Perio-Prosthetic Decision Making for Peri-Implant Esthetic Complications

Implant esthetic complications are rarely a soft tissue problem alone. Implant position, adjacent attachment, and restorative contour set the bar for what surgery can achieve. This lecture presents a perio-prosthetic decision blueprint for when to keep or remove the restoration, when to maintain or explant the implant, and how to perform a VISTA approach with different graft materials.

Learning Objectives

• Assess the risk factors for peri-implant soft tissue dehiscence and predict achievable coverage
• Select between prosthetic correction, VISTA coverage, submergence with re-restoration, and explantation
• Describe the VISTA sequence and justify graft selection

A Modified “Double-VISTA” Technique for Managing Non-Carious Cervical Lesions

Gingival recession is a multifactorial condition influenced by a combination of predisposing and precipitating factors. Non-carious cervical lesions (NCCLs) are frequently associated with gingival recession and present unique challenges due to their complex pathophysiology. This lecture presents a periodontal-restorative approach for managing multiple adjacent NCCLs using connective tissue grafts (CTGs) combined with a modified vestibular incision subperiosteal tunnel access (VISTA) technique. By employing two or more vestibular incisions, clinicians can facilitate tunnel access, CTG insertion, and coronal repositioning of the gingival margins. Several clinical cases will be reviewed, highlighting the principles and outcomes of this modified VISTA approach for achieving predictable root coverage, even at sites where the maximum achievable root coverage is predetermined.

Educational Objectives

• Describe the etiology and pathophysiology of gingival recession associated with NCCLs and the challenges in their management
• Understand the principles and stepwise technique of the modified “Double-VISTA” approach, including CTG placement and coronal repositioning of gingival margins
• Evaluate clinical outcomes and decision-making considerations for achieving predictable root coverage in sites with multiple adjacent NCCLs

Modern Implantology: Fast Track to Function and Esthetics

The field of implant dentistry has undergone a transformative evolution, driven by advances in digital technology, biomaterials, and surgical protocols. This lecture explores the latest innovations that enable clinicians to achieve predictable, efficient, and esthetically pleasing outcomes with minimal patient morbidity and reduced treatment times. It focuses on immediate implant placement and loading, digital workflow integration, soft tissue management, and the role of guided surgery in optimizing esthetic zones, with emphasis on evidence-based approaches that align biological principles with modern restorative demands, providing a streamlined pathway from extraction to final restoration. Attendees will gain insight into contemporary strategies that accelerate functional rehabilitation while preserving, and even enhancing, esthetic outcomes.