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. Preexisting malocclusion 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. The authors emphasize the importance of carefully planning the timing and sequence of performing periodontal, orthodontic, and implant therapies. The advanced techniques and technologies successfully implemented in this case report include the growth factor and titanium mesh (Ti mesh)-assisted bone augmentation; ovate pontic-mediated, noninvasive soft tissue contouring; and photofunctionalization

Clinical Case Review
Dr. Rosenberg reviews a severe clinical case.

Combination Therapy for Soft Tissue Grafting Procedures
Realization of predictable outcomes with shape, shade and unique characteristics of dental restorations has proven to be attainable and maintainable due to the static nature of a carefully prepared foundation and the overlying superstructures. On the other hand, the supporting soft tissue frame, which in turn is controlled by the three-dimensional anatomical characteristics of its surrounding environment, is further complicated by an inherent dynamic nature that is also dependent on a host of biological factors for long-term maintenance of ideal surgical outcomes. Realities and facts vs. hype will be discussed in this presentation based on a review of clinical results achieved and maintained utilizing combined soft tissue grafting approaches with up to 22 years of post-operative follow-up.

The Next Challenge in Implant Dentistry: The Rise in Peri-implantitis and What Can We do About It?
In this presentation, Dr. H. Ryan Kazemi will discuss etiologies for implant failure due to peri-implantitis, its preventive measures, and what treatment modalities work best. He will also describe a new classification to help clinicians choose the optimal treatment approach.

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.

Managing the Extraction Site - Optimal Preservation and Enhancement Techniques
There is rarely a day that clinicians do not have to deal with an extraction site. If implant therapy is a consideration, then bone and soft tissue quantity and quality must be factored into treatment options. The ideal opportunity for bone preservation exists at the time of tooth extraction. All too often this opportunity is lost. Extraction techniques will be demonstrated that not only preserve but augment the amount of alveolar bone. The importance of piezosurgery, atraumatic surgical technique, the use of bone grafts, resorbable membranes and growth factors will be elucidated along with soft tissue enhancement.

Periodontal Clinical Issues
Examination of Different Aspects of Periodontics

Maximizing Esthetic Transformations Using a Closed Flap ErCr - YSGG Modality
The clinical study presented in this article demonstrates that, in selected cases, combining minimally invasive laser therapy with detailed restorative design and technique can satisfy the bioesthetic functional requirements.

Guidelines for the Diagnosis and Treatment of Peri-Implant Disease
Although some risk factors of peri-implant disease are well defined, the lack of efficient and predictable approaches to treat peri-implantitis has created difficulty in the management of those complications. The aim of this review was the evaluate the reliability of the diagnosis methods and to provide a set of guidelines to treat peri-implant disease. A search of PubMed and a hand search of articles related to peri-implant diseases were conducted up to August 2013. A summary of the current methods for the diagnosis of peri-implantitis, its potential risk factors, and a flow chart to guide the clinical management of these conditions are presented.

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.