Live Course

Contemporary Soft Tissue Grafting for Implant Reconstruction

Apr 24-26, 2025

Tampa, FL

credit hours

Financing Available

Contemporary Soft Tissue Grafting for Implant Reconstruction

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Contemporary Soft Tissue Grafting for Implant Reconstruction

About the Course

Course Overview

^{Gingival Grafts | Subepithelial Connective Tissue Grafts | Pedicle Tunnel Connective Tissue Grafts™ | Vestibuloplasty | Acellular Dermis Matrix (ADM) Allografts | Esthetic Zone Reconstruction | Growth Factor Technology}

Includes Hands-on Workshop & Live Surgery

Gingiva & Subepithelial Connective Tissue Grafts

Pedicle Tunnel Connective Tissue Grafts™

Vestibuloplasty & Acellular Dermis Matrix (ADM) Allografts

Esthetic Zone Reconstruction

Growth Factor Technology

Master the practical application of the entire spectrum of soft tissue grafting protocols and concepts. Learn from decades of meticulous case documentation synergized with the most modern advancements in soft tissue techniques, materials and regenerative principles.

By taking this course, you will facilitate confidence and proficiency in performing successful and predictable implant soft tissue surgery and management concepts that will continue for the rest of your career.

Course Objectives

Course Topics

20 hours lecture (AGD Subject code: 490)
3 hours participation (AGD Subject code: 490)

Pikos Institute Philosophy of oral implant rehabilitation for soft tissue therapy - "Think Outside the Bone™".
Key principles for evidence based predictable soft tissue grafting.
Site specific soft tissue anatomy and wound healing of peri-implant tissues.
Soft tissue manipulation and incision flap design for predictable bone grafting.
Optimal sequencing of soft tissue procedures for successful implant surgery and bone grafting.
Guidelines, indications and surgical protocols for the following:
Gingival grafts, subepithelial connective tissue grafts, and acellular dermis matrix allografts.
Development of optimal peri-implant soft tissue architecture.
Eight most commonly used suturing techniques for implant surgical reconstruction.
Soft tissue grafting protocols for esthetic zone reconstruction.
Predictable protocols for extraction site management with and without simultaneous implant placement.
Growth factor technology (L-PRF, PRGF, PDGF) in conjunction with soft tissue grafting protocols.
Risk management issues/ informed consent for advanced soft tissue grafting.
Recognition, management, and prevention of complications associated with soft tissue grafting.

Top Reasons to Attend Contemporary Soft Tissue Grafting for Implant Reconstruction

Course Speakers

Course Agenda

THURSDAY

7:00 AM - Registration/ Continental Breakfast

7:30 AM - Introduction / Lecture

10:00 AM - Break

10:30 AM - Lecture/Discussion

12:00 PM - Lunch

1:00 PM - Lecture/Discussion

3:00 PM - Break

3:30 PM - Lecture/Discussion

5:30 PM - Social Hour: Pikos Institute

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FRIDAY

7:00 AM - Breakfast

7:30 AM - Live Surgery Case 1

9:00 AM - Break

9:30 AM - Live Surgery Case 2

11:00 AM - Lecture / Discussion

12:00 PM - Lunch

1:00 PM - Lecture/Discussion

2:00 PM - Break

2:15 – 5:00 PM - Hands-on Training‍

SATURDAY

7:00 AM - Breakfast

7:30 AM - Lecture/discussion

9:30 AM - Break

10:00 AM - Lecture/discussion

11:30 AM - Lunch

12:30 – 3:30 PM - Lecture/discussion

Featuring 12 of the World's Master Clinicians!

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Featuring 12 of the World's Master Clinicians!

Dr. Sofia 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 a 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 an honorary professorship at the same university in 2012.

Her dream came true in 2018 when 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 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 multiple recession type defects have been evaluated in different types 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 situations. Therefore, the treatment of multiple recessions with a single surgical technique is a more complex task, since the diversity of anatomical conditions 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 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 decision-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 anatomical 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 decision-making process to achieve predictable results in the most complex clinical cases.

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

Dr. Joseph Kan

Dr. Joseph Kan received his Prosthodontic and Implant Dentistry training from Loma Linda 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, the 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 the 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 his 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. He 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 four of Dr. Kan’s publications as the Top 100 Cited Articles in Implant Dentistry. In 2020, Praveen G et al. (J Prosthet Dent) cited two of Dr. Kan’s publications as among 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 the 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 implants.

Dr. Henriette Lerner

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

She is the 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 the Past President of the Digital Dentistry Society International (DDS), and holds a Doctor of Philosophy on the topic of Digital Dentistry. In addition, she is a 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
Author 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 3D Bone and Soft Tissue Grafting: A Scientific and Clinical Update

Bone autograft is still considered 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 defects in bone tissue as a surgical procedure is time-consuming and technically difficult. Milling and printing (3D additive manufacturing) of bone and tissue in the specific volume and structure previously 3D planned seem to be the next step.

