A recent study (Stefanini et al. 2018), by providing greater soft tissue thickness to those defects starting with less KTH, underlines the effectiveness of CTG adjunct in the treatment of multiple gingival recession defects. This resulted not necessary for those gingival recessions with baseline KTH > 2 mm, which facilitated surgical stabilization of CAF and made patient plaque control and tooth brushing simpler and more efficacious. The only significant difference between defects treated with or without the CTG adjunct was the KTH variation over time. At year 3, there were no significant differences in KTH between the CAF and the CAF +CTG sites. It is still not clear if the increase in KTH can be ascribed to the tendency of the mucogingival line to regain its genetically determined position or to be a consequence of an induction caused by the quality of the connective tissue of the graft or, merely, of the exposure of connective tissue deriving from the palatal fibro-mucosa whether the graft don’t remain covered by the flap The objective of the conference will be to discuss the changes in the gingival dimensions following MCAF plus CTG, with regard to the width of keratinized tissue, and to identify the factors related to these changes.
The Umbrella Concept is more than a concept, it is the bibliographic review of many topics on the subject of preservation of the peri-implant marginal bone crest, of the three-dimensional position of the implant, of the gingival phenotype present at the time of implant placement. The three-dimensional vision of the emergence profile that the prosthesis on implants must have, the volume of the tissue around the prosthetic abutment, the biological space that must be created, the supra-crestal complex of the implant, all this makes said prosthesis have an aesthetic appearance. on a stable biology.
Fibrin Sealant (FS) is a drug of human origin used in general and specialist surgery for many decades. It is validated from over 6,000 papers in the literature. In oral surgery, FS enhances and maintains the natural clot. It has a hemostatic, adhesive, sealing and inductive action for hard and soft tissues. Mixed with biomaterials, it allows better management of the graft that, becoming plastic and adhesive, adapts perfectly to bone defects without shedding of granules. It also protects surgical wounds and stimulates faster soft tissue healing. The F.I.R.S.T., devised by Dr. Foti in 2016 and published in 2020, is based on the triad fibrin sealant, collagenated heterologous bone, collagenated heterologous lamina. In horizontal GBR the F.I.R.S.T. allows in simple and quick way a very stable complex lamina/graft, micro–movements free, essential pre–requisite for the neo–angiogenesis and the newly formed bone. Finally, it will be presented the “One–Time Cortical Lamina”, a variant of the F.I.R.S.T. technique particularly suitable for ASA II patients, where it is achieved a vestibular horizontal bone augmentation that not need surgical re–entry.
Today, there is a wide range of training available on surgical management of full-arch implant rehabilitations, for instance on All-on-4 technique, but uncertainty remains about the prosthetic issue, both provisional and definitive. The latter is still stressful for both clinicians and technicians, undermining the advantages resulting from the simplification of the surgical approach.
In fact, proposed protocols are often full of unnecessary steps and full of complexity. Our philosophy is to continuously update a complete protocol that will lead the dental team to a perfect aesthetic and functional outcome while dealing with advanced full-arch rehabilitations. This means SHORTER TIMES and LOW COMPLEXITY STEPS.
This allows to ‘switch off the brain’ and conduct cases automatically regardless of their apparent complexity, reducing stress and human error.
The dental prosthesis has a fundamental influence in the management of gingival tissues in prosthetic rehabilitation on natural teeth and implants. However, there are basic differences related to the different biological bases. These differences must be known to be successful in any area of the oral cavity, especially in the aesthetic area. The objective of the report will be to highlight these clinical differences and indicate how the prosthesis can optimize the aesthetic and functional results in relation to biological principles.
Management of peri-implant hard and soft tissues as a key to long-term success in the treatment of atrophic cases. Clinical and scientific evidence.
An apparently modern vision of implantology too often leads to therapeutic choices influenced by the contraction of surgical and prosthetic times that lead to underestimate the crucial importance of correct hard and soft tissue management of peri-implant tissues in relation to the final prosthetic result. This report aims to discuss clinical and scientific results of prosthetically and aesthetically guided regenerative methods in atrophic cases.