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Recessions. All types of flap & tunnel techniques
4.82
33 votes
20 Jul 2021 - 20 Jul 2024
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Mariano Sanz
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Homa Zadeh
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Giulio Rasperini
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Martina Stefanini
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Robert Carvalho da Silva
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Ion Zabalegui
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Leandro Chambrone
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Sofia Aroca
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Nelson Carranza
Course details
Course lessons
Course lessons
Lecturers
Reviews
Details
10 lessons (15h 17min)
3.25 CE Credits

English
Description
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Lesson 1.Coronally advanced flap: when a connective tissue graft is needed?
– Coronally advanced flap: indications
– Connective tissue graft sampling:
- Trap door
- "L" technique
- Envelope technique.
– Selection of the donor zone for graft collection
– Advantages of de-epithelized graft
– Closing recessions: anatomical and clinical aspects of the choice of treatment method
– Surgical protocol for the treatment of a single recession: a clinical example
– Closing multiple recessions: a technique for creating a forced recession
– Treatment of gingival recessions in the molar region: protocol.
Recommended for: Implantologist, Periodontist, General dentists.
Lesson 2.VISTA: Periodontal Plastic Surgery. Part 2
– Peri-implant plastic surgery: indications and risk assessment;
– Gingiva vs peri-implant mucosa;
– Significance of peri-implant mucosa;
– Importance of implant position;
– Soft tissue augmentation techniques:
- Free gingival graft (FGG),
- Allograft/xenograft,
- L-PRF,
- Pedicle flap,
- Vascullarized inter-position (VIP) graft,
- VISTA;
– Material selection:
- Connective tissue graft (CTG),
- Tuberousity,
- Allograft/xenograft,
- Growth factors,
– Extraction socket management;
– Soft tissue management during implantation;
– Flap design;
– Vestibular depth management:
- Fibrin immobilisation vestibular extension (FIVE) technique;
– Esthetic enhancement;
– Clinical cases.
Lesson 3.VISTA: Periodontal Plastic Surgery. Part 1
– Periodontal plastic surgery: indications and risk assesment;
– Periodontal plastic surgery techniques:
- Coronally advanced flap,
- Laterally closed tunnel,
- Pinhole surgical technique,
- Vestibular incision subperiostal tunnel access (VISTA);
– Root prominence classification;
– Odontoplasty;
– Recession outcome predictors:
- Flap tension,
- Gingival margin position,
- Flap thickness;
– Full and partial thickness flap: comparison;
– Material selection:
- Autograft,
- Allograft,
- Growth factors,
– Tuberosity harvest;
– VISTA:
- Advantages,
- Step by step protocols,
- Clinical cases,
- Long-term results.
Lesson 4.Surgical recession coverage with a modified coronal advanced tunnel technique
Information on the lecturer's participation is to be updated.
Lesson 5.Treatment of deep (severe) gingival recessions with LAST (Laterally Stretched Flaps)
– Diagnosis and decision criteria for treatment of gingival recessions;
– Treatment alternatives for deep/narrow and deep/wide recession defects;
– The Laterally Stretched Flap concept: Technical variants;
– Palatal connective tissue harvesting with the Modified Double Blade Harvesting Technique;
– Selection of an adequate grafting technique, and graft customization to the recipient bed
– Management of complex cases: Multiple deep recessions.
Lesson 6.Localised gingival recessions. Definition, classification, aetiology and risk factors
– The lesions amenable for root coverage procedures;
– Classification of these lesions and define the most important factors in their diagnosis;
– The ethology and pathogenesis in the development of LGR;
– The risk and predisposing factors for the development of LGR;
– The consequences of treating and non-treating these lesions;
– The current approaches to their management.
Lesson 7.Soft tissue management in periodontal regeneration: interproximal attachment gain in RT3
– The adequate healing time of the periodontium after non-surgical therapy
– How to make clinical decision based on the site’s phenotype
– The operative sequence according to the defect’s characteristics
– The most advanced plastic regenerative surgical techniques for interdental attachment gain
– Techniques to treat RT3 recessions.
Recommended for: Implantologist, Periodontist, General dentists.
Lesson 8.Root coverage decision tree revisited: tunnel or flap procedures
– Decision-making strategies for treating various forms of recession;
– The decision tree;
– Advantages and disadvantages of using tunneling procedures and regular flaps;
– Comparative characteristics of the use of autologous tissue graft vs substitutes and growth factors;
– The etiology of the gingival recessions;
– When applying the connective tissue graft;
– The role of the growth factors;
– The proper indications of the tunneling procedure;
– The technique step by step.
