Connective Tissue Graft Using Alloderm
Lee H. Silverstein, DDS, MS, FACD, FICD
Healing of Gingival Recessions Using a Collagen Membrane with a Demineralized Xenograft
A Randomized Controlled Clinical Trial
Biologic Width Adjacent to Loaded Implant with Machined and Rough Collars in the Dog
Dental implant surface technology has evolved from a relatively smooth machined implant surface for osseointegration to more roughened osteoconductive surfaces. Recent studies suggest that peri-implant soft tissue inflammation with progressive bone loss (ie peri-implantitis) is becoming a prevalent condition. One possibility that could explain sucha a finding is that more bacterial plaque forms on the roughened implant and abutment surfaces, which may result in the peri-implant inflammation if the soft tissues. This study compared 36 tissue-level implants with a machined transmucosal collar to 36 implants with a relatively roughened transmucosal surface in the dog. The results demonstrated that the connective tissue contact was similar between the two implant types but that the junctional epithelium and biologic width dimensions were greater around the implants with the machined collars...
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.
Minimally Invasive Protocols for Total Esthetic Reconstructions
One of the biggest challenges that we dentists have are those cases that require a multidisciplinary approach which traditionally were managed using invasive and long term treatments. Nowadays, and depending on the case, the contemporary dentist can offer minimally invasive treatments which allow us to modify the shape of the hard and soft tissues.
The combination of surgical lip repositioning with periodontal plastic surgery yields highly effective results in the treatment of gummy smiles. During patient examination it is important to establish the etiology responsible for the excessive gingival display. The combined technique can be considered as an alternative option to more invasive procedures. The prognosis is acceptable and the patient realizes that the esthetic problem has been minimized.
Crown Lengthening in Comprehensive Esthetic Therapy: The Complete Surgical Video A to Z
In this complete surgical video, Dr. David Wong performs an esthetic crown lengthening procedure to address a "gummy smile" as part of comprehensive therapy and smile enhancement. Dr. Wong will outline the indications for crown lengthening surgery as opposed to orthognathic correction. The surgical video will demonstrate the complete crown lengthening surgery, including incision design, flap management and instrumentation. In addition, suturing and post-operative care will also be outlined in detail.
A Microsurgical Approach in the Esthetic Zone: Recession Coverage Utilizing a Modified Tunneling Technique
This surgical video is intended to present a predictable technique for recession coverage. Using micro surgical instruments in a minimal invasive manner, we can avoid tissue damage and we can enhance the healing of the surrounding structures.
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".
Esthetic Zone Reconstruction: Synergy of Hard and Soft Tissue Grafting
The loss of alveolar ridge contour in the esthetic zone compromises both esthetics and function. This clinical presentation will focus on the application of both hard and soft tissue grafting in the esthetic zone implementing state of the art interactive CT diagnosis and treatment planning for optimal esthetic implant reconstruction.
Emphasis will be on indications, graft and harvest site assessment, timing, and use of bioactive modifiers including BMP, PRGF and PDGF. The surgical protocol utilizing allogeneic and autogenous grafts in conjunction with connective tissue grafts, acellular dermis matrix, and related soft tissue procedures to avoid functional and esthetic pitfalls will be featured. Pre and post-grafting prosthetic workup, interactive CT graft assessment and perio prosthetic driven implant planning, stent driven implant placement, and computer milled abutment fabrication including guided surgery will be included.
The Critical “Pink” Interface in Esthetic Dentistry—A Cross-Disciplinary Approach: Options, Limitations, and Solutions
This program is a perspective into how cross- disciplinary interface planning has become and integral part of clinical esthetic dentistry, in particular implant diagnostics. Today it is essential to combine “white” tooth esthetics with “pink” gingival aspects. Understanding the individual prosthetic, surgical, and biologic limitations is part of innovative treatment-planning protocols developed in an approach to provide, simplify, and expedite minimally invasive limited therapy. Preemptive CBCT and 3D CAD/CAM planning of soft and hard tissue procedures, implant placement, ridge reduction, and restorative design now utilize new innovative protocols for the entire restoration from top to bottom - implant, abutment, and restoration - and the interfaces in between.
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