Connective Tissue Graft Using Alloderm
Lee H. Silverstein, DDS, MS, FACD, FICD
Oral Soft Tissue Laser Ablative and Coagulative Efficiencies Spectra
The key to the success of soft tissue
lasers is their ability to cut and coagulate the
soft tissue at the same time. Present work is
aimed to derive the wavelength-dependent
differences in photo-thermal ablation and
coagulation efficiencies for oral soft tissue
pulsed dental Near-IR Diode, Mid-IR Erbium
and IR CO2 lasers. Even though the soft tissue photothermal
ablation has been extensively
studied, there remains a discrepancy
between (a) the widely proliferated notion
about efficient Near-IR 800-1,100 nm laser
ablation of the oral soft tissue, and (b)
studies reporting the inefficient soft tissue
Near-IR absorption/ablation. Indeed, the notions about “the key to
the usefulness of the Nd:YAG is that this
wavelength is highly absorbed in oral soft
tissue”, and “all currently available dental
laser instruments and their emission wavelengths
have indications for use for incising,
excising... oral soft tissue surgery”,
contradict an observation illustrated here...
Changes in Soft Tissue Dimensions Following Three Different Techniques of Stage-Two Surgery: A Case Series Report
The aim of this case report is to compare the resilts of the increase in keratinized mucosa using three different techniques of stage-two surgery. Thirty-two patients with one to eight dental implants who received prosthetic rehabilitation of the maxilla were included. Patients were divided into three groups based on preoperative anatomical considerations. Stage-two surgery was performed using wither the apically repositioned flap, the roll flap, or an apically repositioned flap combined with a connective tissue graft.
The Aesthetic Smile: Diagnosis and Treatment
Until recently, dentists' and the public's concept of dental aesthetics was necessarily limited to alterations of the teeth themselves. Dentists concerned themselves with changing the position, the shape and the color of the teeth -basically restoring missing units or enhancing those already present. For the most part the dentist was forced to accept the pre-existing relationship between the three components of the smile; the teeth, the gingival scaffold and the lips.
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.
Papilla Preservation and Tunneling Technique in Root Coverage - Part 2: The Use of AlloDerm
The utilization of AlloDerm techniques in root coverage of multiple adjacent recession defects.
The "Modified Tunnel" Technique and the development of the Lateral Tunnel Approach
The "Modified Tunnel" technique is a method of esthetic connective tissue grafting that protects the interdental papillae. First published in 1999, this lateral tunnel approach uses vertical incisions on both sides of the treatment area. These vertical incisions facilitate placement and positioning of the graft over the root surfaces without the need to disturb the interdental papillae. This technique is very useful in esthetic areas and those that involve several teeth. An acellular dermal connective tissue allograft is an excellent choice of graft material to use with this technique.
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 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 Periodontal Surgery: Making Recession Defects Disappear by Grafting
Expert discussion of soft tissue grafting; first an overview of current trends, the second showing a specific allograft technique for treating multiple adjacent recession defects.
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