Osteocom Interproximal Attachment Gain and Papilla Reconstruction – Giulio Rasperini, Emilia Kazarian 2024

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Category: Periodontology Instructor(s): Giulio Rasperini, Emilia Kazarian Course structure: Lessons: 8 lessons | Duration: 6 h 58 min Course overview Who the course is for:For oral surgeons, periodontists, and implantologists with prior clinical experience who wish to deepen their knowledge of the latest and most advanced techniques for managing peri-implant disease and furcations, reconstructing the papilla, and regenerating interproximal attachment. Prof. Rasperini and Dr. Emilia Kazarian present a cutting-edge course focused on innovative techniques for interproximal attachment gain and papilla reconstruction. Using an evidence-based approach, the course aims to preserve natural teeth, enhance clinical outcomes, and establish regeneration as the new standard in periodontology. Participants will explore advanced methods for managing periodontal diseases, from early diagnosis of interproximal attachment loss to treating gingival recession and papilla loss. Emphasis is placed on shifting from traditional resective techniques to regenerative approaches. The lectures integrate advanced biomaterials and techniques tailored to various phenotypes and complex clinical cases. Key topics include managing papilla loss, treating infrabony and soft tissue defects simultaneously, and minimizing complications during regenerative procedures. The course features clinical videos and a live ReLIVE Surgery demonstrating the 3D Tunneling Technique. This allows participants to follow each step of the procedure, gaining a detailed understanding of its execution and potential in interproximal attachment reconstruction. Topics covered in the course:-New concepts and paradigm shift in the management of periodontal disease-The evolution of periodontal surgical techniques-Decision making for the treatment of interdental attachment loss-Periimplantitis: main role and step by step development of correct emergency profile-Soft tissue and bone regeneration: protocols, timing and biomaterials-3D Tunnelling Technique-Role of microsurgical approach-Classification of furcation defects-Furcation defects: regeneration, premolarisation and root resectionAt the end of the course, you will be able to:-Preserve and rebuild papilla and interdental tissue attachment-Know when is it truly necessary to extract teeth-Put infection under control through one-stage full-mouth disinfection and to slow or stop perimplantitis progression-Manage residual pocket depths-Treat type 3 recessions on upper and lower jaw-Regrow the interproximal attachment in teeth with suprabony defects and no intrabony component of the defect-Regrow the papilla in the upper jaw-Simultaneously regrow bone and soft tissue-Deal with black triangles, gingival asymmetry, and phonetic challenges Curriculum Redefining the concept of hopeless tooth In this first video lecture, Prof. Rasperini will redefine the concept of hopeless tooth by introducing a paradigm shift in the management of periodontal disease. Participants will deepen the importance of focusing on preserving natural dentition and re-evaluating tooth extractions. The lesson delves into the diagnosis and classification of periodontitis, highlighting the critical issue of interdental attachment loss rather than the traditional focus on pocket depth. Treatment goals will be discussed and, thanks to several clinical videos, Prof. Rasperini will show how to achieve infection control, reduce plaque levels and slow or stop the progression of periodontal disease also managing residual pocket depths. In particlar, this lecture covers the following topics: A new definition of success in Periodontology The management of severely compromised teeth How to treat and re-evaluate teeth before considering extraction Diagnosis and classification of perimplantitis How to identify the disease by observing the interproximal attachment loss Treatment goals, phases and the complete data collection The challenge of the interproximal attachment gain This video lesson explores a transformative shift in periodontal regeneration, moving beyond a sole focus on intrabony defects to emphasize the importance of interproximal attachment. The discussion delves into the challenges of gaining interproximal attachment and traces the evolution of techniques and biomaterials designed to address complex periodontal conditions. Prof. Rasperini will provide participants an overview of regenerative procedures over time, highlighting foundational studies in guided tissue regeneration and the essential elements for successful wound repair. The lesson examines the causes of papilla loss and outlines the clinical parameters to consider, such as papilla height, width, phenotype, and keratinization. The evolution of techniques and biomaterials is explored, showcasing how advancements have enabled the simultaneous treatment of infrabony and soft tissue defects. A detailed comparison between Emdogain and membranes underscores Emdogain’s advantages, including fewer complications and comparable surgical outcomes, supported by 25 years of follow-up data. In particlar, this lecture covers the following topics: The challenge of interproximal attachment gain and the evolution of techniques and biomaterials Guided tissue regeneration key studies over time Basic elements for wound repair Which is the cause of papilla missing? Advancements in regenerative materials and approaches In this video lecture, Prof. Rasperini explores how advancements in regenerative materials and approaches have enhanced clinical outcomes and minimized complications. Membrane-related complications are also discussed, providing insights into their impact on regenerative procedures. Practical strategies for managing papilla loss in cases of