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...

The Tunnel Technique in the Periodontal Plastic Treatment of Multiple Adjacent Gingival Recession Defects
“Originally published in Inside Dentistry, 2008. Copyright 2008. AEGIS Communications. Reprinted with permission.”

Soft Tissue Procedures Related to Dental Implant Surgery
Clinicians often encounter an insufficient amount of keratinized soft tissue in the proposed implant site. When this occurs, the question arises: Should the necessary softtissue manipulation be performed before, during, or after placement of the implant? There are three answers or scenarios for this question, according to Lee Silverstein, DDS, associate professor at the Medical College of Georgia in Augusta.

Plastic-Esthetic Periodontal and Implant Surgery: A Microsurgical Approach - Part 1
This 2 part presentation is a comprehensive overview of the principles, indications, and clinical techniques of plastic-esthetic periodontal and implant microsurgery, focusing especially on minimal soft tissue trauma and maximally perfect wound closure. Microsurgery provides clinically relevant advantages over conventional macro-surgical concepts for regenerative and plastic-esthetic periodontal surgery, especially in the all-important esthetic zone. The microsurgical principles and procedures presented will described using high resolution multimedia. 

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.

Tissue Thickness, Cement & Platform Switching; The Science
Mucosal tissue thickness was shown to be the factor having impact on crestal bone stability. Even platform switching of the implant-abutment connection does not reduce crestal bone loss, if soft tissues at the implant placement are thin.

Positive & Negative Factors in Stem Cells & Wound Healing: Solutions for Long Term Stability
The main factor for soft and hard tissue healing is the speed and quality of new vascularization. This lecture will present all the positive and negative factors who control the angiogenesis, blood supply and bone metabolism: -Biological factors as vit. D and cholesterol have to be checked before the surgery -The management of the flaps with sutures is one the main factor for the bone and soft tissue maintenance.. -The soft brushing technique is a new technique which increases the flap without periosteal incision nor bleeding. -Careful Implant placement without too much torque, specially in cortical bone or grafted bone at the re-entry.. -The A-PRF liquid and i-PRF are solutions to reduce the mobility of the granules (sticky bone) with an improvement of angiogenesis The use of growth factors is a stimulation of angiogenesis. The prevention of the negative factors will allow us to achieve the long term stability.

Critical Concepts in Implant and Gingival Surgery; Flap Designs, Suture Techniques and Soft Tissue Management
This presentation by the Troeltzsch Brothers features the fundamentals of surgical procedures in the oral cavity. Highlighted are the basic concepts we all must integrate into our daily clinical practice. A discussion of the essential anatomic guidelines as they relate to flap design options and indications are emphasized. Furthermore, material selection, sutures and techniques of wound closures are clearly addressed. Critical solutions to common surgical complications are also described. This lecture is intended for surgical beginners as well as experienced clinicians who want to update their surgical knowledge. These fundamentals are also very popular in the hands-on courses given by the Troeltzsch brothers.

Bone Augmentation & Vascular Enhancement Concepts: It’s Time to Make it Simple!
Growing bone is fascinating, and clinicians have developed many techniques in that matter, most of them restricted to an elite. Yes, it does take a lot of skills to harvest bone blocks, to stabilize them with screws etc, and without forgetting the soft tissue handling as it can be a real challenge to cover the bone graft especially for a vertical augmentation. 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.