Pikos Symposium 2024

Dr. Sophia Aroca has been practicing Periodontology and Implantology exclusively since 1996.

Parallel to her private practice, she never stopped  doing clinical research, teaching activities and lecturing around the world.

She is Visiting Professor in the Department of Periodontology at Bern University , Switzerland .

Dr. Aroca has been awarded a PhD  degree at  the University of Szeged, Hungary in 2011 and was also awarded of an honorary professorship at the same University in 2012.

Her dream came true in 2018 where she co-created a Continuing Education and Clinical Research Center in Paris, France.

In 2019, Dr. Aroca was elected to the Osteology expert council.

Main Podium Lecture

Multiple Coronally advanced flap vs Modified coronally advanced tunnel technique: A decision making process for treatment of multiple recession type defects

For recession coverage, the most studied and cited surgical technique in the literature is the coronally advanced flap with a connective tissue graft (CAF + CTG) as the meta-analyses from several systematic reviews showed the greatest potential for recession reduction and complete root coverage. Therefore, the CAF+CTG being the “gold standard” is still the approach of choice so far. However, we can take issue with this statement when we face multiple recessions because of the increased biological and anatomical complexity.

Several surgical techniques for the treatment of multiples recession type defects have been evaluated in different type of studies ( RCT,Meta-analyses, systematic reviews) among them the Multiple coronally advanced flap (MCAF) and Multiple coronally advanced Tunnel (MCAT). These two techniques showed their capacity to reach the previous objective requirement (i.e. CRC) as long as they are adapted to thoroughly evaluated clinical situation. Therefore, the treatment of multiple recession with a single surgical technique is a more complex task, since the diversity of anatomical condition in any single tooth , the wider avascular areas, and the position of the teeth.

Various elements must be taken into account at the initial evaluation. So far, there is no a clear distinction in which of them are major or minor determinants and how they influence the surgical choice and the decision making process is still a hard task for the surgeon.

The aim of this presentation is to share a decisional making process based on literature and clinical experience to identify the most indicated surgical procedure for the treatment of multiple recession type defects in any particular anatomic conditions.

Learning objectives:
• To understand the biological and anatomical bases of the two most used surgical techniques for multiple recession coverage.
• To clearly differentiate the major determinants for the right choice of the surgical procedure.
• To learn how to apply the decisional making process to achieve predictable results in the most complex clinical cases.

Hands-on Workshop with Dr. Massimo de Sanctis (Wednesday, October 2, 2024 | 8:00am - 5:00pm)

Periodontal Plastic Surgery

• Periodontal plastic surgical procedures aiming to treat multiple recession defects have been extensively described in the literature. Most of them can be combined with CTG or with soft tissue substitutes in order to increase the marginal gingiva thickness which in turn ensures the long term stability.
• Nevertheless, the surgical techniques used are very technical sensitive and need a deep knowledge on behalf of the clinician in order to obtain predictable results.
• The course will focus on presenting step by step of the tunnel technique and a comprehensive philosophy of surgical risk factors which need to take into account to optimize the clinical outcomes. Clinical cases and surgical techniques using connective tissue grafts and a new resorbable matrix will be demonstrated.

Dr. Alberto Fernandez

• Bachelor in Medicine and Surgery UNAV.
• Specialist in Stomatology UNIOVI
• Specialist in Occlusion, Dysfunction and Oral Rehabilitation CEU
• Specialist in Oral Surgery by the UIB
• Director of the Master's Degree in Oral Surgery, Implantology and Aesthetics UIB
• Professor at Alfonso X el Sabio University.
• Master Oral Surgery and Implantology Professor UV
• Professor at Salamanca University. Diploma of specialization Advanced Implantology on maxillary buttresses
• Co-author of the book “Immediate Implantology” Ripano 2007.
• Co-author of the book "Complications in Implantology" Ripano 2012
• Co-author of the book "Atlas of Zygomatic Implants" Libermed 2020
• Author of the book "All about Zygomatic Implants" Quintessence (launch 2024)
• Medical Director of the Portal of Oral Surgery and Implantology www.oralsurgerytube.com

Main Podium Lecture

Zygomatic Implants and Innovative Bone Regeneration Techniques: A New Approach to Prevent Complications.

