissue Thickness
Soft tissue problems (ie, gingival recessions) are common in implantology and are often associated with thin soft tissue biotypes or buccally placed implants. Goaslind described 2 types of biotypes commonly found in the natural dentition: thick and thin. It has been suggested that thicker soft tissue biotypes are associated with less tissue recession, higher crestal bone levels, and better aesthetics. A thin tissue biotype has been shown to be more prone to tissue recession. Gingival recession is always associated with alveolar bone dehiscences. Furthermore, there is evidence that thick soft tissue may be protective against crestal bone loss (ie, tissue thickness of ,2.5 mm resulted in crestal bone loss of 1.45 mm vs. thicker tissues had 0.26 mm). This protective effect occurred, despite the supracrestal position of the implant-abutment interface.
Current Trends in Gingival Recession Coverage 2
The recession of the gingiva is increasingly becoming a prominent condition in the oral health of many patients and should be treated at its earliest detection. Part I of this discussion reviewed the multifactorial etiology and decision modality; a treatment option was demonstrated for gingival recession using the tunneling technique. This concluding part of the discussion highlights two clinical cases using alternative approaches. The correction of Class I and II gingival recessions are presented as a means of minimizing surgical trauma and achieving predictable aesthetic results.
Esthetic Crown Lengthening
Dr. Silverstein discusses the steps to successful esthetic crown lengthening.
Peri-Implant Treatment-Complications & Management
Case presentations & management of failure at the implant site.
Free Gingival Graft - Current Strategies
Techniques in grafting free gingival tissue
Prosthetic Soft Tissue Development From Single to Full Arch Reconstruction
In addition to surgical intervention is the creation of the specific emergence profile that is essential in the aesthetic zone. The emergence profile composed of 2 parts, the abutment and the subgingival part of the crown. The shape of abutment can be individually shaped so that it gives natural appearance and varies individually (depending on the depth, angulation and diameter of the implant). Sometimes it even dictates the implant position. From a surgical perspective, soft tissue height, position and thickness need to be diagnosed and corrected when needed. From the prosthetic point of view, the emergence profile has to be created to mimic the natural appearance and maintained over time in respect to the biological changes. The course teaches step by step how to be successful with implant prosthetics from single tooth, partially edentulous to full arch reconstruction.
Acellular Dermal Grafts in the Correction of Gingival Recession: Discovering the Possibilities
In this presentation, follow the evolution of root coverage surgery from autogenous grafts to the more contemporary alternatives of today.
The Evolving Role of Soft Tissue Enhancement in Esthetic Reconstructive Dentistry
Soft tissue grafting techniques, new regenerative materials and bioactivators will be highlighted. The expanding role of allograft materials (Perioderm), platelet rich in growth factors (PRGF, PRF), and when to utilize them will be suggested. The ability of these combined protocols to alter the soft tissue profile around natural teeth, implants, and dentulous ridges, will be reviewed as to its critical role in "Complete Esthetics".
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