Lección 43 de 114
Peri-implant soft tissue dehiscence/deficiencies in the esthetic zone
Etiology, Classification and Recommended treatment protocols
GZ
Giovanni Zucchelli
LT
Lorenzo Tavelli
TráilerGratissin tarjeta de crédito
WhatsAppPregunta por WhatsApp+39 340 1401788
Esta lección forma parte del curso
Zucchelli Channel International
114 lecciones · 99h 31min
De qué trata
The incidence of a peri-implant soft tissue dehiscence is not a rare finding in everyday activity.
Despite the rich literature available, (with multiple attempts aimed at correcting the peri-implant soft tissue esthetic failures), a classification of these conditions has not yet been proposed.
Bearing into consideration the eziological risk factors connected to peri-implant soft tissue dehiscence, and with the aim of erasing any risk of discrepancy in the reported treatment outcomes, in 2019 the publication "Classification of facial peri-implant dehiscence/deficiencies at single implant sites" saw the light on Journal of Periodontology.
With the video that follows, created with Dr. Lorenzo Tavelli, this classification is presented in a very direct and engaging format.
Starting with a comprehensive literature review and risk factor analysis, 4 classes of PSTDs are discussed. The position of the gingival margin of the implant-supported crown in relation to the homologous natural tooth, as well as the bucco-lingual position of the implant head are the key factors that lead this classification. Each class was further subdivided into 3 subclasses based on the height of the anatomical papillae.
For each category a suggested surgical approach is identified (including bilaminar techniques, the combined prosthetic-surgical approach or soft tissue augmentation with a submerged healing), with precious tips made available in the video.
Despite the rich literature available, (with multiple attempts aimed at correcting the peri-implant soft tissue esthetic failures), a classification of these conditions has not yet been proposed.
Bearing into consideration the eziological risk factors connected to peri-implant soft tissue dehiscence, and with the aim of erasing any risk of discrepancy in the reported treatment outcomes, in 2019 the publication "Classification of facial peri-implant dehiscence/deficiencies at single implant sites" saw the light on Journal of Periodontology.
With the video that follows, created with Dr. Lorenzo Tavelli, this classification is presented in a very direct and engaging format.
Starting with a comprehensive literature review and risk factor analysis, 4 classes of PSTDs are discussed. The position of the gingival margin of the implant-supported crown in relation to the homologous natural tooth, as well as the bucco-lingual position of the implant head are the key factors that lead this classification. Each class was further subdivided into 3 subclasses based on the height of the anatomical papillae.
For each category a suggested surgical approach is identified (including bilaminar techniques, the combined prosthetic-surgical approach or soft tissue augmentation with a submerged healing), with precious tips made available in the video.
Las lecciones del curso 114 lecciones
The first stage of this learning experience focuses on the theoretical aspects
characterizing the rationale behind periodontal surgery.
Participants will receive a comprehensive and up-to-date training on the latest developments in the surgical management of simple and complex cases with standard and replicable protocols.
The module includes 5 theoretical video lectures featuring the presentation of various clinical cases, followed by 2 final ReLIVE Surgeries that are shown and discussed step by step to put the previously presented theoretical concepts into practice.
Specific attention is paid to periodontal anatomy and diagnosis, palatal connective graft harvesting and placement techniques, and the management of coronal displaced flaps.
Participants will receive a comprehensive and up-to-date training on the latest developments in the surgical management of simple and complex cases with standard and replicable protocols.
The module includes 5 theoretical video lectures featuring the presentation of various clinical cases, followed by 2 final ReLIVE Surgeries that are shown and discussed step by step to put the previously presented theoretical concepts into practice.
Specific attention is paid to periodontal anatomy and diagnosis, palatal connective graft harvesting and placement techniques, and the management of coronal displaced flaps.
- 1Diagnóstico y pronóstico del tratamiento de recesiones gingivales1h 4min
- 2Colgajo de avance coronal con incisiones de liberación verticales (colgajo trapezoidal)53min
- 3Técnicas de obtención de injertos de tejido conjuntivo1h
- 4Colgajo de avance coronal para recesiones gingivales múltiples1h 40min
- 5Técnica “wall” de injerto de tejido conjuntivo en el tratamiento de recesiones gingivales asociadas a defectos óseos verticales30min
- 59Esthetic treatment of altered passive eruption 59min
- 68Renewals 2024 - Increase in the anterior papilla prior to orthodontic treatment52min
- 77Renewals 2025 - Management of Perforations in Mucogingival Surgery42min
In this second module, Dr. Zucchelli deals with the techniques
and protocols that every periodontist should fully master to manage the
treatment of single gingival recession with competence and efficiency.
