Surgical Veneer Grafting - Compensation for Natural Labial Plate Remodeling After Immediate Implant Placement
Contemporary implant therapy aims to provide highly esthetic and predictable treatment outcomes while decreasing treatment duration and complexity. The clinician must therefore be cognizant of circumstances with a predisposition toward esthetic outcomes and treatment plan accordingly. Preservation of the surrounding hard and soft tissues associated with an immediate postextraction socket implant to replace a nonrestorable tooth in the esthetic zone is one of the greatest challenges facing the dental team. A case report of a hopeless maxillary left central incisor in a patient with a thin periodontal phenotype illustrates this new surgical and prosthetic approach. Clinical, radiological, and esthetic parameters were recorded to evaluate primary treatment outcomes.

Enhancing Esthetics with a Fixed Prosthesis Utilizing an Innovative Pontic Design and Periodontal Plastic Surgery
During the past two decades, significant advancements with the integration of periodontal plastic surgery into esthetic restorative dental procedures have received increased attention. While ovate pontics have traditionally been used as a restorative design following augmentation procedures to enhance esthetics, an alternate E-pontic design aims to predictably support and maintain the gingival architecture between a single missing anterior tooth adjacent to a natural tooth or an implant that is in harmony with the lip line and face. In addition, the E-pontic design promotes the gingival facial tissue to coronally migrate over the pontic, creating a gingival sulcus. This article describes an innovative new technique and a pontic design that predictably will develop, support, and maintain the gingival architecture to provide a long-term esthetic and functional outcome.

Acellular Dermal Matrix Grafts for Root Coverage Procedures: Review of Products and Introduction of a New Technique
Gingival recession remains a significant problem in dental esthetics as well as periodontal health. Adequate zones of keratinized, attached tissue are vital for long-term periodontal health and maintenance. The correction of gingival recession is an important principle in cosmetic dental procedures that requires a harmonious gingival complex. Correction of deficient gingival tissues by either autogenous or allogenic tissue grafts has been well documented in the literature. This article will delineate differences among the various acellular dermal grafts as well as introduce a new technique that can enhance success.

Partial Extraction Therapies: From Failure to Everyday Practice - Part 2 of 4
Tooth extraction is usually followed by the resorption of support tissues that may compromise the aesthetic and functional prognosis of the final rehabilitation. There have been numerous publications suggesting Partial Extraction Therapies contribute to the maintenance of the alveolar ridge dimensions. These techniques consist in intentionally preserving a buccal root fragment in order to avoid tearing the periodontal ligament and loosing the bundle bone, which leads to bone resorption. It has been reported that these are very sensitive techniques and may lead to some complications. In order to avoid these complications, the dental surgeon must know which cases can be treated with Partial Extraction Therapies and how to correctly perform them. In these presentations we will show what are the indications and contraindications, how to perform these techniques, the literature that sustains it, how can we benefit from digital technology to today's world, etc.

The Evolving Role of Soft Tissue Enhancement in Esthetic Reconstructive Dentistry - Part 2 of 3
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".

The Science Behind the Papillae - Part 2 of 2
In 1992, Tarnow’s study on the effect of the distance from the contact point to the crestal bone on the presence of interproximal dental papilla gave us a new and ground breaking insight into the management of pink aesthetics. Later Team Atlanta furthered that study, analyzing the different measures between teeth, implants and pontics, giving us an even deeper understanding of how bone height influences in papilla growth. In my understanding, this study was one of the most important in the history of dentistry due to its true crossover between dental surgery and the prosthodontic field, combining aesthetics, oral rehabilitation and oral surgery in treatment planning. Never has interdisciplinary dentistry been more valued. This lecture will go over past and present techniques that can be performed to achieve an optimal aesthetic outcome in the managing of soft tissue.

Immediate Implant Provisionalization: A Critical Aspect in Tissue Care and Esthetics-Part 2
The management of the hopeless tooth or an edentulous span in the Estheitc Zone is amongst the most clinically demanding procedures in tooth replacement do to the demands of tissue preservation and patient management during the healing phase. As important as the implant surgical process in these areas is the role of the immediate provisional restoration. Tissue support, emergence profile and The provisional restoration phase of implant therapy has become one of the most critical steps in immediate or delayed placement for several reasons including the following...

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.

Esthetic Tissue Reconstruction Around Implants - Part 2 of 2
Esthetics in implant-supported restorations is an important clinical objective in contemporary dentistry. Understanding the biological behavior of hard and soft tissues following tooth extraction is the first step to anticipate the physiological tissue remodeling and its consequences. Our objective in these 2 sequential lectures was to provide straightforward decision trees related to several clinical scenarios observed in routine clinical practice. The 3 fundamental pillars for peri-implant excellence are: restorative-driven implant position, hard and soft tissue reconstruction using different biomaterials and grafts, and prosthetic management. Using this philosophical approach seems to provide esthetic and stable results over time irrespective of the initial clinical condition.