Soft Tissue Procedures Related to Dental Implant Surgery
Clinicians often encounter an insufficient amount of keratinized soft tissue in the proposed implant site. When this occurs, the question arises: Should the necessary softtissue manipulation be performed before, during, or after placement of the implant? There are three answers or scenarios for this question, according to Lee Silverstein, DDS, associate professor at the Medical College of Georgia in Augusta.

The Management of Recession Midfacial to Immediately Placed Implants in the Aesthetic Zone
Immediate placement and loading protocols are the most technique sensitive and at the highest risk of complication, especially in the aesthetic zone. The peri-implant tissues undergo a resorption pattern that may see exposure of parts supporting the restoration, otherwise intended to be submerged, with extreme aesthetic compromise or even complete failure of treatment. The literature is not definitive in terms of any one treatment modality to recover such a complication. Grafting the exposure by a guided bone regeneration technique and an adjunct soft tissue augmentation could well restore an unaesthetic recession exposure. Recovery of midfacial recession by soft tissue augmentation alone may be successful, as is presented hereafter.

Esthetic Correction of Gingival Recession Using a Modified Tunnel Technique and an Acellular Dermal Connective Tissue Allograft
Esthetic correction of gingival recession is an important goal of periodontal therapy. This article describes a surgical technique that combines a modified tunnel technique and an acellular dermal connective tissue allograft. With the aid of vertical incisions, a tunnel is created under the buccal mucosa of the affected tooth. These incisions enable easy access for graft placement and create mobility for gingival coronal positioning. The use of an accelular dermal connective tissue allograft eliminates the need for a surgical palatal donor site. This minimizes post-surgical complications.

Soft Tissue Grafting Around Compromised Dental Implants in the Esthetic Zone
Dental implant esthetics can be challenging, but these challenges are magnified when a patient has had multiple failed implant and bone grafting surgeries.  This video demonstrates the treatment of one such case.  This is a surgical video demonstrating the VIP-CT (Vascularized Interpositional Connective Tissue) graft.  While multiple treatment options exist, this start-to-finish video highlights the patient's initial presentation, the surgical technique, and the final outcome at 2 years. 

Acellular Dermal Grafts in the Correction of Gingival Recession: Discovering the Possibilities
In this presentation, follow the evolution of root coverage surgery from autogenous grafts to the more contemporary alternatives of today.

Prosthetic Soft Tissue Development From Single to Full Arch Reconstruction
In addition to surgical intervention is the creation of the specific emergence profile that is essential in the aesthetic zone. The emergence profile composed of 2 parts, the abutment and the subgingival part of the crown. The shape of abutment can be individually shaped so that it gives natural appearance and varies individually (depending on the depth, angulation and diameter of the implant). Sometimes it even dictates the implant position. From a surgical perspective, soft tissue height, position and thickness need to be diagnosed and corrected when needed. From the prosthetic point of view, the emergence profile has to be created to mimic the natural appearance and maintained over time in respect to the biological changes. The course teaches step by step how to be successful with implant prosthetics from single tooth, partially edentulous to full arch reconstruction.

Surgical Veneer Grafting Protocol: Step-by-Step Utilization in the Esthetic Zone
In the lecture, are discussed all the parameters to achieve the correct diagnosis of the socket and the various treatment plan correlated to each anatomical type of socket. The Dual Zone approach (bone zone and tissue zone) will be evaluated and discussed in detail, regarding each of their variables. In the surgical part, it will be described the criteria necessary for successfully utilizing minimally invasive protocols within the esthetic zone and the possibility of placing or not placing a bone graft in the “gap” and the opportunity to use a connective tissue graft to overbuild the site bucco-lingually, performing the Surgical Veneer Grafting Protocol, idea'ed by the Agnini brothers.

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.

Esthetic Periodontal Surgery: Making Recession Defects Disappear by Grafting
Expert discussion of soft tissue grafting; first an overview of current trends, the second showing a specific allograft technique for treating multiple adjacent recession defects.