The principle of guided bone regeneration (GBR) has been in clinical use for almost three decades. A thorough understanding of the underlying biological mechanisms of GBR is essential in order to optimise treatment modalities and clinical success. Recent findings suggest that membranes used for GBR play a much more active role in the healing event than previously understood. This presentation will discuss the history, evolution and the latest findings with regard to biological events taking place when using resorbable and non-resorbable membranes and how they affect the clinical use and outcome. The presentation will also discuss how modifications of the membrane materials interact with wound healing and how these can be used in the clinical setting. 

Learning Objectives

• To understand the current biological principles of GBR.
• To understand how different membrane materials interact with wound healing.
• To be aware of suitable combinations of bone substitute and membranes with regard to defect types.
• To understand the clinical steps that need to be addressed for optimal regenerative outcome.

Dr Christer Dahlin is a Professor in Guided Tissue Regeneration and Oral Surgery at Department of Biomaterials, University of Gothenburg, Sweden. He is also a senior consultant in Oral & Maxillofacial Surgery at NÄL Medical Center Hospital, Trollhättan, Sweden. He is a visiting Professor at University of Michigan, Ann Arbor, MI, USA.  He is Vice President and member of the Executive board for the Osteology Foundation. He also acts as a member of editorial boards for several journals in the dental field. Professor Dahlin is considered one of the pioneers in the development of the concept of guided bone regeneration (GBR). He has over thirty years of experience in this field as well as in implant treatment and related research. He is currently involved in both basic research focusing on the biological mechanisms related to GBR as well as clinical trials. He has published numerous articles and textbooks on these topics. He frequently travels worldwide to lecture, conduct research and teach on this and other implant-related topics.

Qualifications: DDS, Ph.D, Dr. Odont

Implant treatment on the aesthetic zone aims for healthy, functional and also aesthetic results. In order to obtain an aesthetic result it is mandatory that the implants are placed in optimal 3D position and completely surrounded by healthy bone.  

A harmonious and healthy status of the soft tissues is also a pre-requisite of an aesthetic result. 

Due to the alveolar ridge destruction caused by trauma and dental or implant infections, bone availability is often not ideal to obtain a good aesthetic result.  In order to treat such cases predictably there are surgical techniques that allow a complete 3D reconstruction of the alveolar ridge. 

When an implant is malpositioned on the aesthetic zone, it is more susceptible to develop biological (periimplantitis) and aesthetic failures. If a malpositioned implant is infected, the implant should not be treated, since although bone can be regenerated, the new bone is highly susceptible to new bone resorption because an important part of the etiology of the problem is the wrong implant position (especially too labial and too deep). In such cases, extraction of the implant and 3D bone regeneration of the resulting defect is desirable in order to place a new implant in optimal 3D position so a highly aesthetic restoration may be achieved. Furthermore, for an optimal aesthetic result,  periodontal plastic techniques have also to be performed.

All these topics will be addressed in this lecture.

Learning Objectives

• To understand 3D bone regeneration techniques: GBR using PTFE and Ti reinforced membranes and Khoury's Technique.
• To understand the regenerative techniques needed to treat aesthetic and biological implant failure in the aesthetic zone.

Dr David González obtained his PhD degree (Doctor in Odontology) at the University Complutense of Madrid achieving a qualification of “Summa cum Laude”, presenting the Doctoral Thesis “Risk Factors of Periodontal Disease” in 1999.

David studied a 3-year full time postgraduate program in Periodontology at the University Complutense of Madrid (directed by Dr Mariano Sanz) between 1996 and 1999. He also completed his studies regarding dental implants with a Specialty in Osseointegration at the University Complutense of Madrid (also directed by Dr Mariano Sanz) in 1999-2000. 

David is the author of the Book “Atlas of Plastic and Regenerative Implant Surgery on the Esthetic Zone” (IN SPANISH) printed by Editorial Quintessence. He has been a Specialist Member of the Spanish Society of Periodontology and Osseointegration since 2000 and the European Federation of Periodontology. He was a Professor in the General Dental Council of Spain from 2004 to 2012.

