Modern Periodontal Care: Tissue-Preserving, Minimally Invasive Solutions

Lesson 1: Periodontal disease treatment options: the development of non-surgical approaches

This lecture focuses on the description of non-surgical treatment options in periodontal therapy for the management of inflammatory and infectious processes. By describing different clinical cases, the author identifies the fundamental parameters that allow to designate a patient for non-surgical therapy: timing, expectations, objectives, instruments and clinical indications for antibiotic use.

Duration: 1 h 18 min

Lesson 2: Periodontal disease treatment options: minimally invasive surgical approaches

The aim of this lecture is to offer a description of the latest minimally invasive surgical approaches in periodontal regeneration, involving new techniques, new materials and a deeper knowledge of the periodontal disease. Through an extensive collection of clinical cases, the author compares periodontal defect treatment options, highlighting the ratio of biological costs/treatment objectives and long term predictability.

Duration: 1 h 28 min

Lesson 3: Minimally invasive clinical crown lengthening

A practical guide to minimally invasive surgical techniques for exposing more tooth structure, preserving soft tissue integrity.

Duration: 07 min

Lesson 4: Mucogingival surgery on multiple recession with collagen matrix

Learn how to manage multiple gingival recessions using a collagen matrix for soft tissue augmentation and healing.

Duration: 18 min

Lesson 5: Tunneling technique for root coverage

Step-by-step technique of creating a tunnel for root coverage using connective tissue grafts, minimizing trauma.

Duration: 26 min

Lesson 6: Entire papilla preservation technique

A surgical protocol to maintain interproximal papilla while gaining access to the defect, ensuring aesthetic results.

Duration: 22 min

Lesson 7: Minimally invasive approach to deep intrabony defects on elements 14 and 15

This video shows the surgical treatment of deep intrabony defects on a patient previously subject to non-surgical periodontal therapy. The positive outcome of the non-surgical therapy allows the author to observe a minimally invasive approach to the defects, thanks to a single-flap approach (described in the literature by Trombelli and Cortellini) that does not move the papillas and leaves a very narrow yet functional access to the defects.

Duration: 18 min

Lesson 8: Single flap approach in periodontal regeneration

This video shows the surgical treatment of a deep intrabony defect (9 mm) on a patient previously subject to non-surgical periodontal therapy. The elements subject to treatment are 24 and 25, the latter being very palatal and presenting non-optimal access to the defect. The single flap approach is therefore modified with a minor medial vertical releasing incision in order to improve visibility.

Duration: 14 min

Lesson 9: Periodontal regeneration in interproximal crater and papilla management with minimally invasive approach

The video shows the surgical treatment of a deep periodontal defect on element 46. The minimally invasive approach observed allows to avoid releasing incisions, while great attention is paid to the description of those surgical details that make a great difference in periodontal regeneration, especially in terms of flap management and non-surgical therapy related scar tissue removal. The final Laurell-Gottlow suture is finely described in order to outline the details of wide papillas management.

Duration: 28 min

Lesson 10: Regeneration of the periodontal interdental attachment in a Perio-Proshodontic case

Interproximal clinical attachment loss near a tooth with an old crown, and the adjacent tooth with radiographic bone loss but with a good clinical attachment level, is a frequent clinical situation. The possibility to maintain the natural tooth and the attachment of the neighbor tooth is definitely the most conservative and appropriate choice.

Watching this video you will learn:

• Criteria when to keep or extract teeththe pero-prosth operative sequence
• Intra-surgical prosthetic tooth preparation
• Intra-surgical prosthetic relineregenerative surgical technique

Duration: 24 min

Lesson 11: Soft Tissues and Implants: Tunneling with Connective Tissue Graft

The presence of multiple recessions near implants in posterior areas of the lower jaw is a clinical situation that must be correct especially when little width of keratinized tissue is present. In this case the primary aim is to increase the soft tissue thickness.

