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.

Bipolar Soft Tissue Management & Functional Mock-Ups
Patients desiring a cosmetic smile improvement can present challenges to the dentist when treatment planning. An excessive display of gingiva due to a high lip line often complicates treatment planning and can compromise the final esthetic result when proper planning is not considered prior to finalizing the case. We often have to ask ourselves as we evaluate the patient, do we “lower the river” (increase tooth length incisally), “raise the bridge” (increase tooth length gingivally) or a combination…

Laser Assisted Crown Lengthening
Clinical scenarios where crown lengthening procedures are indicated within the esthetic zone require special consideration to achieve predictable restorative results. Whether they are performed for the purposes of exposing sound tooth structure, or to enhance the appearance of the definitive restorations, these procedures must be planned to satisfy biologic requirements, while simultaneously avoiding deleterious esthetic effects. The implementation of diagnostic criteria, along with evidence-based…

Combined Augmentation Therapies in the Aesthetic Zone
Combined Augmentation Therapies in the Aesthetic Zone

Bone Augmentation & Vascular Enhancement Concepts: It’s Time to Make it Simple!
The purpose of this presentation is to make the participant think biology first and not mechanic first. A biological thinking will dramatically simplify vertical and/or horizontal bone augmentation procedures. We will also be introducing a new approach for the simplification of soft tissue handling: the Soft Brushing Technique, that will allow the coronal advancement of both buccal and lingual flaps, but also the palatal flap without the need for periosteal releasing incisions.

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

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.

Vertical or Shoulderless Preparations in Contemporary Prosthodontics
Tooth preparations without a defined finish line have been termed in several different ways, such as knife edge, feather edge, or shoulderless. From a biological standpoint, preserving a maximum amount of sound tooth structure, as it is done in vertical preparations, might also offer a more conservative alternative to a horizontal margin design in other clinical conditions such as endodontically treated teeth, vital teeth in young individual, teeth affected by caries at the cervical third. Vertical margins on zirconia crowns have been tested in vitro and clinical reports have been published. A re-evaluation of possible advantages and shortcomings of vertical preparation design in contemporary prosthodontics will be presented in light of recently published literature.

Innovative Sequencing for Interdisciplinary Aesthetic Treatment
Smile enhancement therapy has become an important facet of the everyday aesthetic practice. Aesthetic evaluation utilizing facial aesthetic design to diagnose tooth position demands effective communication between the periodontal-restorative team. This presentation will review innovative sequencing techniques for interdisciplinary cases which require aesthetic crown lengthening for the treatment of excessive gingival display, and for gingival augmentation for root coverage, and the correction of poor gingival quality. Immediate implant placement with immediate non–loaded provisional fabrication will also be reviewed.