From the protocol for coronal flap repositioning to the techniques for the harvesting, processing and positioning of palatal connective grafts, passing through the analysis of the best practices for clinical crown lengthening and augmentation, to the use of matrices for root coverage.
The module consists of 6 ReLIVE Surgeries in which the participant will be guided step by step in the process of acquisition of practical and theoretical skills that will assist him in the continuation of his daily clinical activity.
From the protocol for coronal flap repositioning to the techniques for the harvesting, processing and positioning of palatal connective grafts, passing through the analysis of the best practices for clinical crown lengthening and augmentation, to the use of matrices for root coverage.
The module consists of 6 ReLIVE Surgeries in which the participant will be guided step by step in the process of acquisition of practical and theoretical skills that will assist him in the continuation of his daily clinical activity.
- 6Procedimiento de alargamiento coronario en un premolar fracturado23min
- 7Tratamiento de una recesión gingival en el incisivo central inferior30min
- 8Colgajo desplazado lateralmente para la cobertura de una recesión gingival en el incisivo central inferior49min
- 9Colgajo de avance coronal + CTG para el tratamiento de una recesión gingival en el maxilar superior: como tratar la ausencia de tejido queratinizado y profundidad vestibular1h 3min
- 10Resolución quirúrgica de una recesión gingival en el incisivo inferior: manejo de la extensión del colgajo en presencia de frenillo, ausencia de tejido queratinizado y fenotipo delgado1h 4min
- 11Coronally advanced flap and connective graft for gingival recession resolution in zone 261h 36min
- 61Treatment of a palatal recession31min
- 78Renewals 2025 - Coronal Advancement for a Deep Defect on Lateral Incisor and Management of Recession on Adjacent Central Incisors1h 37min
- 80Renewals 2025 - Management of the Thin Papilla between the Two Premolars with Simultaneous Coronally Advanced Flap57min
After having comprehensively discussed single gingival recessions,
in this training module Dr. Zucchelli's main focus is on the management of multiple recessions.
The techniques examined in the previous module such as coronal flap displacement and the application of grafts and matrices represent the basis for approaching the clinical cases presented here.
Thanks to the ReLIVE Surgeries, commented punctually by Dr. Zucchelli, participants will observe the protocols for performing distal releases and the innovative 'Connective Wall Technique'.
The final clinical cases will be exemplary: risk factors are discussed, with a special focus on their prevention and intra-operative management.
The techniques examined in the previous module such as coronal flap displacement and the application of grafts and matrices represent the basis for approaching the clinical cases presented here.
Thanks to the ReLIVE Surgeries, commented punctually by Dr. Zucchelli, participants will observe the protocols for performing distal releases and the innovative 'Connective Wall Technique'.
The final clinical cases will be exemplary: risk factors are discussed, with a special focus on their prevention and intra-operative management.
- 12Colgajo de avance coronal con injerto de tejido conjuntivo para el tratamiento de recesiones múltiples y la mejora de la papila interdental1h 12min
- 13Colgajo de avance coronal con injerto de tejido conjuntivo para el tratamiento de recesiones múltiples de los incisivos inferiores1h 5min
- 14Técnica bilaminar múltiple con incisión vertical en la mandíbula superior con cobertura de recesión por medio de un injerto de matriz alternativa1h
- 15El tratamiento de recesiones gingivales múltiples con injertos de tejido combinado1h 7min
- 16El tratamiento de recesiones múltiples en la zona estética con colgajo de avance coronal e injerto de tejido conjuntivo45min
- 17Cirugía conservadora anterior en el maxilar superior con injerto de tejido conjuntivo38min
- 18Tratamiento de recesiones múltiples con injerto de tejido mixto: CTG en 23 y matriz de colágeno en 241h 3min
- 19Colgajo avanzado vertical (VAF) con CTG simultáneo en 31 y 411h 2min
- 20Resolución quirúrgica de recesiones gingivales múltiples: la técnica "False Gingival Recession"1h 2min
- 21Coronally advanced flap and connective graft for the treatment of two gingival recessions in zone 33-341h 16min
- 65False recession to perform a flap to treat multiple recessions1h 1min
- 66Renewals 2024 - Treatment of multiple recessions with a focus on the coronal attachment of the frenulum, narrow papilla, and the deficiency of keratinized gingiva1h 1min
- 67Renewals 2024 - Recession on highly vestibularized canines and reduced recessions on the fourth and fifth1h 11min
- 70Renewals 2024 - The management of multiple gingival recessions with different depths53min
- 73Renewals 2024 - Multiple gingival recessions in the posterior mandibular areas57min
The bilaminar technique is increasingly used to manage recessions due
to its effectiveness and predictability, without considering the
biological advantages that allow better tissue healing.
