Current concepts for augmenting soft tissue volume in a vertical and/or buccal direction are based on the use of autologous tissue that is harvested most often from the palatal area. These transplants have a long history in dentistry and numerous articles have been published documenting their effectiveness, safety and long-term stability.

Limitations and disadvantages of autologous tissue grafts include:

• Availability and thickness of the donor tissue vary according to anatomic dimensions of the palatal vault. 
• Length and thickness are limited by anatomy, such as a thick alveolar process, exostoses and the palatine nerves and blood vessels. 
• Patients very often complain about pain and numbness at the donor site.

To overcome these issues and reduce the morbidity due to graft harvesting, research activities have focused on developing soft tissue graft substitutes from various sources and for a number of clinical indications. For soft tissue volume augmentation, a suitable biomaterial must provide volume stability over time and favorable biological behavior that allows normal modeling and remodeling processes. 

The long-term health of the peri-implant soft tissue depends on various factors, one of which is the keratinized soft tissue supply. Especially in the edentulous posterior mandible, there is often a deficiency due to bone resorption. Under which conditions and with which techniques more keratinized tissue can be created prior to implant placement is explained step-by-step based on a clinical case. A major focus is directed towards the necessary nature and the fundamentals of processing free gingival graft transplants.

In this module, the anatomical structures and characteristics of the posterior part of mandible are described, which need to be considered when placing implants. Based on these anatomical characteristics, the methods of implantation in combination with bone augmentation techniques are reviewed. An overview with information about different biomaterials used in bone augmentation procedures closes this module. 

In this module, we will discuss the details of the surgical procedures when placing an implant with simultaneous bone augmentation procedures in the posterior mandible. We will go through pre-operative medication, selection of anesthesia mode, incision design, the properties and selection of bone materials, as well as instructions for post-operative care. The aim is to guide the reader in a detailed manner through this surgical intervention.

Augmentation protocols have become dependable tools in the surgical tool kit. They have become indispensable in everyday implantology and oral surgery. But which materials can be used under which conditions and with what prospects of success?
In principle, different defect classes can be used to derive techniques and material from them, which may be found in the corresponding guidelines (the author of this module was the group lead for the development of these guidelines for two leading German associations in implant dentistry – DGI, and oral and maxillofacial surgery - DGZMK).

Defects with a size of 3 mm vertically or horizontally can be regenerated very predictably with guided bone regeneration techniques using Geistlich Bio-Oss® and Geistlich Bio-Gide®. If these defects displace the soft tissue, a less favorable result must be assumed.

For defects exceeding these dimensions, i.e., larger lateral and vertical defects, stable barrier or autologous block techniques are recommended. A titanium mesh is particularly suitable for graft stabilization.

It turns out that autologous bone is not necessarily the gold standard for all indications. It has some disadvantages and must therefore be used specifically and consciously for certain indications. Overall, it is important to have knowledge of various biomaterials and bone substitute materials to be able to offer patients suitable solutions

The success of an implant depends on many factors. The patient in particular, with the individual medical history and habits, often brings difficulties into the treatment that are not always easy for the surgeon to control surgically. These range from obvious problems such as underlying diseases (e.g., diabetes), pharmacological influences such as antiresorptive drugs and proton pump inhibitors, to bruxism and functional complaints. Besides the area of the mouth (details on this in module five) and the complications to be expected, the patient factor is extremely important in the prospective case assessment. The underlying anatomy, in particular the different areas of the blood supply in the oral cavity, are an important prerequisite for determining the incision technique. If careful attention to these structures is paid, the complication rate can be reduced and, in particular, the long-term blood circulation in the relevant area of implant placement will be impaired as little as possible.

Clinical approaches to different defect sizes and to situations, in which complications are already prevalent and responsible for a worsening of the overall situation, are presented here.

This module focuses on the key aspects of oral surgery, including treatment planning, product selection, surgical procedure, post-surgical care, follow-up, with a full-length surgical video. Learners will gain an understanding of the different treatment planning options available for implant dentistry, and how to select the appropriate products based on the patient's individual needs to perform simultaneous guided bone regeneration procedure. The video features the surgical procedure for  extracting a tooth with the explanation why it is required and then how to place an implant in the posterior mandible. An intra-operative x-ray is taken to confirm the correct placement of the implant. Learners will also gain insights into the post-surgical care required for patients and how to conduct effective follow-up appointments to ensure optimal patient outcomes. By the end of this clinical video module, learners will be equipped with the knowledge and skills necessary to perform successful implant placement procedures and provide optimal patient care.