In recent times, the use of zygomatic implants has become popular. However, surprisingly, they have been proposed as an alternative to bone regeneration techniques. Throughout this presentation, we will share key aspects for a proper diagnosis of each case, enabling appropriate surgery to minimize the incidence of complications.

Learning Objectives:
• Provide an update on the latest trends in zygomatic implants.
• Make zygomatic implants more accessible to general implantologists.
• Provide appropriate theoretical training for the described techniques.

Dr. Joseph Kan

Dr. Joseph Kan received his Prosthodontic and Implant Dentistry training from Loma Loma University (LLU) in 1997. He is currently a Professor at LLU and also maintains a private practice.

He has received numerous awards and recognition throughout his career, including the 1997 Academy of Osseointegration (AO) Best Research Award, 2003 Judson Hinckey Scientific Award from the Journal of Prosthetic Dentistry and the 2005 Robert James Implant Dentistry Award. In 2019 he was given Honorary Membership by the UK Association of Dental Implantology and received the LLU Distinguished Research Award and Greater New York Academy of Prosthodontist Distinguished Speaker Award in 2020. Most recently Dr. Kan received the American Academy of Periodontology (AAP) Honorary Membership for contribution to the field of Periodontology as well as the Clinical Research Award in 2021.

He serves on the editorial boards of the International Journal of Esthetic Dentistry, and the Journal of Esthetics and Restorative Dentistry and was the Program Chairman for the 2018 AO Annual Meeting and is currently a member of the AO Executive Board of Directors. He performed a live surgery at the 104th AAP Annual meeting in 2018. In 2017, Fardi et al (Int J Maxillofac Implants), listed 4 of Dr. Kan’s publication as the Top 100 cited articles in Implant Dentistry. In 2020, Praveen G et al (J Prosthet Dent), cited 2 of Dr. Kan’s publications as the top 100 most cited articles in Prosthodontics. Besides lecturing nationally and internationally, Dr. Kan has published over 140 referenced articles and book chapters on interdisciplinary treatment planning, periodontal peri-implant tissue management, and immediate tooth replacement concepts.

Main Podium Lecture

Anterior Immediate Tooth Replacement: Lessons learned over 27 Years

Achieving anterior implant esthetics is challenging. To create implant restorations with harmonious gingival contour that emulate nature is a fusion of science and art. Understanding biologic and physiologic limitations of soft and hard tissue will facilitate predictability in simple to complex esthetic situations.

This presentation will focus on anterior immediate implant tooth replacement philosophies and methodologies. Emphasis will be placed on diagnosis and treatment planning, surgical, prosthetic and complications management for anterior implant.

Dr. Ricardo Kern

Firmly entrenched within the high aesthetic requirements of Brazilian dentistry, Dr. Kern had focused my work on the demanding soft tissue design and reconstruction disciplines.

Vast experience in immediate implant placement with temporization, from single tooth to full arch rehabilitation. Have been invited to lecture and to do training about the soft tissue (design, preservation, and reconstruction) on several postgraduation courses as well as congress and seminars from Latin America to overseas.

Main Podium Lecture

Aesthetic and Biology Behind Immediacy

The quality and design of the tissues surrounding implants are not only important for longterm
maintenance but fundamental for aesthetic purposes.

Delivering “pink-free” restorative solutions over implants requires the full presence of the
gingival contour, natural emergence profile, and respect for the aesthetic proportion ratio of
crowns and bridges. Achieving the perfect balance between pink and white contour is a Key
point.

Immediate extractions can present an outstanding initial situation of tissue contour. In these
cases, preserving the gingival “frame” is the goal of our treatment. Atraumatic extraction, the
proper 3D position of the implant, primary stability, gap grafting, and soft tissue phenotype
modification are on the protocol of immediacy in fresh sockets! But much more than the
basic, the knowledge about the biology of peri-implant remodeling after extraction,
abutment/provisional design, and minor surgical maneuvers can boost aesthetic results,
bone formation, and long-term tissue stability!

