Recession coverage on teeth.

Management of Implants in the Aesthetic Zone.

Recession coverage on teeth and implants with the VISTA (Vestibular

Incision Subperiosteal Tunnel Access) Technique.

Soft tissue defects around teeth and implant are common. These can be managed

by treatment of gingival recession around teeth, as well as improvement of

soft tissue quality (keratinized gingiva). A variety of techniques are available for

soft tissue augmentation. However, the conventional techniques have a

number of limitations including, exposure of graft material due to flap opening,

scar formation at recipient sites due to surface incisions and relapse of recession

due to muscle pull during healing. This presentation will discuss the

various techniques and will introduce a novel, minimally invasive approach,

referred to as “vestibular incision subperiosteal tunnel access” (VISTA),

together with a method for stabilizing mucosal margins to achieve optimal

coronal positioning. The rationale and technique of VISTA will be presented

and illustrated with clinical cases.

Presentation objectives:

• Rationale and technique of VISTA for soft tissue augmentation around teeth and implants.
• Application of autogenous tissue, allograft, xenograft and growth factors for soft tissue augmentation.
• Video demonstration of the step-by-step VISTA procedure and suturing with bonded composite for soft tissue augmentation.

Management of Implants in the Aesthetic Zone with simultaneous hard

and/or soft tissue augmentation.

The management of implants in the aesthetic zone remains a clinical challenge.

Major ridge augmentation surgery involves high morbidity and long treatment

times for the patient and is technique-sensitive for the clinician. Implants

can be placed 6 to 8 weeks after extraction, once the soft tissue has healed.

At the time of early implant placement in the aesthetic zone, bone augmentation

is indicated to treat the common bone deficiency on the buccal and occlusal

side of the implant. A novel and simple technique will be presented (L-Shape

Technique) where a xenograft mixed with collagen will be trimmed into an

L-Shape and positioned simultaneous to the the implant, on its buccal and

occlusal side. This technique provides proper stability for the bone graft, resulting

in healthy and esthetic hard and soft peri-implant tissues.

Presentation objectives:

• Rationale for early and delayed implant placement with bone augmentation.
• Discussion of incision design, implant position, bone augmentation, membrane coverage and tension-free suturing.
• Step-by-step demonstration of the L-Shape bone augmentation surgery together with implant placement.