Watching this video you will learn:

• How to improve the soft tissue quality near implants
• Surgical instrumentshow to prepare the tunnelhow to harvest the connective tissue graft from the palatesuture technique to stabilize the tissues in correct position

Duration: 27 min

Lesson 12: Tunnelling with connective tissue graft 44-45-46

The tunnelling technique for root coverage procedure is indicated for multiple recession therapy, especially when little width of keratinized tissue is present. this technique, apparently simple, require a precise knowledge of each step.

Watching this video you will learn:

• Indications for tunnelling technique
• Surgical instrumentshow to prepare the tunnelhow to harvest the connective tissue graft from the palatesuture technique to stabilize the tissues in correct position

Duration: 31 min

Lesson 13: CAF + Fibro-Gide matrix for single recession

The autologous connective tissue graft is indicated when the phenotype of the site is thin. When a single recession in the upper jaw and a medium thickness must be treated, the biomaterial of choice to stabilize the clot and the flap can be a matrix.

Watching this video you will learn:

• Surgical technique of coronally advanced flap to treat single gingival recessionwhen to use a matrixhow to use the Fibro-Gide matrix (Geistlich)suture techniques

Duration: 22 min

Lesson 14: CAF + Connective Tissue Graft for single recession thin phenotype

The elective therapy to treat single gingival recession, when at least 2mm of keratinized tissue is present apical to the recession, is the coronally advanced flap. When the phenotype (the gingival thickness) is thick it is not necessary to add a connective tissue graft, on the contrary when the tissue is thin it is indicated to add an autologous connective tissue graft harvested from the palate.

Watching this video you will learn:

• Surgical technique of coronally advanced flap to treat single gingival recessionwhen is necessary to add the connective tissue harvested from the palatehow to harvest the connective tissue from the palatesuture techniques

Duration: 25 min

Lesson 15: Tunnelling + Connective Tissue Graft for lower multiple recessions

The tunnelling technique for root coverage procedure is indicated for multiple recession therapy, especially when little width of keratinized tissue is present. this technique, apparently simple, require a precise knowledge of each step.

Watching this video you will learn:

• Indications for tunnelling technique
• Surgical instrumentshow to prepare the tunnelhow to harvest the connective tissue graft from the palatesuture technique to stabilize the tissues in correct position

Duration: 32 min

Lesson 16: Regenerative procedure in lower furcation class II

When the periodontal disease involve the furcation, the tooth prognosis is seriously compromised. Very important is an early diagnosis, the inflammation control by means of an adequate initial therapy and when the furcation involvement is of II grade it is possible to apply a regenerative procedure to favorably modify the prognosis.

Watching this video you will learn:

• When is indicated to use a regenerative procedure to treat furcation defects
• The surgical technique in case of optimal soft tissue conditionshow to properly clean the defect
• The choice of the biomaterialsuture technique

Duration: 17 min

Lesson 17: Regenerative procedure in upper furcation class II and Connective tissue graft

When the periodontal disease involves the furcation of the upper jaw, considering the anatomy, the tooth prognosis is severely compromised. If we add the presence of a gingival recession and a thin phenotype the clinical case become very difficult, because to the regenerative therapy of the furcation is necessary to add a coronally advanced flap and the positioning of a connective tissue graft to correct the gingival phenotype.

Watching this video you will learn:

• Extremely advanced case, to apply a regenerative technique and simultaneously improve the soft tissue and a area with difficult access and with a complicated anatomyhow to design a flap for regenerative and mucogingival techniques
• How to harvest the connective tissue graft in a palate with unfavorable anatomythe choice of the biomaterialshow to release the periosteumthe suture in 2 steps, how to stabilize the graft and the flap

Duration: 32 min

Lesson 18: Where are the limits in periodontal therapy

A reflective and integrative session reviewing the boundaries of what periodontal therapy can achieve with current techniques and materials.

Duration: 1 h 12 min