In this module, Dr. Zucchelli illustrates the protocols behind the bilaminar grafting technique in mucogingival surgery.
The differences between the use of single and multiple bilaminar flaps is discussed and the rationale behind the selection of one or the other flap is explained.
Through the viewing of ReLIVE Surgeries, participants will experience surgical procedures for covering severely deep gingival recessions and managing very exposed root elements.
In this module, Dr. Zucchelli illustrates the protocols behind the bilaminar grafting technique in mucogingival surgery.
The differences between the use of single and multiple bilaminar flaps is discussed and the rationale behind the selection of one or the other flap is explained.
Through the viewing of ReLIVE Surgeries, participants will experience surgical procedures for covering severely deep gingival recessions and managing very exposed root elements.
This module, fully focused on periodontal regenerative procedures,
comprises 4 theoretical lectures preparatory to the optimal fruition
of the following ReLIVE Surgeries.
Dr. Zucchelli presents the rationale behind the decision whether to extract or regenerate the dental element according to the different entities of the periodontal defect.
Diagnostic protocols, various types of vertical bone defects and techniques such as the Wall Technique are examined in detail in the initial theoretical part of the course and then transferred into practice with the ReLIVE Surgeries.
Dr. Zucchelli presents the rationale behind the decision whether to extract or regenerate the dental element according to the different entities of the periodontal defect.
Diagnostic protocols, various types of vertical bone defects and techniques such as the Wall Technique are examined in detail in the initial theoretical part of the course and then transferred into practice with the ReLIVE Surgeries.
- 25El tratamiento de tejidos blandos en la regeneración periodontal1h 11min
- 26Diagnóstico y pronóstico de los defectos óseos verticales42min
- 27Un enfoque novedoso para minimizar la recesión gingival en la regeneración periodontal: la importancia del tratamiento no quirúrgico21min
- 28Un enfoque novedoso para minimizar la recesión gingival en la regeneración periodontal: el tratamiento quirúrgico40min
- 29Tratamiento quirúrgico de recesiones gingivales múltiples y regeneración tisular combinada con matriz de gel de amelogenina y xenoinjerto de tejido dérmico alternativo26min
- 30Colgajo de avance coronal en el incisivo central e injerto de tejido conjuntivo en el lado lingual12min
- 31Técnica “wall” con abordaje de colgajo único para la regeneración periodontal alrededor de los incisivos inferiores1h 6min
- 58Regenerative surgery on a vertical defect on tooth 2318min
- 74Renewals 2024 - Advancements in Regenerative Periodontal Therapy for Frontal Area Intraosseous Defects57min
- 86Renewals 2025 - Complex Case of Periodontal Regeneration on the Entire Upper Arch1h 21min
In this module, Dr. Zucchelli gives participants a comprehensive
overview of the most important aspects of peri-implant soft tissue
treatment and prevention.
The similarities and differences between recessions around teeth and those around implants are thoroughly explained, and complex treatment protocols such as post-implant vestibuloplasty are reviewed.
In addition, participants will discover the risk factors of the regenerative therapy in the aesthetic area and how to address and prevent them.
Complete surgery with implant placement using a computer-guided approach is also shown, and the strategies for achieving aesthetically pleasing results are analysed.