This lecture addresses the workflow for implant immediacy cases in the aesthetic zone and
how to achieve superior results from tissue remodeling.

Learning Points:
• Critical points for long-term bone and soft tissue maintenance. How to build up a solid
and healthy peri-implant tissue!
• Increasing thickness of peri-implant tissue with prostéticas design.
• Inter-proximal bone peaks between two implants, how to improve the width and vertical
position!
• How to use the Gingival Condition Cast and the Gingival Impression Index.

Dr. George Kotsakis

• He is a clinical researcher focusing on bone regeneration procedures in Implant surgery and Peri-implantitis Therapy. At Rutgers, he directs the NIH-funded Translational Periodontal Research Lab conducting research on the biological mechanisms underlying peri-implant bone loss and developing novel treatments for dental and biomedical implants. Dr. Kotsakis has published over 100 peer-reviewed scientific articles and textbook chapters with nearly 20,000 citations of his work (h-index: 36). He is one of the few Dental researchers to have been published in prestigious medical publications, such as the Lancet, the BMJ and PNAS.  

• He has been the recipient of multiple career and research awards from the American Academy of Periodontology, the Academy of Periodontology Foundation, the IADR, and other organizations including: 

• Clinical Research Award, American Academy of Periodontology                      2022 
• IADR Sigmund Socransky Award                                                                 2022 
• IADR Innovation in Implantology Research Award                                         2022 
• AAP Teaching Fellowship, American Academy of Periodontology                      2016 
• Clinical Science award, American Academy of Periodontology                         2015 

Main Podium Lecture

An evidence-based roadmap to successful peri-implantitis management

Peri-implantitis has been receiving attention following recent studies that showed that it is highly prevalent and difficult to manage. This lecture will provide the latest evidence-based information on peri-implant diseases with emphasis on the role that titanium particle release has in destructive bone inflammation around implants. Strategies for prevention and mitigation will be presented through clinical cases.

Learning Objectives:
• Define peri-implantitis and diagnostic criteria.
• Understand the interactions between biological peri-implant environment, oral bacteria and biomaterial that lead to titanium release
• Review the role of titanium in perturbing oral tissue homeostasis
• How to appropriately clean implants without releasing titanium particles.

Dr. Henriette Lerner

Henriette Lerner PhD, FDS RCS, is specialist in oral surgery, focusing on implantology and aesthetics.

She is owner and director of HL Dentclinic and Academy in Baden-Baden, Germany, an academic clinical, teaching and research facility of the Johann Wolfgang Goethe University, in Frankfurt on Main, Germany.

Dr. Lerner is Past President of the Digital Dentistry Society International (DDS), holds a Doctor of Philosophy on the topic of Digital Dentistry. In addition, she is visiting Professor at Universiapolis, International University of Agadir and a Fellow of the Royal College of Physicians and Surgeons in Glasgow.

Dr Lerner actively contributes to the field of digital dentistry, AI and dental technology through education, research, publications and product development. Her work spans the fields of clinical oral research, complex implant cases in esthetic and function, soft and hard tissue augmentation, biomaterials research as well as occlusion in complete oral rehabilitation:

• Board Member & Expert for the German Society of Oral Implantology
• Board Member and Past President of the Digital Dentistry Society International (DDS)
• Editorial Advisor for 4 scientific journals
• author of numerous scientific papers
• Coauthor in: Esthetics in Dentistry – Implant Esthetics – Digital Occlusion in Implant Rehabilitation
• Coeditor and coauthor of the book Digital Dentistry Science and Clinics
• Autor of the Book Oral Implantology / Handbook for Patients (German)
• Contributed to the development of two implant systems, dental Apps and surgical instruments

Main Podium Lecture

Innovative Digital Technologies in 3 D Bone and Soft Tissue Grafting. A scientific and clinical update.

