Keys to Esthetic Gingivectomy
Dr. Silverstein shows the gingivectomy procedure.

Papilla Regeneration in Patients with Gummy Smile
A lost interdental papilla is difficult to regenerate. Only a few successful case reports have been published and there are no studies reporting a predictable technique to reconstruct the papilla. In this presentation we talk about the biological determinants of gingival papilla. We show different clinical cases ranging from simple cases, where papilla preservation techniques are applied, to complex cases of patients with gingival smile where we apply papilla regeneration techniques.

Tooth Makeover to a True Smile Makeover
Dr. Warren Roberts strategically integrates facial rejuvenation with the cosmetic smile makeover using his 30+ years of dental expertise, making this a relevant issue for any dentist.

Excessive Gingival Display Managed by Surgical Lip Reposition, Aesthetic Crown Lengthening and Veneers
Excessive gingival display can be managed by a variety of treatment modalities, depending on the etiology. Mild and moderate gummy smiles can be successfully treated by periodontal plastic surgery, however for excessive gingival display as in cases of VME II or III with 5 to 8 mm or more of gingival exposure this procedure is not enough. Many patients decline the more invasive Le Fort osteotomy and opt for a less invasive surgical lip repositioning procedure. Currently Botox is used as alternative, but this is only a temporary treatment with very short effectiveness. That is why we suggest surgical lip repositioning as an effective procedure to reduce gingival display by positioning the upper lip in a more coronal location. The long-term stability of the results remains to be seen, but it holds promise as an alternative treatment to more invasive procedures.

Integrative Management of the Gummy Smile: Lip repositioning, Crown Lengthening & Restorative Nuances
The gingival smiles can be mild, moderate and severe , according to the degree of gingival exposure while smiling . Depending on the etiology of the problem , mild and moderate gummy smiles can be treated with moderate periodontal plastic surgery , however for severe , this procedure is not enough .

Effective Treatment for Herpetic or Traumatized Oral Lesions
In this tip of the week, Dr. Sergio Rubinstein shares his clinical experience with Proginicin in the treatment of herpetic or ulcerative oral lesions and soft tissue healing.

Modern Crown Lengthening: Classification and Clinical Application
Crown lengthening procedures are indicated to provide adequate tooth structure in case of subgingival tooth fracture or caries, uneven gingival level, un-esthetic short crowns due to the tooth wear, inadequate axial height, altered passive eruption ,forced eruption of a single or multiple teeth and finally in case of gingival smile. The treatment modality for esthetic crown lengthening procedure should be based on detail diagnosis in each case because of the multifactorial etiology and because of the type of therapy selected by the clinician, will have a direct implication for the esthetic result.

Treating the Terminal Dentition: A Patient-Center Approach
In patients with terminal dentition esthetic and functional replacement is a necessary objective, but no longer a sufficient-objective: nowadays, due to the clinical and extra clinical characteristics of these patients, management of the therapy is as important as its conclusion. Respect of the principle of autonomy, reduction of treatment length, simplification of surgical procedures and prosthetic management of implant immediate loading are the cornerstones of this philosophy and are the object of this lecture.

Advanced Immediate Implant Placement Strategies Including the Socket Shield (SS) Technique and its Complications
Immediate implant placement in the aesthetic zone has become a controversial topic with regards to the long term aesthetic demands that both the profession and our patients have placed on this treatment modality. Since the controversy broke a few years ago there have been a number of outstanding developments that have revolutionized the way we do immediate implant placement. Soft tissue augmentations using the tunnel technique as well as the socket whiled technique are 2 of these techniques which form the baseline of treatment in our clinic. This lecture will go through all the updated protocols of immediate implant placement supported by the literature as well as deal specifically with the finer details of the socket whiled technique including step by step photos and video of the technique. More importantly it will cover numerous complications that we have had to deal with over the last few years that we have been doing this technique.

Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy
Platelet derived growth factors are now routinely utilized in reconstructive therapy. This presentation describes very detailed and evidence based guidelines for clinicians interested in enhancing their abilities in tissue engineering, especially as it relates to bone augmentation. Specifically, while successful bone augmentation requires the standard surgical parameters of space maintenance, low pressure on the grafts and tension-free flap closure, optimization of this goal requires management and enhancement of the local biological conditions with growth factors. Towards that end, platelet concentrates through the constant release of growth factors are able to promote and enhance new vascularization, provide plasma protein, normal lipidemia, as well as increased collagen and fibrin activity.

A Periodontal-Restorative Approach to Achieving an Esthetic Outcome in Worn Dentition
Esthetic dentistry demands more of clinicians than just simeple knowledge of tooth anatomy and the proper dimensions of teeth. Dentists must also know and understand the proper positions of the teeth in relation to the gingiva, the lips, and entire face. Esthetic measurements are not the only important factors. Other considerations need to include the patient's phonetics and function. A example of a situation where this knowledge and awareness is imperative is in the case of the worn dentition (eg, attrition, abrasion, etc). This article addresses a simple case of how a patients esthetics have been compromised as a result of erosion as well as parafunctional activity (toothbrush abrasion) and how the patient was eventually restored with an interdisciplinary approach between the restorative dentist and the periodontal surgeon.

Restoration of Optimal Esthetics in Complex Clinical Situations
Patients often neglect or delay dental care for an extended time because of their negative experiences with and fear of dental treatments. This neglect may result in the advance of periodontitis with severe bone loss, a substantial number of missing teeth, and problems with the remaining teeth. Pre-existing malocculsion can aggravate this condition. This case report demonstrates an interdisciplinary strategic approach, in combination with the use of biologically grounded, clinically proven, and viable techniques and technologies to restore optimal esthetics and function in such complex cases.

Clinical Realities - Papilla and Free Gingival Margin Preservation in Multiple-Tooth Extraction
Bone atrophy is a natural response to tooth extraction, and anatomic and functional aberrations can be magnified when alveolar atrophy is accompanied by periodontitis, root fracture, radicular caries, apical processes, or endoperiodontal complications.