The old reconstructions have to be replaced. But how? A challenging case treated by Dr. Sven Mühlemann, University of Zurich.

Female patient looking for a treatment to improve the appearance of her smile.

Contents - Laser - Basic Concepts - Principles of Fluorescence Measurement - Nonsurgical Periodontal Therapy - Surgical Periodontal Therapy - Treatment of Cervical Dentin Hypersensitivity Synopsis The primary goal of periodontal therapy is to remove bacteria-laden dental plaque otherwise that will lead to progressive decay. In addition to the classic forms of periodontal therapy, laser modalities have also been proposed in recent years. The Er:YAG laser appears to be the most promising laser system for the treatment of marginal periodontitis. Several studies have demonstrated this laser's excellent ability to remove subgingival calculus without producing thermal effects in adjacent tissues. In addition, controlled clinical studies have shown that the Er:YAG laser leads to a signifi cant increase in clinical attachment in both nonsurgical and surgical periodontal therapy. Preliminary clinical results indicate that this minimally invasive tool permits instrumentation of very deep and fl at pockets (eg, when removing root cement or in patients with increased gingival recession) without injuring hard and soft dental tissues. This live operation video demonstrates use of the Er:YAG laser for both nonsurgical and surgical periodontal therapy.

Morphological abnormalities such as peg-shaped laterals are quite frequent dental problems which must be addressed by restorative means. An ideal aesthetic correction can be achieved with minimal or no-loss of tissue, what is known as "Minimally Invasive Dentistry", a concept becoming popular also in Aesthetic Dentistry. This video demonstrates the reconstruction of two lateral incisors with direct composite application, following the "Natural Layering Concept", which implies the use of separate dentin and enamel increments, mimicking the natural tooth anatomy. Step by step procedures will be detailed, which include shade selection, placement of the rubber dam, adhesive procedures, dentin and enamel build-up and finishing-polishing procedures, which finalize the restorative work. By following a precise and meticulous operative protocol, perfectly natural looking restorations can be produced, in a predictable way.

Contents: 1. Removal of free connective tissue graft from palate 2. Suturing to close graft removal site 3. Making the incision for coronal sliding flap 4. Cleaning and smoothing root surface with instruments 5. Removal of granulation tissue 6. Setting the free connective tissue graft into position 7. Graft fixation 8. Mobilizing the coronal sliding flap 9. Flap fixation

Straightforward periodontal treatments by Dr. Sanz Martin

The current restoration is insufficient and the supporting implants show periimplantitis. A new full-mouth rehabilitation has to be planned. This comprehensive case was treated by Dr. Thomas Hitz, Frauenfeld, Switzerland.

Comprehensive case in a woman with periodontitis and large bone defects.

The patient was treated by Dr. Francine Brandenberg (University of Zürich). The Swiss Social System supported the treatment. However, the financial support was restricted to removable prostheses.