27th PSP Annual Conference

Enhancing the biological potential of mesenchymal stem cells within periodontal ligament and stimulating the periodontal regeneration are recognized as being clinically possible. Basic Fibroblast Growth Factor (FGF-2), one of the well-known cytokines, stimulates the proliferation, migration and differentiation of a variety of cell types and strongly induces angiogenesis. We carried out a series of animal studies and revealed that topical application of FGF-2 into experimentally-prepared intrabony defects significantly stimulated the periodontal regeneration accompanying new attachment. In randomized controlled double-blinded clinical trials conducted in Japan, a significant difference in % increase in alveolar bone height at intrabony defects of the periodontitis patients was demonstrated by standardized radiographs between Placebo Group and 0.3% FGF-2 Group at 9 months after the treatment. This FGF-2 medicine has been officially approved and has become commercially available (Regroth®) in Japan since 2017. In this lecture, I would like to explain the mode of actions, efficacy and safety of new FGF-2 medicine (Regroth®) for periodontal regeneration and discuss the future outlook of this therapy.

The mouth is the mirror to ones health. The connection is mutual. When there is poor systemic health, the mouth often reacts with inflammation, xerostomia, periodontal disease... When we take certain medications or undergo hormonal changes, our mouth reflects this...

On January 30, 2020, the World Health Organization (WHO) identified a new virus, SARS-CoV-2, to be a global emergency, and on March 11, 2020, declared it a pandemic. As the death toll keeps climbing, the CDC now predicts the virus will be among the leading cause of death, just behind heart disease and cancer.

Respiratory diseases, like those caused by COVID-19, predispose patients to bacterial superinfections that complicate disease treatments. Oral bacteria have been implicated in those bacterial superinfections. This lecture presentation will highlight biologic mechanisms on the association of periodontal disease and COVID-19-related pulmonary problems. Stressing the importance of maintenance of oral hygiene...implications to dentists and to the public. Future directions would be development of vaccines, antiviral treatment strategies and genetic testing.

Optimal smile in about 70% of the population with medium to high smile lines can be enhanced by proper scalloping alignment of gingiva in the esthetic zone. The pink gingival esthetics is essential and has to be taken strong consideration when managing any types of dental procedures involving possible alteration of dento-gingival junction. Whether it be maintaining or re-creating, the hopeless status of the anterior teeth gives rise to a much challenging clinical situation to achieve satisfactory result. To save or to extract can be tackled either way, however, the efforts and suffers to both patient and treating dentists can be very different. The goal of this presentation is to discuss the most appealing treatment principles for management of hopeless anteriors to achieve gingival esthetics.

Four etiologies of hopeless teeth are discussed, namely, periodontal, endodontic, structural and traumatic. Treatment planning attempt to rescue in the first 2 and to remove on the later 2. Due to time constraint, the rescue mission will be focused on the periodontal hopeless and the removal mission on the structural hopeless. Less is more principle is the major concept to approach the treatment modalities. That is minimal surgeries and less involvement of surgeries are endeavored. Different from posterior teeth, various types of provisionalization during the treatment will also discussed to prevent the social embarrassment due to transient loss of anterior teeth.

I always had a dream as a periodontist to provide a patient centered treatment involving less time, money and morbidity to patient as possible. Your attitude determine your altitude.

Esthetic Clinical Crown Lengthening for 20 Teeth in the Smile Zone – Are You Crazy or What?

Clinical crown lengthening surgery is one of the most popular procedures referred from restorative dentists to periodontists or performed by general dentists for retaining structurally compromised teeth due to caries, deep finishing or fracture lines. Nevertheless, esthetic clinical crown lengthening surgery is by far the fastest and most appealing smile enhancement procedures that patients can appreciate almost instantly following surgery.

Generally speaking, esthetic clinical crown lengthening will involve more than one subjected tooth. For harmonious gingival alignment is concern, it was planned to cover at least 6 upper anterior teeth for most of the time. However, when the smile is further dictated by excessive gingival display due to altered passive eruption with hypermobile upper lip, the surgical zone will increase up to 10 teeth for maxillary teeth. What if additional mandibular teeth also suffer from altered passive eruption? It will then have to call for a surgery to treat another lower 10 for a total of 20 teeth.

10 teeth at a time, the surgeries can be accomplished within one hour for each arch. The results are predictable and lasting if all 10 steps from incision to suture for soft and hard tissue management are followed closely.