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This clinically relevant presentation will describe and identify key factors for performing immediate single tooth replacement of hopeless maxillary central incisor teeth the focus on the importance of “virtual” CBCT planning and the surgical key factors. The treatment of the maxillary central incisor is considered a Complex SAC procedure, as it is seen as having the most long-term esthetic failures resulting in unhappy patients. The “Updated 10 Keys checklist” (2 diagnostic, 5 surgical and 3 prosthetic keys) published in the Academy of Osseointegration News(2022), if sequentially followed, will provide high predictability in preventing esthetic complications and offers guidelines to ensure high success based on published clinical-CBCT studies.
This clinically relevant presentation will describe and identify key factors for performing immediate single tooth replacement of hopeless maxillary central incisor teeth the focus on the importance of “virtual” CBCT planning and the surgical key factors. The treatment of the maxillary central incisor is considered a Complex SAC procedure, as it is seen as having the most long-term esthetic failures resulting in unhappy patients. The “Updated 10 Keys checklist” (2 diagnostic, 5 surgical and 3 prosthetic keys) published in the Academy of Osseointegration News(2022), if sequentially followed, will provide high predictability in preventing esthetic complications and offers guidelines to ensure high success based on published clinical-CBCT studies.
When a tooth adjacent to an implant is lost, particularly in the esthetic zone, local anatomy and bony architecture changes occur. Most challenging is the loss of proximal periodontal attachment, resulting in reduced papilla height. Esthetic consequences of this include papilla blunting, “black triangles” and alterations of tooth form to compensate. Consequently, when adjacent teeth are lost, a different strategy needs to be used beyond socket management to prevent these changes and prevent cosmetic compromises, such as partial extraction therapy (socket shield). This presentation will illustrate how different evidence-based approaches to tooth replacement were used to preserve pink and white esthetics as teeth were lost in the esthetic zone in a particularly demanding patient. Treatment goals were to maintain optimal outcomes with maximum treatment efficiency, without compromises. The first tooth lost was replaced using the “10 Keys” approach. 5 years later, PET was used when the adjacent tooth failed.
At the completion of this presentation, participants will:
Anticipate alveolar changes following tooth extraction that can impact dental esthetics.
Be familiar with “10 keys” approach for single tooth replacement.
Appreciate rationale and technique for PET when adjacent teeth need replacement.
The Esthetic Dichotomy: Balance and Imbalance in Smile Aesthetics” delves into the delicate relationship between gingival tissue and teeth, which is pivotal in sculpting the perfect smile. This session will illuminate the nuanced strategies that clinicians employ to harmonize smile aesthetics, particularly the decision making process on when to augment or diminish gingival tissue for achieving aesthetic equilibrium. Emphasizing a comprehensive perspective, this presentation ensures that each case adjustment advances towards a superior aesthetic result. Attendees will dissect the critical interplay of these elemental components, armed with a deeper comprehension of manipulating this balance to elevate their cosmetic dentistry practice.
The tunnel technique, reported by Allen in 1994, is one of the superior root coverage procedures for obtaining blood supply to the connective tissue graft and esthetic. However, in cases of deep gingival recession, the tunnel technique may be inapplicable because the graft is widely exposed. Furthermore, in such deep gingival recession, it is difficult to make the tunnel tension-free, and it is extremely difficult to cover the CTG by coronal advancement of the tunnel. In 2018, Sculean and Allen reported a very simple technique called laterally closed tunnel technique to overcome this disadvantage. This technique reduces the depth of recession by horizontally suturing deep gingival recession. I will show a case of deep\ gingival recession treated with some modifications to the laterally closed tunnel technique.
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Autogenous gingival tissue harvesting has occupied the minds of surgeons sinceBjorn first published on the “free transplantation of gingiva propia” in 1963.There is a balance to be had between graft indication and ease of graft harvestversus post operative comfort for the patient. The most common autogenoustissue harvest techniques discussed today are the subepithelial connectivetissue graft, particularly the single incision palatal harvest technique (pCTG); thede-epithelialized free gingival graft harvest technique (dFGG); and the tuberosityconnective tissue graft (tCTG). This debate poses the question to two private-practice ISPPS Members for discussion: How do you choose?
As a periodontist we pride ourselves on obtaining the optimal results for our patients and profession. We are the global experts in mucogingival surgery and my personal experience over the past 20+ years has provided evidence in clinical outcomes that provide me confidence that I can deliver the optimal long-term result by adding biologic factors and principles to mucogingival procedures. Whether this is too improve soft tissue healing or to obtain the optimal attachment to the previously exposed root surface, biologics are a major factor in my clinical practice. This short lecture will expose you to philosophy, research, and clinical outcomes in regards to utilizing various biologic factors during mucogingival procedures. Evidence based dentistry is critical in analyzing outcomes, techniques and most importantly, long-term stability. I am hopeful that this presentation will allow you to think outside the box and search for new techniques and factors that can improve our results for the field of periodontics and our patients.
Primary closure of the interdental papillae is important in periodontal regenerative therapy. If primary closure is not achieved and the regenerative material is exposed, it is contaminated by bacteria and the desired amount of regeneration cannot be obtained. Various surgical techniques have been devised to improve the primary closure rate of the interdental papilla, such as the papilla preservation techniques and minimally invasive surgical techniques. Recently, tunnel-like approaches that do not incise the defect-associated interdental papillae has been developed and good results have been reported. I will discuss the advantages and disadvantages of the tunnel-like approaches. I would also like to present a new surgical technique.
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This clinically relevant presentation will describe key factors in performing periodontal regeneration on pathologically migrated teeth affected by severe periodontitis followed by orthodontic therapy. The optimal interval between periodontal regenerative surgery and orthodontics has been the subject of ongoing debate. Historically, this important issue has been a “gray area” for practitioners. This presentation will provide official guidelines based on published clinical studies to ensure happy and healthy patients for successful long- term outcomes.
A variety of soft tissue augmentation procedures have been utilized for treatinggingival recession defects and enhancing mucosal deficiencies around implants.Periodontal plastic surgery (PPS) is crucial for periodontal and implanttherapies. However, results can be unpredictable and not consistentlysuccessful. Recently, growth factors like EMD and FGF-2 have garneredattention. These factors constitute one of the three essential elements forregenerating periodontal tissue and can be employed in PPS to enhance reliableoutcomes. This presentation will validate the efficacy of EMD and FGF-2 byexamining cases illustrating both successful and unsuccessful outcomes.Furthermore, the presentation will delve into the causes of failure and strategiesfor recovery.
Many surgical techniques have been introduced in the literature and many clinicians have advantages using these techniques in their practices. The modern clinician must know various opportunities for the periodontal and peri-implant surgical procedures to improve the tissue condition and esthetic outcomes. The lecture will highlight methodology and research using variety of techniques and materials to establish good clinical success.
Traumatic dental injury often results in the ankylosis of a maxillary anterior tooth. If this occurs in a growing patient, the condition will affect the development of the dentition and alveolar ridge, creating a challenge for tooth replacement. This presentation will discuss treatment strategies to help optimize future prosthetic treatment.
This joint talk will discuss the Tunneled Coronally Advanced Flap (TCAF) and itsapplication when treating gingival recessions and mucogingival defects aroundnatural teeth and their counterpart, peri-implant soft tissue deficiencies arounddental implants.
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