Lesson 9.Tunnel technique for single and multiple gingival recession
– Mucogingival surgery: principles of biological healing
– Phases of graft healing
– Split and full-layer flap: advantages and disadvantages
– RT сlassification of recessions
– Bilaminar technique for eliminating single and multiple recessions
– Indications and goals for surgical elimination of recession
– Contraindications for conducting tunnel technique
– Сollection of a connective tissue graft from the palate: the significance of the anatomy and phenotype of the donor site
– Tunnel technique: protocol and demonstration of the methodology
– New surgical approach for treating RT3 recession.
Lesson 10.Predictability of root coverage procedures: clinical scenarios and evidence-based treatment options
– The main factors influencing the predictability of root coverage procedures according to the different patient-, procedure- and outcome-related factors;
– The main clinical scenarios depicted in the AAP Regeneration Workshop;
– Evidence-based findings on soft tissue (RC) of recession-type defects to daily clinical practice;
– Evidence-based findings to clinical practice, by presenting treatment approaches to the most common “clinical scenarios” related to gingival recession treatment;
– The influence of the keratinized tissue band on the long-term stability of results achieved by reconstructive soft tissue procedures.
Course includes next lessons:
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1h 50min
Lesson 1
Coronally advanced flap: when a connective tissue graft is needed?
Martina StefaniniShow lesson program
0:01
Introduction and lecture overview
1:52
Coronally Advanced Flap: history and philosophy
5:52
Connective tissue graft: rationale and indications
7:30
Palatal harvesting techniques (trapdoor, envelope, L-technique)
23:15
De-epithelialized free gingival graft: technique and evidence

Lesson 2
VISTA: Periodontal Plastic Surgery. Part 2
Homa ZadehShow lesson program
0:01
Introduction & Scope of Peri-implant Plastic Surgery
4:42
Importance of Keratinized Peri-implant Mucosa
14:25
Tissue Thickness, Biologic Width, and Recession Risk
21:34
Soft Tissue Augmentation Techniques (Grafts & VISTA)
29:03
VISTA Tunnel Technique and Connective Tissue Grafting

Lesson 3
VISTA: Periodontal Plastic Surgery. Part 1
Homa ZadehShow lesson program
0:01
Introduction: Periodontal Plastic Surgery
1:32
Indications and Risk Assessment for Recession Treatment
4:23
Recession Treatment Techniques and VISTA Overview
9:12
VISTA: Subperiosteal Tunnel and Suturing Technique
16:01
Donor Tissue Selection: Tuberosity vs Palatal Connective Tissue
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Lecturers 9
Professor and Chair of Periodontology at University Complutense of Madrid, Spain. Adjunct Professor at University of Oslo, Norway. Adjunct Professor at University of Bern, Switzerland. Past President of European Federation of Periodontology (EFP, 2014-2016). Director of ETEP research group on Etiology and Therapy of Periodontal and Peri-Implant Diseases.
Over 44 years of clinical and academic experience in periodontology since graduating in medicine in 1981. Received MD degree from University Complutense of Madrid (1981), degree in Stomatology (1983), and Doctor of Medicine (PhD, 1985) with doctoral thesis on bacterial invasion to gingival tissues in advanced periodontitis supervised by Dr. Antonio Bascones Martínez. Specialization in Periodontology from University of California Los Angeles (UCLA, 1987). Former Dean of Faculty of Odontology at University Complutense of Madrid (2004-2012). Director of Postgraduate Program of Specialization in Periodontology at UCM since 1989. Co-Director of Diploma in Research Methodology and Biostatistics at UCM.
International authority in periodontal research having published more relevant scientific articles in dentistry during the past decade than any other author globally. Past President of Spanish Society of Periodontology (SEPA), European Federation of Periodontology (EFP, 2014-2016), and European Association for Osseointegration (EAO). Past President of European Division of International Association for Dental Research (IADR). Former Chairman of European Council of Deans of Faculties of Odontology. Received honorary doctorates from University of San Sebastian, Santiago, Chile; University of Gothenburg, Sweden; and University of Coimbra, Portugal.