intrabony defects are presented, with techniques tailored to specific phenotypes. For thick phenotypes, approaches such as the Soft Tissue Wall Technique and CA+EPPT are examined. For thin phenotypes, solutions include Soft Tissue Wall combined with Connective Tissue (CT), Connective Tissue Wall, CA+EPPT, and AICAST. This lesson provides a comprehensive overview of state-of-the-art techniques and biomaterials, providing clinicians with the knowledge to optimize periodontal regeneration outcomes while addressing diverse clinical challenges. In particlar, this lecture covers the following topics: The simultaneous treatment of both infrabony and tissue defects How to manage membrane complications A comparison between the use of Emdogain and membranes What to do in case of papilla loss, thin phenotype and infrabony defect? What to do in case of papilla loss, thick phenotype and infrabony defect? Papilla loss and intrabony defect treatment possibilities This video lecture provides a historical overview of the treatment options for cases involving papilla loss and intrabony defects, tracing the evolution of techniques and approaches in periodontal therapy. Special attention is given to the Tunnel Technique, designed to manage deep attachment loss in challenging cases where pockets are present, but the papilla is absent. The importance of respecting soft tissues throughout the treatment process will be emphasized and participants will understand when to prescribe antibiotics and how to simultaneously treat intrabony and soft tissue defects. In particlar, this lecture covers the following topics: Deep attachment loss and no papilla: Tunnel Technique The proper healing time before undergoing surgery The treatment of infrabony defects with simplified approaches The simultaneous treatment of both infrabony and soft tissue defects Periodontitis - the sixth most common disease in humanity This video lecture focuses on periodontitis, the sixth most common disease worldwide, affecting over 50% of the population. Dr. Kazarian emphasizes the critical importance of early diagnosis, explaining that interproximal attachment loss evaluation is the only reliable method for early detection, as radiographic imaging and CBCT are insufficient. The role of normal probing in the initial assessment is also highlighted, alongside an overview of sulcus, junctional epithelium, and ligament morphology in a healthy periodontium. The progression from periodontal health to disease is explored, starting with plaque accumulation and gingivitis and the differences between gingivitis and periodontitis are clearly outlined. Participants will understand how treatment begins with non-surgical therapy, focusing on reducing inflammation without invasive procedures or addressing gingival recessions. Clinical pathways following non-surgical treatment are presented as well as the factors critical for surgical success in periodontal regeneration, such as flap and clot stability, defect access, and primary intention healing. In particlar, this lecture covers the following topics: How to early diagnose periodontal diseases? Clinical options after non-surgical treatment Factor of surgical success in periodontal regeneration Gingivitis VS Perimplantitis Non-surgical initial therapy to remove the inflammation Gingival papilla reconstruction This video lesson explores the revolutionary shift in periodontology, moving from resective techniques, once the gold standard, to advanced regenerative procedures. A highlight of the lesson is the 3D Tunneling Technique, demonstrated through clinical videos. This technique, performed from the buccal, lingual, and interdental sites, is designed to move interdental tissues coronally and maintain them without tension—making it the only reliable method for papilla reconstruction in the lower jaw. The session also includes an overview of the specialized instruments used for buccal and lingual tunneling and the precise positioning of grafts. The functional and aesthetic implications of gingival recession and papilla loss are discussed, including black triangles, gingival asymmetry, food impaction, phonetic challenges, and increased plaque accumulation, all of which heighten the risk of periodontal issues. In particlar, this lecture covers the following topics: How to regenerate tissue by moving it coronally while addressing buccal exposure Interproximal tissue regeneration and clinical attachment level improvement Functional and aesthetic implications of gingival recession and papilla loss 3D Tunnelling Technique surgical protocol and proper instrumentation Advancing Periodontology Regenerative Techniques for Gingival and Papilla Reconstruction This comprehensive video lesson delves into the evolution of periodontal treatment, focusing on cutting-edge methods to regenerate and thicken gingival tissue, address buccal exposure, and restore interproximal tissue—the most challenging area to regenerate. A highlight of this lesson is the introduction to 3D Tunnelling, a revolutionary technique that enables the coronal movement of interdental tissues while maintaining stability and tension-free results. In particlar, this lecture covers the following topics: Predictable outcomes for recession types (RT1, RT2) and challenges in RT3 The impact of papilla loss on aesthetics and function (black triangles, asymmetry, plaque accumulation) 3D Tunnelling: a technique to move and stabilize interdental tissues coronally, restoring papillae, especially in the lower jaw Clinical videos demonstrating instrumentation, graft positioning, and tailored approaches for different phenotypes ReLIVE Surgery - 3D Tunnelling Technique The channel concludes with a ReLIVE Surgery that provides a detailed, step-by-step demonstration of the 3D Tunneling Technique, offering a comprehensive understanding of its application in papilla reconstruction. Show more