Boney defects around an implant may cause problems for the patient in the long-term – guided bone regeneration procedures are used to treat such bone defects, helping to prevent a loss of dental implants. During this hands-on workshop and demonstration, you will observe, learn and apply yourself to treat a minor bone defect around an implant with simultaneous bone augmentation procedures. You will be introduced to the Geistlich vLab® workshop kit, find out what is inside the kit and what you will need to prepare before you start the hands-on workshop. Most importantly, you will be guided through the whole procedure, step-by-step, from incision, to flap elevation, implant bed preparation (you will not place an implant during this course), bone harvesting and performing a minor bone augmentation with bone substitute materials and a membrane to treat a boney defect. Hints and tips are given from beginning to the end, when the flap is closed with sutures. You will perform the whole procedure on your own typodont, giving you the necessary skills and knowledge to perform such a procedure in your daily practice.

This case presentation module aims to provide an overview of diagnosing and assessing posterior edentulous extraction sites for ridge deficiencies, selecting the timing and suitable regenerative techniques as indicated by the case, and selecting the appropriate implant placement protocol, including immediate, early, and delayed approaches. The module discusses the importance of a thorough diagnosis and assessment of the extraction site prior to implant placement, including evaluation of bone quantity and quality, soft tissue condition, and patient factors. By following these guidelines, clinicians can achieve optimal outcomes for implant placement in posterior edentulous extraction sites.

When a patient requires removal of a tooth in the posterior maxilla, several factors need to be considered. This module is designed to help the clinician’s decision-making process as to whether an Alveolar Ridge Preservation procedure should be performed, which materials are ideal, and what evidence we have to support our treatment advice.

We will explore the biological aspects in the management of extraction sockets including anatomical considerations and the dynamics of bone tissue formation in extraction sockets. A short overview of surgical considerations will lead the clinician into the subsequent module which will focus on the clinical aspects of extractions sockets in the posterior maxilla.

Clinical success is essential for both patient and clinician satisfaction. While ridge preservation is in many ways a technically simple procedure, having clarity about the patient, tooth and material selection is key to confident patient management.

We will explore the clinical aspects surrounding the management of tooth extraction, including anatomical considerations, technique and the equipment required and desirable.

A brief overview of dental implant placement timing will also be presented.

This module focuses on the anatomical landmarks and bone architecture of the maxillary sinus, as well as various surgical techniques and materials used for implant placement with the crestal sinus augmentation procedure. We will discuss indications and contraindications for implant placement, including sinus health and disease as well as common complications that arise during surgery, and their management. A decision tree guides you in your choice of the surgical technique and hints and tricks are given on the geometry and positioning of the implants.

Additionally, we will discuss the available bone graft materials and go through some of the scientific evidence for safety, success and stability of the Geistlich biomaterials used in this indication. Finally, some clinical experience is presented on how to handle complications that may arise during surgery.

This module focuses on the clinical aspects of the crestal sinus floor augmentation procedure so that you are equipped with the knowledge and skills necessary to perform it on your next patient. In this module we will cover various topics, including the pre-operative information, incision techniques, and surgical instruments required for the procedure. You will also learn about flap elevation and the anatomic risks associated with surgery. In addition, we will provide detailed information on the sequence of use and rationale of surgical instruments, graft material selection and placement, implant placement, flap closure, and transmucosal healing. The module ends with the post-operative information and medication needed to ensure proper healing of the augmented site, as well as information on bone healing time after implant placement.

Sinus floor elevation today has become a well-established procedure. This comprehensive course dives into the biological aspects of implant placement with the lateral sinus procedure. You'll explore the anatomical landmarks of the posterior maxilla and emphasis is placed on the evaluation and assessment of the maxillary sinus architecture. You'll also learn the latest surgical techniques, when to choose a 1-stage or 2-stage procedure, the ins and outs of graft materials, membrane use in the lateral window approach, and how to avoid or manage typical complications. This course is designed to equip you with essential knowledge you need to provide safe and effective care to your sinus patients.

This clinical oriented course builds your understanding of what to consider practically for 1-stage implant placement with sinus lift procedure. From pre-op preparation to post-op care, you'll learn about incision techniques, how to prepare suture flaps, learn the key skills and instruments for successful sinus membrane elevation, and how to graft the sinus and place implants. With a focus on thorough planning, top-notch surgical skills, and expert post-operative care, this course will show you the tools you need to build confidence in performing sinus lifts with precision, and take your dental expertise to the next level.