MD (1981), DDS (1983), PhD (1985) from University Complutense of Madrid. Certificate in Periodontology from UCLA (1987). Published extensively in leading peer-reviewed journals including Journal of Clinical Periodontology, Journal of Dental Research, Journal of Periodontology, and Journal of Periodontal Research. Research focus on oral microbiology, clinical trials in periodontology and implant dentistry, etiology and pathogenesis of periodontal and peri-implant diseases, periodontal and bone regeneration, mesenchymal stem cells, and bacterial-host interactions. Chairman of ETEP research group since 2005 leading multi-center research on antimicrobial approaches in treatment of gingivitis and periodontitis. Regularly invited as keynote speaker at major international periodontal congresses worldwide.
Periodontist and immunologist specializing in periodontal plastic surgery, implant surgery, and tissue engineering. Former tenured Associate Professor at USC Ostrow School of Dentistry. Inventor of the VISTA (Vestibular Incision Subperiosteal Tunnel Access) technique for treating gingival recession.
Over 37 years of clinical and academic experience in periodontics. Served as full-time faculty at University of Southern California for 28 years (1991-2019), achieving tenure status. Director of Postdoctoral Periodontology Program at USC (2012-2019). Chair of Periodontology Section at USC (2003-2006). Director of the prestigious Annual International USC Periodontal & Implant Symposium. Former Director of Laboratory for Immunoregulation and Tissue Engineering (LITE), funded by National Institutes of Health. Research focus on immune regulation, tissue engineering, growth factors, and regenerative periodontal therapy.
Internationally recognized authority having lectured in over 40 countries at prestigious conferences on aesthetic periodontal surgery, minimally invasive techniques, implant surgery, and tissue engineering applications. Developer of VISTA technique, a revolutionary minimally invasive approach to multiple-site recession coverage achieving superior aesthetic results with minimal patient discomfort. Serves on advisory panel to Center for Scientific Review of National Institutes of Health. Editorial reviewer for multiple international periodontal journals. Board member of Oral Reconstruction Foundation.
DDS from University of Southern California Ostrow School of Dentistry (1987). Certificate in Periodontology from University of Connecticut School of Dental Medicine (1991). PhD in Immunology from University of Connecticut School of Medicine (1991). Diplomate of the American Board of Periodontology and Implant Surgery. Published nearly 100 scientific papers in peer-reviewed journals and book chapters on periodontal regeneration, implant surgery, tissue engineering, and immune mechanisms in periodontal disease. Director of Comprehensive Surgical and Restorative Implant Training Program at USC. Private practice limited to periodontology and implant surgery in Southern California. Currently affiliated with BioHorizons developing innovative implant systems and surgical protocols.
Associate Professor of Dentistry and Periodontology at the Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy. Adjunct Clinical Associate Professor at the Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, USA.
Over 35 years of clinical and academic experience in periodontology, regenerative medicine, and implant dentistry. Founding member of iPerio Education Center in Piacenza, Italy (2017), established with Dr. Giorgio Pagni and Dr. Raffaele Acunzo to teach modern dentistry philosophy and treatment concepts. Research focus on guided tissue regeneration, periodontal and peri-implant reconstruction, 3D-printed bioresorbable scaffolds for periodontal repair, and tissue engineering applications.
International authority on periodontal regeneration having published extensively and lectured globally on surgical techniques for periodontal reconstruction, enamel matrix derivatives, and biological approaches to tissue regeneration. Winner of multiple research awards: International Quintessence Publishing Award (Boston 2000, 2004), Goldman Prize from Italian Society of Periodontology (1996, 2010, 2017), Clinical Research Award from European Association for Osseointegration (EAO 2010), Earl Robinson Periodontal Regeneration Award from American Academy of Periodontology (AAP 2012), and Align Research Award (2013).
DDS from University of Pavia, Italy (1990). Certificate as Specialist in Orthodontics from University of Milan (1997). Certificate as Active Member of Italian Society of Periodontology and Implantology (SIdP, 1997). Active Member of European Academy of Esthetic Dentistry (EAED, 2009). Full Member of British Academy of Aesthetic Dentistry (2016). Editorial Board member of International Journal of Periodontics & Restorative Dentistry and ad hoc reviewer for multiple international journals. Over 10,900 citations on Google Scholar (H-index 36). Published landmark papers on vertical ridge augmentation, platform switching, soft tissue grafting, 3D-printed scaffolds, and periodontal-orthodontic interactions.
Co-Author of a Chapter within the book “Implant Therapy” edited by M.Nevins and H.L.Wang.
Speaker at national and international conferences on periodontology.
Dental surgeon in private practice as expert in periodontology.
Active member of the Italian Society of Periodontology (SIDP).
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