The similarities and differences between recessions around teeth and those around implants are thoroughly explained, and complex treatment protocols such as post-implant vestibuloplasty are reviewed.
In addition, participants will discover the risk factors of the regenerative therapy in the aesthetic area and how to address and prevent them.
Complete surgery with implant placement using a computer-guided approach is also shown, and the strategies for achieving aesthetically pleasing results are analysed.
- 32Manejo de tejidos blandos alrededor de implantes37min
- 33Factores relacionados con recesión de mucosas alrededor de implantes osteointegrados29min
- 34Colocación inmediata del implante con injerto simultáneo de tejido conjuntivo1h 15min
- 35Colgajo de avance coronal con injerto de tejido conjuntivo en los implantes49min
- 36Colocación guiada de implantes con injerto de tejido conjuntivo39min
- 37Colocación de implante con colgajo de avance coronal21min
- 38Colocación de implantes en el elemento 21 y aumento de los tejidos duros y blandos1h 41min
- 63Immediate loaded guided implants with bone reconstruction and CTG1h 19min
- 69Renewals 2024 - Bone regeneration procedure with a membrane anchored to the periosteum in implant therapy and soft tissue augmentation1h 39min
- 72Renewals 2024 - Connective Tissue Graft for Aesthetic Correction of Gingival Translucency Adjacent to an Implant1h 11min
3945minENEN / ES
Cobertura de dehiscencia del tejido blando alrededor de coronas implantosoportadas: factores claveGiovanni Zucchelli
79,00 €
401h 25minENEN / ES
Surgical technique: soft tissue dehiscence around single implant-supported crownGiovanni Zucchelli
89,00 €
4159minENEN / ES
Manejo de tejidos blandos antes y después de la colocación del implante: prevención de la dehiscencia bucalGiovanni Zucchelli
79,00 €
4241minEN
Colocación de implantes post-extracción y carga inmediata en la zona estética con técnica CTGGiovanni Zucchelli
79,00 €
4336minENEN / ESVer gratis
Peri-implant soft tissue dehiscence/deficiencies in the esthetic zone
Giovanni Zucchelli, Lorenzo Tavelli
441h 45minENEN / ES
Enfoque multidisciplinario quirúrgico y protésico para tratar implantes desplazados y el alargamiento estético de corona en los elementos adyacentesGiovanni Zucchelli
99,00 €
451h 36minEN
Colocación de implantes post-extracción con carga inmediata en el elemento 11Giovanni Zucchelli
99,00 €
4789,00 €
601h 23minEN
Post-extractive guided implant in zone 11 with bone recontruction and soft tissue augmentation Giovanni Zucchelli
89,00 €
711h 5minEN
Renewals 2024 - Soft tissue augmentation in post-extraction implant therapyGiovanni Zucchelli
89,00 €
751h 10minEN
Renewals 2024 - Immediate post-extractive implant placement in the central incisor with concurrent correction of altered passive eruption of adjacent teethGiovanni Zucchelli
89,00 €
7654minEN
Renewals 2025 - Implant Placement Post-Extraction and Management of the Resorbed Papilla with Simultaneous Treatment of Adjacent Multiple RecessionsGiovanni Zucchelli
79,00 €
8189,00 €
8249minEN
Renewals 2025 - Approach to the Management of a Small Vestibular Soft Tissue Dehiscence of an Implant in the Upper Lateral AreaGiovanni Zucchelli
79,00 €
8444minEN
Renewals 2025 - Soft tissue approach to immediate post-extraction implant installationGiovanni Zucchelli
79,00 €
This module offers the latest guidelines on soft
tissue augmentation procedures around osteointegrated implants.
Among the covered topics there are keratinised tissue augmentation, the performance of mucogingival surgery for implant coverage, and the use of the connective platform technique to fill edentulous saddles.
During the 6 ReLIVE Surgeries in this module, participants will acquire the knowledge and confidence necessary to successfully perform these complex procedures.
Among the covered topics there are keratinised tissue augmentation, the performance of mucogingival surgery for implant coverage, and the use of the connective platform technique to fill edentulous saddles.
During the 6 ReLIVE Surgeries in this module, participants will acquire the knowledge and confidence necessary to successfully perform these complex procedures.