Undergoing implant placement in the edentulous posterior maxilla is often impossible without prior sinus floor elevation. Meanwhile a routine surgery, it still entails risks, and a proper approach requires sound knowledge on the anatomical and biological level. In this clinical video module, Colin Campbell will lead you through the principles of sinus floor elevation with simultaneous implant placement. It will show a practical approach, starting with the patient’s medical and dental history, the risk assessment and treatment planning. A full-length surgical video will then lead you through the individual steps of the surgery, explaining in detail what, how and why these steps are done. Tips and tricks on technical nuances, including an overview of instruments for sinus floor elevation, will improve your understanding of what skills are needed and how to prevent avoidable mistakes.

One of the most critical steps in sinus floor elevation (SFE) is access to and elevation of the Schneiderian membrane. Although sinus floor elevation is regarded a predictable standard procedure, gaining skills by simulation on models and supervised clinical practice should always precede autonomous SFE on real patients in order to reduce the risk of intra-operative complications and decrease the potential for error. In this guided hands-on workshop, you can follow an expert’s approach on a mouth model and repeat step-by-step the surgical incision and flap preparation, detachment of the Schneiderian membrane, application of the bone graft, and final wound closure. The model allows you to familiarize yourself with the typical anatomy of the sinus cavity and with the proper handling of SFE instruments, to become aware of typical pitfalls, and take a view into the sinus, and self-control the success of the exercise.

Maxillary bone resorption leads to the formation of insufficient alveolar ridge dimensions for implant placement, both vertically and horizontally. The sinus floor augmentation (sinus lift) technique is presently considered as a predictable and safe procedure, based on long clinical experience as well as scientific literature with long-term follow-up. The aim of this clinical case presentation is to describe the surgical approach for sinus grafting procedures and implant placement. A recommended treatment plan and step-by-step surgical protocol will be illustrated. Pre-operative and post-operative pharmacological treatment will be analyzed.

Get ready to level up your skills in extraction socket management in the anterior maxilla and mandible. Understand the anatomy and surgical risks involved in implant placement. Discover the secrets of ridge alterations and how they can impact your patients' esthetic results. Gain insights in the surgical techniques for volume preservation or augmentation in the anterior region. Learn about the different timing options for implant placement, including immediate, early, and delayed placement, and why 3D positioning is crucial for success. This course is a must-attend for dental experts looking to expand their knowledge in extraction socket management and how to achieve quality results.

In this module, we are diving into the clinical world of anterior extraction socket management, covering knowledge from minimally invasive extraction to established techniques in implant placement. You will learn how to classify and manage extraction sockets in the anterior maxilla and mandible and become confident in using surgical instruments. We will explore some of the science behind alveolar ridge preservation, healing time, and implant placement, and equip you with post-operative information to minimize risks. This comprehensive course will give you the practical knowledge you need to tackle anterior tooth extractions. Do not miss your chance to become an expert in extraction socket preparation, wound healing, and implant placement for optimal patient outcomes.

The role or importance of keratinized mucosa around dental implants has been an extensive matter of debate in recent years. Objectives of this module are: to highlight the differences between keratinized and non-keratinized tissues around teeth and implants, the role of keratinized tissue around implants, to get a better understanding of the anatomy of donor sites for autologous soft tissue grafts and to gain some insights into alternatives to autologous soft tissue grafts.

The role or importance of keratinized mucosa around dental implants has been an extensive matter of debate in recent years. Objectives of this module are: Pre-operative information for the patients, incision techniques for free gingival grafts (FGG), harvesting of FGG, and  fixation of FGG, post-operative information and risks, alternatives to FGG, the role of keratinized tissue around implants, to get a better understanding of the anatomy of the donor sites for autologous soft tissue grafts, and to gain some insights into alternatives to autologous soft tissue grafts.

In this module we will start with discussing the role of peri-implant mucosa, not only for esthetics but for oral health as well. We will learn how to optimize peri-implant soft tissue. We will have a look at the anatomic area of harvesting a connective tissue graft (CTG) and learn about the risks and morbidity involved. We will discuss the outcomes of the CTG in different indications and also discuss the alternatives to CTG. We will focus on the development and characteristics of Geistlich-Fibro-Gide® and on the scientific background of Geistlich Fibro-Gide® including preclinical and clinical studies.

In this module we will cover the clinical considerations for peri-implant soft-tissue management. We will discuss risk assessment and focus on the pre-operative information. We will investigate which incisions to make and how to harvest a CTG. How to prepare the recipient site and how to fixate the CTG. We will talk about the post-op information and risks. We will learn which incision techniques are used for Geistlich Fibro-Gide and how to prepare the recipient side. How the Geistlich Fibro-Gide should be handled extra-orally and how we need to fixate it.