David is a visiting Professor  of the P|ostgraduate Program of Periodontology in the University of Barcelona (since 2003). He has publications in the Journal of Clinical Periodontology, The International Journal of Esthetic Dentistry, JOMI and in Clinical Oral Implants Research.

He has lectured about periodontology and implant dentistry specifically on bone regeneration and soft tissue management worldwide.

Since 2005  David has run a private practice dedicated exclusively to periodontology and implantology  in Murcia, Spain (Clínica OrtoPerio).

Qualifications: DDS, PhD

Bone augmentation procedures are often involved in implant dentistry since tooth loss and pathology reduce the available bone for a correct 3-dimensional implant placement. Biological knowledge of new bone formation is fundamental for a clinician who wants to perform predictable surgeries. This lecture will  focus on those biological aspects that have a relevant clinical impact on the outcome of the surgical procedures, to help the surgeon make the optimal choice in terms of technique and graft material to be selected.

Learning Objectives

• To understand the biological principles for bone augmentation
• To know the biological classification of the defect
• To understand when autogenous bone is the right choice
• To understand hard tissue augmentation strategy in a critical size defect

Luca De Stavola graduated in Dentistry at the University of Padua (Italy) in 2001. He undertook the Post Graduate program in Oral Surgery at Prof. Khoury's Clinic (Olsberg, Germany) in 2007 (2003-2007), and the Master of Oral Medicine in Implant Dentistry at the University of Munster (Germany) in 2007. He is a member of the European Association for Osseointegration (EAO) and of the Italian Academy of Osseointegration (IAO) and since 2021 has been on the Society Board of IAO. 

Luca has private offices in Padua and Treviso (Italy) dedicating his work to the field of periodontology, oral surgery, implant dentistry and bone regeneration.  He has been an invited speaker in many Courses and Congresses since 2005, in particular at the Spanish Society of Periodontology Annual Congresses (SEPA) 2016 and 2018, at the EAO Annual Congresses 2017, 2019 and 2022, and at EUROPERIO 10 in 2022. He is the author and co-author of peer-reviewed manuscripts published in international journals.  

Luca is Visiting Professor and Lecturer at the University of Padua (Italy), Eastman Institute UCL (London, UK), University of Reggio Emilia and Modena (Italy), and University La Sapienza Rome (Italy). 

Qualifications: DMD, Oral Surgeon, MOM (Master of Oral Medicine in Implantology)

A correct soft tissue architecture is key and determinant to achieve excellence in implant-supported final restorations. The evaluation of the volume and shape of the surrounding soft tissues may determine the course of treatment in terms of the need of surgical or prosthetic compensation depending on the degree of deficiency.  The partial or complete reconstruction of these defects is a big challenge in the aesthetic zone, especially interproximally. In some cases, modifications in the prosthetic design or the addition of pink ceramic, according to the extension of the defect, may be required. In other cases, different kinds of soft tissue grafts might improve vertically the height of the area and favour an appropriate gingival contour. Several clinical situations, on other hand, require a multidisciplinary approach to address the deficiencies. 

Learning Objectives

• To be able to identify the different types of aesthetic defect
• To understand the potential of non-surgical and prosthetic strategies prior to the surgical procedures
• To be aware of surgical alternatives to improve the vertical dimension of the tissues using soft tissue grafts

Prof.  Paulo Fernando Mesquita de Carvalho received his dental degree from Alfenas University in 1994, and Maxillofacial Surgery at Alfenas University (1998); He is board certificated in Periodontics at Ribeirão Preto Dental School/Sao Paulo University (2002); in Dental Esthetics at SENAC (2008), and completed his Master programs at São Leopoldo Mandic Dentistry Research Center in Campinas (2004). He is also a professor at the ImplantePerio Institute - research and advanced dental training in São Paulo, and is author and co-author of several scientific publications and chapters in textbooks with emphasis on periodontal tissue management around teeth and implants. He is one of the authors of the books “Aesthetic Tissue Reconstruction” (2009) and “Esthetic Perio-Implantology” (2015).

Qualifications: DDS, PhD