Bone Autograft is still considered to be the gold standard but it is also associated with disorders at the site of collection and poor availability. Allografts and xenografts carry the risk of excessive immune reaction. Reconstruction of the defect in bone tissue as a surgical procedure is a time-consuming and technically difficult process. Milling and printing ( 3 D additive Manufacturing) of Bone and Tissue in the specific volume and structure previously 3 D planned seem to be the next step.

Oral soft tissue defects are a frequently encountered problem in dental praxis. The autologous graft as gold standard for gingiva and oral mucosa augmentation, causes prolonged pain, limited amount of harvested tissue, and increased risk of infection have prompted the search for off-shelf alternatives. Several acellularized dermal matrices have been studied without satisfactory results. A newly developed collagen-based sponge is currently in clinical studies for long term evaluation. In these approaches however, the matrix needs to be tailored chair-side for each specific defect. 3D printing technology represents a promising solution as it offers precise production of an individualized 3D graft based on a defined shape and inner structure via a specific computer-aided design using a biomaterial of choice.

Learning Objectives:
• State of the Art virtual planning and digital manufacturing Bone Grafting will be shown in science and clinics
• State of the Art of virtual planning of Soft Tissue grafting and the newest digital manufacturing technologies will be shown in science and clinics
• A view to more advanced digital technologies will be illustrated .

Dr. Ramon Gomez Meda

• Degree in Dentistry from the University of Santiago de Compostela
• PHD In Oral Pathology and Health by the University of Sevilla
• Thesis Award of the Autonomous Community of Galicia for Academic Excellence
• Postgraduate training in Periodontics and Implantology (Madrid); Occlusion and Temporo-mandibular Dysfunction (Valencia) and Orthodontics (University of Santiago de Compostela).
• International speaker on Periodontics, Esthetic Dentistry and Multidisciplinary Treatments.
• Director of two years Master program in Implants and Implant Prosthesis. UAX
University (Madrid, Spain)
• Director of Post-graduate program in Implants and Implant Prosthesis. UAX University (Madrid, Spain)
• Adjunct Assistant Professor of the Department of Prosthodontics at LSUHSC School of Dentistry (New Orleans, Louisiana, USA)
• Founder of MEDA Training Center, Spain

Main Podium Lecture

The use of digital technologies and new biomaterials for bone augmentation: When, where and how to use them

In recent years, dentistry has seen remarkable advancements in technology and materials which allow the clinician to plan clinical cases better by virtually placing implants in the ideal 3D position.

These advancements have also benefited bone augmentation procedures, but is it worth implementing them in every single case? What about new biomaterials? Are they always the best option? Many questions are still in the pipeline for clinicians because strong evidence about these new workflows has not been provided.

The aim of this lecture is to answer these questions by discussing the advantages and indications of these workflows, as well as their disadvantages.

Learning Objectives:

• Understand the advantages of digitally planning cases with severe bone defects.
• Recognize when digital workflows can become time-consuming and not worth implementing.
• Know how to use new biomaterials to reduce patient treatment time, cost, and morbidity.

Hands-on Workshop (Wednesday, October 2, 2024 | 1:30pm - 5:30pm)

Soft tissue management during and after bone reconstruction:

When severe bone defects are present, to properly release the tension of the flap is mandatory in order to avoid a wound dehiscence. Moreover, after the bone regeneration procedure, the mucogingival junction position will be displaced and it will be necessary to apply different mucogingival techniques to correct such a situation.

This workshop will tackle the management of soft tissues during and after the bone augmentation procedure to ensure predictable results. The attendee will learn how to perform: Coronally reposition flap management and flap releasing technique. A free gingival graft plus vestibuloplasty. Onlay grafts for vertical soft tissue reconstruction.

Dr. Richard Miron is currently lead educator and researcher at Advanced PRF Education and an Adjunct Visiting Faculty in the department of Periodontology in Bern, Switzerland where he completed his PhD studies since 2009.

He has currently published over 350 peer-reviewed articles and lectures internationally on many topics relating to growth factors, bone biomaterials and guided bone regeneration.