- 48Mejora lingual-bucal y apical-coronal de los tejidos blandos de la zona desdentada con CAF26min
- 49Estética en dientes naturales e implantes: grosor vs. fijación1h 26min
- 50Mejora del tejido blando buco lingual alrededor de un puente implantosoportado en la zona estética55min
- 51Técnica de la plataforma de tejido conectivo: aumento tridimensional del tejido blando en el espacio edéntulo del incisivo central maxilar1h 39min
- 52Aumento de tejidos blandos en la zona 212h 5min
- 62Guided implant on a healed crest with CTG 1h 5min
- 64Guided implant on site 35 with connective tissue graft29min
- 79Renewals 2025 - New Mucogingival Approach with Buccal Soft Tissue Augmentation in Lateral Agenesis before Implant Placement47min
The last module of the learning experience offered by
"Zucchelli Channel" sees an in-depth discussion about the
management of gingival recessions and soft tissue around the implant.
Dr. Zucchelli provides an in-depth explanation aimed at making participants aware of the procedures for immediate post-extractive implant placement with and without the use of CTG.
At the end of this module, participants will be able to manage complex cases and perform in the best possible way each surgical step preparatory to achieving optimal aesthetic-functional results.
Dr. Zucchelli provides an in-depth explanation aimed at making participants aware of the procedures for immediate post-extractive implant placement with and without the use of CTG.
At the end of this module, participants will be able to manage complex cases and perform in the best possible way each surgical step preparatory to achieving optimal aesthetic-functional results.
- 53Tratamiento de recesiones múltiples en dientes e implantes con colgajo de avance coronal e injerto de tejido múltiple58min
- 54Tratamiento de recesiones gingivales en el implante en posición de incisivo central1h 3min
- 55Resolución de un defecto del tejido blando periimplantario bucal mediante CTG+CAF1h 20min
- 56Colocación de implante en el elemento 14 y CTG con resolución simultánea de recesiones gingivales múltiples1h 7min
- 57Corrección estética de un implante en el incisivo central superior1h 5min
- 83Renewals 2025 - Management of the Papilla and Coverage with a Connective Tissue Graft for Optimizing the Implant Emergence Profile43min
- 85Renewals 2025 - Mucogingival Surgery for the Treatment of a Vestibular Esthetic Issue on Implant in Site 221h 8min
- 88Renewals 2026 - Coronobuccolingual Soft Tissue Augmentation and Treatment of Interproximal Recession with Attachment Loss1h 33min
- 89Renewals 2026 - Soft Tissue Augmentation and Bone Defect Regeneration in the Canine–Premolar Area of an Orthognathic Patient with Root Coverage and Papilla Reconstruction48min
- 90Renewals 2026 - Treatment of Grade II Furcation Defects with Horizontal Probing on Lower First and Second Molars Using the Wall Technique57min
- 91Renewals 2026 - Soft Tissue Augmentation of the Pontic–Implant Area with Papilla Reconstruction and Passive Eruption Correction of the Central and Lateral Incisors1h 7min
- 92Renewals 2026 - Treatment of Multiple Anterior and Posterior Recessions on Five Teeth Using a Coronally Advanced Flap without Vertical Releasing Incisions55min
- 93Renewals 2026 - Combined Treatment of a Single Recession with Limited Keratinized Tissue on Tooth 4 and Optimization of the Prosthetic Emergence Profile on Canine and Lateral Incisor Using a Coronally Advanced Flap and Connective Tissue Graft at the Molar Level1h
- 94Renewals 2026 - Conservative Surgical Approach with Intrasulcular Rolling Technique in Orthodontic Patient with Horizontal Bone Loss1h 21min
- 95Renewals 2026 - Management of Implant Malposition and Buccal Soft Tissue Optimization1h 8min
- 96Renewals 2026 - Bilaminar Coronally Advanced Flap and Localized Connective Tissue Graft for the Management of the Defect on Tooth 41 and Phenotype Enhancement on Tooth 31 in the Absence of Keratinized Tissue54min
- 97Renewals 2026 - Periodontal Regeneration with the Wall Technique for an Extensive Infrabony Defect in the Mandibular Incisor Area1h 1min
- 98Renewals 2026 - Root Coverage of Central Incisor Recession in an Orthognathic Patient Using Bilaminar Technique Before Interincisal Expansion
