The "Robin Hood" Approach to Tissue Engineering
Autogenous tissue is still a gold standard for augmentation procedures. There are great sources of patient’s own tissue, often in adjacent areas, that can be utilized. The soft tissue can be moved, flipped, rolled, pediculated - in order to take from the rich sites and give to the poor ones. A novel approach for the wound closure after ridge augmentation and/or implant placement in lateral maxilla will be presented.

The “VISTA” Vestibular Incision Subperiosteal Tunnel Access Technique for Treatment of Multiple Anterior Recession Defects
In this clinical video, the “VISTA” Vestibular Incision Subperiosteal Tunnel Access Technique is displayed in the treatment of multiple anterior recession defects on previously restored teeth. Debridement, root conditioning, incisions, ACDM placement, instrumentation and suturing are highlighted as well as two week postop results.

Abutment Selection and Tissue Modeling in Implant Dentistry
Dr. Barry Goldenberg outlines the unique role that the implant abutment/connection complex plays in peri-implant tissue stability. Specifically, how the interactions of the various components in this complex, and their relationship to each other, influence the shape, color and contour of the critical soft tissue around implants in the esthetic zone. In addition, stock and custom abutments are compared relative to their respective benefits.

Hard and Soft Tissue Augmentation: Optimizing Esthetic Results for the Restorative Dentist
Contemporary patient expectations have made esthetics a major requisite of all treatment plans, especially in situations where there is a high smile line. Although new restorative materials have highly improved predictability and esthetic outcomes, soft and hard tissue management play a fundamental role when working in esthetic areas. To achieve ideal esthetics, preservation of the natural soft and hard tissue architecture is a primary clinical objective. These new proposed techniques illustrate the importance of pre-prosthetic soft and hard tissue management when working in highly esthetic compromised areas.

Vertical or Shoulderless Preparations in Contemporary Prosthodontics
Tooth preparations without a defined finish line have been termed in several different ways, such as knife edge, feather edge, or shoulderless. From a biological standpoint, preserving a maximum amount of sound tooth structure, as it is done in vertical preparations, might also offer a more conservative alternative to a horizontal margin design in other clinical conditions such as endodontically treated teeth, vital teeth in young individual, teeth affected by caries at the cervical third. Vertical margins on zirconia crowns have been tested in vitro and clinical reports have been published. A re-evaluation of possible advantages and shortcomings of vertical preparation design in contemporary prosthodontics will be presented in light of recently published literature.

Esthetic Management for Compromised Extraction Sites - Part 2 of 2
Missing soft tissue is the main reason for compromised results in the aesthetic zone. But since the soft tissue has to be supported by a sufficient amount of bone, our focus has also to be on bone. Due to the fact that no bone-preservation technique (at the time of tooth extraction) available today, gives us the perfect result we need, augmentation procedures are still needed. Appropriate bone and soft tissue engineering in all three dimensions enhances the aesthetic performance of long-lasting restorations that blend in well and emerge from the periimplant sulcus in harmony with the neighboring teeth.

Fibrin Assisted Soft Tissue Promotion (FASTP)
Soft tissue recession around teeth and implants is an epidemic problem in the field of dentistry. A predictable and long-term soft tissue augmentation outcome is primarily dependent on proper diagnosis, prognosis and treatment planning. Harvesting limitations of autogenous tissue from the palate represent a true challenge when treating patients with multiple recessions or gingival deformities around teeth and dental implants. The Advanced Platelet Rich Fibrin (APRF) and injectable platelet-rich fibrin (iPRF) are promising tissue promoters that can be a suitable alternative option.

Fundamentally Changing Soft Tissue Grafting
Soft tissue augmentation procedures to increase the existing zone or create a new zone of keratinized tissue have been classically, and are routinely, performed using the patient's palate as the donor material. This article describes the simplistic use of a periodontal material that can be used for soft tissue augmentation procedures without using the patient's own palate to procure the donor tissue. This periodontal material is an acellular dermal allograft that has been used extensively in medicine.…

Bone Regeneration and Tissue Acceptance of Human Fascia Lata Grafts Adjacent to Dental Implants
The biologic principle of guided tissue regeneration (GTR) has been studied extensively in hopes of regenerating alveolar bone. Various materials have been utilized as regenerative membranes; however, all materials have disadvantages, and the ideal membrane material is yet to be identified. In this case report, human freeze-dried fascia lata strips were used as a regenerative barrier membrane in conjunction with the placement of endosseous root implants and demineralized, freeze-dried bone allograft.…

The Management of Immediate Implant Placement to Optimize Aesthetic Outcome in the Anterior Maxilla
Following tooth extraction the implant surgeon may select between various implant placement timing and loading protocols. Ideally these are to be determined prior to extraction, be it immediate, early, or late placement. Immediate implant placement even in the aesthetic zone is a literature supported treatment modality with success comparable to alternative placement protocols. Meticulous restorative treatment planning of a tooth destined for extraction is essential. Selecting the appropriate implant and techniques may preserve and ensure natural aesthetics. Utilizing the patient’s own tooth crown can better provisionalize the implant with a ‘walk out as you walk in’ result.