Apical Mattress Suture: Prevention of "Oxidative Stress" of Bone & Soft Tissue
It’s impossible to heal well and fast when the tissue is in oxidative stress.. It occurs when there is an excess of oxidants or deficiency of antioxidants: smokers and diabetics have issues because they are in chronic oxidative stress... Tension free flap closure in mandatory. Otherwise, soft tissue and bone will fall in oxidative stress. The solution is to suture the flaps with an adequate technique. In this presentation, we show how to achieve soft tissue immobility and fixed buccal flap. How to manage the sutures? When to remove them? What’s the best material? How to handle a flat knot and the following knots? How to increase the soft tissue thickness? etc… All details and clinical follow-up are described in this short presentation.

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.

Free Gingival Grafts - Return of the Mack
Clinicians are often encountered with soft tissue deficiencies which can compromise the long term stability of both natural teeth and dental implants. Subsequently, correct diagnosis of the nature of these deficiencies is critical in determining the appropriate treatment approach required. This lecture will focus on clinical decision making when utilizing connective tissue graft-based procedures versus free gingival grafting and apically positioned flap procedures in the treatment of gingival phenotype deficiencies around teeth and implants.

Esthetic Tissue Reconstruction Around Implants - Part 1 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 sequencial 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.

Crown Lengthening in Comprehensive Esthetic Therapy: The Complete Surgical Video A to Z
In this complete surgical video, Dr. David Wong performs an esthetic crown lengthening procedure to address a "gummy smile" as part of comprehensive therapy and smile enhancement. Dr. Wong will outline the indications for crown lengthening surgery as opposed to orthognathic correction. The surgical video will demonstrate the complete crown lengthening surgery, including incision design, flap management and instrumentation. In addition, suturing and post-operative care will also be outlined in detail.

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.

Combination Therapies in the Esthetic Zone: Steps for Success
This presentation will cover the critical aspects to consider for deciding the sequence and implementation of combination therapies. Successful esthetic zone treatment must begin with a well thought-out space management plan. This plan involves a three dimensional adjustment of the periodontal attachment, with a possibility of root submergence and partial extraction technique. Following this, a decision is made concerning the timing and position of implant placement, and an adequate hard tissue foundation can be restored using GBR with titanium mesh and collagen membrane. On top of this base a more efficient soft tissue augmentation and adjustment completes the requirements for success in the esthetic zone.

Soft Tissue Cone-Beam Computed Tomography: A Novel Method for the Measurement of Gingival Tissue and the Dimensions of the Dentogingival Unit
The purpose of the present study was to develop a soft tissue cone-beam computed tomography (ST-CBCT) to improve soft tissue image quality and allow the determination of the dimensions and relationships of the structures of the dentogingival unit. Two separate CBCT scans were obtained from three patients with different periodontal biotypes. The first was a scan following standard methods; however, for the ST-CBCT the patients wore a plastic lip retractor and retracted their tongues toward the floor of their mouths.

Use of the Natural Tooth for Soft Tissue Development - A Case Series
esults from this study showed that all patients achieved a normal or Class 1 papilla appearance similar to the original appearance of the natural tooth.

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...