In this module we are covering the rationale for tooth removal, assessing the health and stability of the soft and hard tissue structures, tooth removal with minimal damage to the supporting structures, degranulation and infection control. Furthermore, we will discuss the evolution, selection, location, and secure placement of dental implants, hard and/or soft tissue augmentation and development of the emergence profile. Loading protocols for dental implants will be explored as well as provisional restorations to provide temporary tooth replacements during the implant healing process. Finally, you will gain an understanding of the steps involved in final restorations, including the selection of appropriate materials and techniques for achieving optimal esthetic and functional outcomes.

Implant placement with simultaneous GBR is a regular treatment that has been successfully performed for more than 20 years. In addition to function and long-term success, the esthetic aspects are of particular importance in the anterior region.

This module shows the differences between particulate bone substitute material and the block-shaped Geistlich Bio-Oss® and how the L-Shape technique in combination with Bio-Oss© Collagen is successfully applied in the esthetically demanding anterior region. You will understand the differences in volume stability when using granules versus stabilized graft materials (2D versus 3D) preclinically and clinically, and learn about the indications for the L-Shape technique and their scientific background.

This module will provide you with a good biological understanding of flap design, incision techniques, flap closure and suturing techniques and familiarize you with the main surgical instruments.

Successful placement of implants in complete or partially edentulous patients requires sufficient alveolar ridge width. Horizontal bone augmentation is a common procedure to increase the width of the ridge and may be undertaken prior to or simultaneously with implant placement, depending on the morphology, size and region. Several techniques have been developed, such as GBR, block grafting or bone spreading and using different materials for regeneration of bone volume. This module provides up-to-date information and basic guidelines for what to consider in horizontal bone augmentation.

Resorption of the alveolar ridge often results in insufficient bone volume for implant-supported restorations. Especially after tooth loss, the hard- and soft-tissue structures can lose significant volume in a short period of time and require extensive augmentative measures prior to implant placement. Various techniques can be used to correct these severely atrophied structures, such as block grafting using intraoral or extraoral grafts (onlay technique, sandwich technique), guided bone regeneration (GBR) using bone substitutes combined with containers and membranes, distraction osteogenesis or combinations of different techniques.

This clinical video will provide a comprehensive understanding of the treatment planning, product selection, surgical procedures, post-surgical care, and follow-up involved in implant dentistry. You will be introduced to the different treatment planning options available and will learn how to select the appropriate products based on the patient's needs. The course will cover the L-shape technique used in implant surgery with the help of Geistlich Bio-Oss® Collagen, Geistlich Bio-Oss®, Geistlich Bio-Gide® and you will be able to watch a surgical video demonstrating this surgical technique. The post-surgical care and follow-up procedures will also be discussed, to ensure that you are able to provide the necessary support to patients during the recovery period. This clinical video of the procedure in full length will provide you with a thorough understanding of this L-shape technique and you will be able to apply this knowledge in your clinical practice.

In the esthetic region it is important to provide as much stability as possible to the soft and hard tissue around an implant. A lack of volume around an implant may compromise the stability and success of the implant, as the implant alone cannot maintain the ridge volume after tooth extraction.

In this hands-on workshop you will dive into prosthetically-driven implant placement in the esthetic region, and subsequent guided bone regeneration using a bone substitute material and a resorbable collagen membrane. In the demonstration clip, you will be instructed on how to prepare for the hands-on workshop, and finally you will be guided through each step of this bone augmentation procedure using Geistlich Bio-Oss® Collagen and Geistlich Bio-Gide®. Starting with the correct incision techniques, followed by flap elevation techniques, you will learn how to handle and prepare the biomaterials, as well as placing and fixing them over the implant (no implant will be placed in this module). Along with the detailed instructions, you will be able to follow step-by-step the clinical procedure on your personal typodont until closing the wound with sutures. The GBR-procedure will focus on the so-called ‘L-shape technique’, allowing to augment volume at the cervico-buccal aspect of the placed implant where it is most needed.

Labially inclined incisors may develop severely compromised periodontal situations. Discover. in this case presentation of a clinically staged lateral bone augmentation. a very special approach in implant dentistry to improve jawbone and soft tissue quality and quantity. From the patients’ background and risk assessment, this module guides you through treatment planning, surgical procedures, to post-op care and tracking results. You'll leave with a complete understanding of this advanced technique and the confidence to treat patients with such exceptional baseline situation of a distal bite class.