For the past 5 years, Dr. Miron has been recognized by Dentistry Today as being one of the top 100 CE providers in the country and the youngest to ever make the list. He is also the top ranked researcher on Platelet-Rich Fibrin therapy as per Expertscape independent review.

He has recently been awarded many recent international prizes in dentistry and is widely considered as one of the top contributors to implant dentistry having won the ITI Andre Schroeder Prize, the IADR Young Investigator of the Year in the field of Implant Dentistry as well as the IADR Socransky Research award in the field of Periodontology (2020).

He has written 8 textbooks widely distributed in regenerative dentistry including his best-seller in 2019 titled: “Next Generation Biomaterials for Bone and Periodontal Regeneration” and “Understanding Platelet Rich Fibrin” in 2021.

Main Podium Lecture

PRF and Exosomes: A Perfect Marriage in Regenerative Medicine

Platelet rich fibrin (PRF) has been utilized in regenerative medicine and dentistry for nearly 3 decades owing to its ability to speed both hard and soft tissue regeneration. Today, as a standard, implant dentists rely on PRF to improve soft tissue healing around grafted/implant sites as well as to improve the handling of bone grafting particles. It is interesting to note that PRF was FDA approved in the early 2010s and it took over a decade before most clinicians adapted the technology in their practice. Many improvements to the technology have been pioneered within our research and clinical affiliates to provide clinicians the most effective means possible to produce proper platelet concentrates within their facilities.

Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with a diameter range of 30–150nm. Their use has gained great momentum recently due to their ability to be utilized as therapeutic options. In simple terms, PRF publications tend to produce roughly 500 publications per year whereas over a 10 fold increase in publications (over 5,000) are currently being published yearly on the topic of exosomes. This number is only expected to dramatically increase as novel therapeutic strategies continue to be investigated. This talk first focuses on understanding exosomes, including their cellular origin, biogenesis, function and characterization. Thereafter, overviews of their therapeutic potential as novel therapeutic options in regenerative medicine with a high focus on dental applications will be discussed.

Highlights:
• Provide an overview of the top 20 improvements in PRF therapy over the past decade to maximize clinicians use of the technology.
• Provide a general understanding of exosomes and their massive potential to help dentists performing regenerative protocols in implant dentistry and periodontology
• Highlight the use of exosomes and PRF in combination approaches in regenerative medicine

Hands-on Work Shop 1 (Wednesday, October 2, 2024 | 8:00am - 12:00pm)

New Trends in PRF therapy

This hands-on course will cover all the new advancements made with respect to the newest formulations of platelet concentrates. These will cover how to make custom-shaped PRF grafts, how to better concentrate liquid-PRF and will provide a better understanding for optimization of the protocols utilized in every day dental practice.
Thereafter, the Bio-Heat technology will be presented. This will cover the heating steps necessary to extend the working properties of PRF from a fast-resorbing 2-3 week membrane towards a membrane that lasts 4-6 months. Various protocols will be demonstrated whereby clinicians will learn how to make an extended-PRF membrane that lasts 4-6 months, as well as how to make a novel sticky bone that contains an outer e-PRF membrane that may be utilized for ridge augmentation procedures.

• Optimization of protocols for any centrifugation device
• Update on Bio-Heat technology and the ability to extend the working properties of PRF from 2-3 weeks to 4-6 months
• Improve cell and growth factor release using concentrated-PRF (C-PRF) protocols when compared to traditional injectable-PRF (i-PRF) on any centrifugation device
• Launch of the Bio-Cool technology
• Importance of PRF tubes for the fabrication of PRF
• Coupon code for Free access to an online 8CE program at www.prf-edu.com

Hands-on Workshop 2 (Wednesday, October 2, 2024 | 1:30pm - 5:30pm)

Natural Regeneration using Platelet Rich Fibrin in Facial Esthetics

Facial aesthetics is booming globally, offering vast opportunities for dentists. Both novice and experienced practitioners seek convenient, safe, and effective therapies to meet growing patient demands.