- 99Renewals 2026 - Wide and Deep Single Recession with Coronal Frenulum Insertion and Limited Keratinized Tissue
- 100Renewals 2027 - Peri-Implant Soft Tissue Refinement After Multiple Grafts: Correcting Excess Volume and Double Contour
- 101Renewals 2027 - Post-extractive Immediate Implant Placement in a Central Incisor With Thin Tissues: Connective Tissue Grafting and Papilla Management
- 102Renewals 2027 - Correction of Superficial Metallic Pigmentation in the Esthetic Zone
- 103Renewals 2027 - Immediate Implant Placement in a Premolar Site: Soft Tissue Preparation and Augmentation, Provisionalization and Gap Management
- 104Renewals 2027 - Implant Placement After Vertical Soft Tissue Augmentation: How to Achieve Papilla Reconstruction and a Correct Emergence Profile
- 105Renewals 2027 - Lower Incisor Recessions With a Thin Phenotype: Planning V-CAF and Connective Tissue Grafting
- 106Renewals 2027 - Inter-implant papilla reconstruction in the aesthetic zone following previous buccal soft tissue augmentation
- 107Renewals 2027 - Mucogingival Approach to Posterior Implant Placement: Increasing Supracrestal Soft Tissue Thickness
- 108Renewals 2027 - Papilla Reconstruction and Soft Tissue Augmentation Before Implant Placement: Platform Technique
- 109Renewals 2027 - Vertical Soft Tissue and Papilla Reconstruction in an Anterior Edentulous Site With Connective Tissue Grafting
- 110Renewals 2027 - Implant Placement With Papilla and Soft Tissue Reconstruction Following Traumatic Loss of an Incisor
- 111Renewals 2027 - Lower Incisor Recession With Limited Vestibular Depth: Managing a Coronally Attached Frenulum, Muscle Pull and the Adjacent Tooth
Docentes
GZ
Giovanni Zucchelli
Giovanni Zucchelli, DDS, Ph.D. graduated in 1988 from the University of Bologna, Italy with a degree in dentistry. He was Professor of Periodontology and Implantology at the University of Bologna, Italy, from 2000 to 2025. Giovanni Zucchelli received many awards for clinical research in periodontology in Europe and the United States. Innovator of several soft tissue plastic surgical techniques, he is also author of more than 100 publications in Pubmed. He is speaker at major international conferences on periodontology and has taught theoretical and practical (with live surgery) courses in numerous countries. Zucchelli is the author of the book titled, "Mucogingival Esthetic Surgery" best seller from Quintessence Publishing which is published in 10 different languages and co-author of two illustrated textbooks on periodontal plastic surgery (Ed. Martina) and of the chapter "Mucogingival Therapy-Periodontal Plastic Surgery" in Clinical Periodontology and Implant Dentistry (Lindhe J, Lang NP, Karring T [eds], Wiley-Blackwell).
LT
Lorenzo Tavelli
Full-time faculty member in the Department of Oral Medicine, Infection, and Immunity, Division of Periodontology at the Harvard School of Dental Medicine (Boston, USA), Dr. Tavelli graduated from the University of Milan in 2017. He completed his three-year residency in Periodontics and his Master of Science in 2020 at the University of Michigan. His main focus has been to conduct clinical research in periodontal and peri-implant plastic surgery. Dr. Tavelli has published more than 80 scholarly publications in international peer-reviewed journals in periodontics and implant dentistry. He has been the recipient of several research awards, including the 2021 Goldman Clinical Research award by the Italian Society of Periodontology (SiDP), the 2020 American Academy of Periodontology Balint Orban Research Competition, first prize in the research competition at the 2020 National Osteology Symposium, the 2020 American Academy of Periodontology Foundation School Research Award, and first prize in the research competition at the third International Symposium on soft tissue management focused on teeth and implant dentistry in Florence, Italy. Since August 2021, Dr. Tavelli has been a full-time faculty at the Harvard School of Dental Medicine, Boston, USA.
Preguntas frecuentes
Yes. Watch the lessons on computer, tablet or smartphone, straight from the browser with no app to install, and each video picks up where you stopped, even when you switch devices: start at the practice, finish at home.