Oral soft tissue defects are a frequently encountered problem in dental practice. The autologous graft, as the gold standard for gingiva and oral mucosa augmentation, causes prolonged pain, limited harvested tissue, and an increased risk of infection, prompting the search for off-the-shelf alternatives. Several acellular 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 of bone grafting will be shown in science and clinics.
State-of-the-art virtual planning of soft tissue grafting and the newest digital manufacturing technologies will be shown in science and clinics.
An illustration of more advanced digital technologies.

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 in 2009.

He has 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 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 (PRF) therapy according to Expertscape independent review.

He has recently received many international awards in dentistry and is widely considered 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).

Dr. Miron 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 due to its ability to accelerate both hard and soft tissue regeneration. Today, implant dentists rely on PRF to improve soft tissue healing around grafted/implant sites and to enhance the handling of bone grafting particles. It is worth noting that PRF was FDA-approved in the early 2010s, and it took over a decade for most clinicians to adopt the technology in their practices. Many improvements to the technology have been pioneered within our research and clinical affiliates, providing clinicians with 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 momentum recently due to their potential as therapeutic options. In simple terms, PRF produces roughly 500 publications per year, while exosome research is generating over 5,000 publications annually. This number is expected to dramatically increase as novel therapeutic strategies continue to be investigated.

This lecture will focus first on understanding exosomes, including their cellular origin, biogenesis, function, and characterization. It will then cover their therapeutic potential, with a strong focus on dental applications, as well as the combination of exosomes and PRF in regenerative medicine.

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.

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

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

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 in the 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 in the Department of Periodontology and the Department of Prosthodontics at the University of Florida College of Dentistry, an Adjunct Professor in the Department of Oral & Maxillofacial Surgery at Aristotle University of Thessaloniki, Greece, School of Dentistry, and an Adjunct Associate Professor in the Department of Periodontology at the 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 Oral and Maxillofacial Surgeon (OMS), Dr. Pikos was 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. He 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 6,500 from all 50 states and 67 countries. Dr. Pikos maintains a private practice limited exclusively to implant surgery in Trinity, Florida.

Main Podium Lecture

Sinus Grafting 34 Years: Clinical Myths and Realities

This clinical-based presentation draws from the presenter’s 30+ years of experience with more than 1,500 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:

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

Publications:

Pikos MA. 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

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

Dr. Istvan Urban

Dr. Urban received his DMD degree and subsequently his MD degree from Semmelweis University School of Medicine and Dentistry (Budapest, Hungary) in 1991 and 1996.

He completed a full-time program in oral surgery at St. Istvan Hospital in Budapest, Hungary (1992-1996). He also completed his internship program in Periodontics at UCLA.

After graduating from the Fellowship Program (1999-2000) in Implant Dentistry at Loma Linda University in Loma Linda, California, Dr. Urban was appointed assistant professor the following year. He is licensed in the state of California (USA) and has a private practice in Budapest, Hungary.

Dr. Urban received his PhD in Periodontology in 2012 at the University of Szeged, Hungary, where he is currently an honorary professor.

He is a board member of the Osteology Foundation and has published numerous scientific articles and textbook chapters on bone regeneration and soft tissue reconstructive surgery around dental implants. Dr. Urban is also an adjunct clinical associate professor in the Department of Periodontology and Oral Medicine at the University of Michigan. Recently, he became a lecturer at the Harvard School of Dental Medicine.

Dr. Urban is the author of the textbook titled Vertical and Horizontal Augmentation published by Quintessence, which has been translated into 12 languages. He recently authored the second part of the book titled VERTICAL 2: The NEXT LEVEL.

Main Podium Lecture

My Perspectives on Vertical and Horizontal Augmentation

Vertical and horizontal augmentation presents one of the greatest challenges in bone regeneration for implant dentistry. This is primarily due to the complexity of the surgical procedure and its potential complications. However, it has been demonstrated that successful clinical outcomes can be predictably achieved when strict protocols are followed.

A detailed understanding of clinical anatomy should guide the clinician when managing soft tissue flaps to securely close them and achieve an optimal healing environment for the graft. Graft immobilization and the optimal use of graft materials are essential in achieving bone formation, even at a distance from the bony walls. This presentation will summarize the essential steps of ridge augmentation and provide insights into how clinicians can master these demanding procedures.

Learning Objectives:

Understand the surgical anatomy of the floor of the mouth.
Learn the surgical principles of ridge augmentation surgery.
Learn the tension-free closure of the flaps after vertical ridge augmentation.
Learn soft tissue reconstructions after ridge augmentation.

What Our Trained Clinicians Are Saying About This Course

Contemporary Soft Tissue Grafting for Implant Reconstruction

Hands-on Workshops

Optional Workshops – Wednesday, October 2, 2024:
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(requires separate registration, not included in main session registration price)

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