This workshop focuses on a 100% natural approach using platelet-rich fibrin (PRF), a well-established method in regenerative medicine now entering the medical aesthetic realm. Through innovations like Bio-Heat Technology, PRF's resorption period can be extended from 2-3 weeks to 4-6 months, yielding a long-lasting biological filler.

Combining PRF with techniques like micro needling (the 'Vampire Facial') promotes collagen synthesis and soft tissue regeneration naturally. This approach, pioneered by www.care-esthetics.com, reflects a rising trend of dentists providing facial aesthetic services in their offices.

Highlights:
• Understanding the potential for dentists to offer additional services in this 100+ Billion dollars Industry.
• Demonstrations and practice on how to perform micro-needling procedures with PRF
• Presentation regarding multi-level branding using CARE Esthetics specific to dentistry
• Coupon code for Free access to an online 8CE program at www.prf-edu.com

Dr. Michael A. Pikos is originally from Campbell, Ohio. He attended The Ohio State University where he graduated Summa Cum Laude and Phi Beta Kappa. He also graduated with honors from The Ohio State University College of Dentistry. Dr. Pikos completed an internship at Miami Valley Hospital and residency training in Oral & Maxillofacial Surgery at the University of Pittsburgh, Montefiore Hospital.

He is a Diplomate of the American Board of Oral and Maxillofacial Surgery, Diplomate of the American Board of Oral Implantology/Implant Dentistry, Diplomate of the International Congress of Oral Implantologists and a Fellow of the American College of Dentists. Dr. Pikos is the recipient of the 2006 Aaron Gershkoff Memorial Award from the American Academy of Implant Dentistry and the 2015 Saul Schluger Memorial Award for Top Educator. He is also the first recipient of the Carl E. Misch Advanced Dental Implant Studies Education Award (2017).

He is an Adjunct Assistant Professor, Department of Oral & Maxillofacial Surgery at The Ohio State University College of Dentistry and Nova Southeastern University College of Dental Medicine. He is also a Courtesy Clinical Associate Professor, Department of Periodontology and Department of Prosthodontics at the University of Florida College of Dentistry, Adjunct Professor, Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Greece, School of Dentistry, and Adjunct Associate Professor, Department of Periodontology, University of Alabama at Birmingham.

Dr. Pikos is on the Editorial Board of the following journals: Implant Dentistry, Inside Dentistry, the Journal of Esthetic and Restorative Dentistry and the Journal of Implant and Advanced Clinical Dentistry.

As an OMS, he is one of the first clinicians to recognize the relevance of Cone Beam CT and interactive CT technology for comprehensive diagnosis and treatment planning along with its implementation for implant based oral rehabilitation. As a result, Dr. Pikos has made this high technology a cornerstone of both his private practice and Institute.

Dr. Pikos has extensive experience in hard and soft tissue procedures and has placed more than 35,000 implants since 1983. He also emphasizes interactive CT technology along with foundational principles of prosthetics and biomechanics that dictate the ultimate success of comprehensive implant rehabilitation.

Dr. Pikos is the author of the book “Bone Augmentation in Implant Dentistry” published by Quintessence Publishing. He has lectured extensively on dental implants in North and South America, Europe, Asia, and the Middle East. Dr. Pikos is an active member and frequent lecturer for the American Association of Oral and Maxillofacial Surgeons, the American Academy of Periodontics, the Academy of Osseointegration, the American Academy of Implant Dentistry and the International Congress of Oral Implantologists.

Dr. Pikos is founder and CEO of the Pikos Institute. Since 1990 he has been teaching advanced bone and soft tissue grafting courses along with full arch immediate reconstruction courses with alumni that now number more than 6500 from all 50 states and 67 countries. Dr. Pikos maintains a private practice which is limited exclusively to implant surgery in Trinity, Florida.

Main Podium Lecture

Sinus Grafting 34 Years: Clinical Myths and Realities

This clinical based presentation is based on the presenter’s 30+ years of experience with more than 1500 sinus grafts. It will focus on 12 commonly held myths of lateral wall and crestal sinus grafting and will provide evidence-based data as well as long term clinical data to explain the realities of these myths. Included in this presentation will be the biology of the sinus membrane and graft materials, membrane anatomy and physiology, management of large and complete membrane perforations, and grafting in the presence of pathology for both lateral wall and crestal sinus grafts.

