Esthetic Crown Lengthening
Dr. Silverstein discusses the steps to successful esthetic crown lengthening.

Papilla Management in a Severe Periodontal and Cosmetic Deformity: Combining Veneer into Full Graft (ViFG) and Veneer into Split Graft (ViSG)
Bone defects and periodontal disease can create challenging defects in the anterior area. When we have such severe defects as the one presented here, it´s essential to plan in advance and to be sure of what is possible to correct with bone grafting and with soft tissue management. The key question in this clinical case is to be able to place the soft tissue graft exactly where you want it to heal. In our clinical practice we use routinely PRGF ENDORET grafts, not only as vehicle for particulate graft transportation, but also as a biological enhancer of both osteointegration and soft tiss

The “Semilunar” Graft Technique in Periodontal Plastic Surgery: Revision and Retreatment of Anterior Recession Defects.
In this lecture and video based Case Report, a patient with multiple recession defects in the Maxillary Anterior Region who was first treated with Tunnel Approach and ACDM grafts reveals breakdown of the result at 3 years in the area of the Maxillary Left Central Incisor with further recession and erosion of the root. The Semi-Lunar Approach is highlighted as a minimally invasive microsurgical approach to this situation. Incision design, instrumentation and suturing are highlighted. Post-op results are displayed.

Connective Tissue Graft Harvesting Techniques
In this presentation, Prof. Giovanni Zucchelli develops a critical comparison between the different CTG harvesting techniques, and shows the correct management of this kind of graft as well as its use in coronally advanced flap surgical technique for the treatment of gingival recessions.

A Defined Algorithm for Regenerative Success Part 1 of 2
These presentations will focus open the above concepts but prioritize the diagnostic phase and surgical common denominators required for a successful regenerative outcome. Flap design, space maintenance, bone and membrane selections and tension free closure provides the template for all the new age materials and technologies to be successful in clinical practice.

Zero Bone Loss Protocol: Influence of Vertical Soft Tissue Thickness on Crestal Bone Stability
Crestal bone stability is considered to be important for bone preservation, longevity of implants and to prevent peri-implant tissue recession. Implant placement level is important for bone stability. Mucosal tissue thickness was shown to be the factor having impact on bone stability. It was showed that platform switching does not reduce crestal bone loss, if soft tissues at the implant placement are thin. It is suggested that thin tissues might be thickened during implant placement, thus reducing bone resorbtion. The role of soft tissue thickness is well established in aesthetic treatment. It is known that thin soft tissues present an unfavorable situation for implant placement, crestal bone stability and subsequent prosthetic treatment.

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…

Maintaining Interimplant Crestal Bone Height Via a Combined Platform-Switched, Laser-Lok Implant/Abutment System: A Proof-of-Principle Canine Study
Interimplant papillae are critical for achieving esthetic implant-supported restorations in the maxillary esthetic zone. Stable papillary anatomy, however, depends upon a stable volume underlying crestal bone for support. Multiple studies have documented a critical interimplant distance of 3mm under which crestal bone resorption occurs. This preclinical proof-of-principle canine study examines a novel implant-abutment system design, combining platform switching with precisely configured laser-ablated abutment and implant microgrooves to maintain interimplant crestal bone at interimplant distances of 2 and 4 mm. Results of this initial preclinical study suggest that it is possible through precise implant/abutment design modifications to place adjacent implants at distance of 2 to 4 mm without inducing subpapillary crestal bone loss.

Soft Tissue Waxup and Mock-Up as Key Factors in a Treatment Plan: Case Presentation
Rehabilitation of edentulous spaces in esthetic areas is a challenge to the clinician due to the loss of soft tissues. In these clinical situations, it would be desirable to evaluate and predict the gingival architecture to recover in the oral rehabilitation. To fulfill this need, the diagnostic was should anticipate the final rehabilitation with the integration of hard and soft tissue.