After this presentation, attendees will:
1. Differentiate clinical myths and realities of lateral wall and crestal sinus grafting.
2. Understand the evidence base for predictable long-term results with lateral wall and crestal sinus grafts.
3. Understand management of sinus graft complications including large and complete membrane perforations, along with sinus grafting in the presence of pathology.

Pikos M.A. Case Report: Sinus Grafting in the Presence of a Large Mucous Retention Cyst, Journal of Clinical & Practical Oral Implantology, 2010 Vol.1:2, pg.5-14.

Pikos MA. (2006). Complications of Maxillary Sinus Augmentation. In Ole Jensen’s, The Sinus Bone Graft, Second Edition. (103-114). Hanover Park, IL: Quintessence Publishing Co, Inc.
Pikos MA. Maxillary sinus membrane repair: report of a technique for large perforations. Implant Dentistry 1999;8(1):29-34.

Dr. Massimo de Sanctis

• In 1982, graduated in Periodontology at Boston University., where he also obtained a Master of Science degree in Periodontology for an experimental study which he conducted between 1982 and 1983

• In 1987, dr de Sanctis was appointed professor of Periodontology at the II University of Rome where he taught until 1989

• From 1989 to 1999 he has held various teaching positions at the University of Bologna

• From 2000 to 2014  he was  professor of Periodontology at the University of Siena

• From 2015 he was nominated Professor at the University Vita-Salute San Raffaele Milano

• He is chair of the program of Periodontology

• Director of the Clinical Department of Periodontology

• Author of more than 100 scientific articles

• He is Fellow of the International College of Dentistry,

• Member of the American Academy of Periodontology

• Past President of the Italian Society of Periodontology.

• Past president of the Italian Coordinating Committee for the Scientific Societies

Main Podium Lecture

The Selective Use of Connective Tissue Graft in Treating Multiple Gingival Recession

The multiple coronally advanced flap (MCAF), proposed by Zucchelli and de Sanctis (2000), has become
the most widely used root coverage procedure for multiple recession defects. It is the first-choice surgical technique in presence of an adequate keratinized tissue width (KTW) apical to the recession and it is very effective with advantages for the patients in terms of aesthetics and morbidity.

The use of a connective tissue graft (CTG) under MCAF has been introduced to increase the predictability of the procedure. The application of CTG is associated with the highest probability to obtain complete root coverage (CRC) as well as with an increase of gingival thickness (GT) and of the KTW over time.

Since very often teeth adjacent to each other present different phenotype, Stefanini et al. (2018)8 in a case
series proposed MCAF with site-specific application of CTG, reporting a significant increase in KTW in the
MCAF + CTG treated-sites compared with baseline.

Learning Objectives:
• A complete understanding of the specific characteristic of multiple recession type lesions
• A clinical and biological explanation of the use of a connective tissue graft
• A new surgical noninvasive technique effectively treat multiple recessions in esthetic areas of the mouth

Hands-on Workshop with Dr. Sophia Aroca (Wednesday, October 2, 2024 | 8:00am - 5:00pm)

Periodontal Plastic Surgery

• Periodontal plastic surgical procedures aiming to treat multiple recession defects have been extensively described in the literature. Most of them can be combined with CTG or with soft tissue substitutes in order to increase the marginal gingiva thickness which in turn ensures the long term stability.
• Nevertheless, the surgical techniques used are very technical sensitive and need a deep knowledge on behalf of the clinician in order to obtain predictable results.
• The course will focus on presenting step by step of the tunnel technique and a comprehensive philosophy of surgical risk factors which need to take into account to optimize the clinical outcomes. Clinical cases and surgical techniques using connective tissue grafts and a new resorbable matrix will be demonstrated.

Dr. Anton Sculean

Dr. Istvan Urban

Back to Pikos Symposium