– Received DDS degree from the University of Maryland Dental School, USA.
– Completed periodontology training and Doctor of Medical Science (DMSc) in oral biology from Harvard School of Dental Medicine, USA.
– Associate Professor at Harvard School of Dental Medicine, and Director of Continuing Professional Education.
– Recipient of the Joseph L. Henry Award recognizing excellence in research and clinical training from Harvard, Balint Orban Research Award; Award for Outstanding Teaching and Mentoring in Periodontics, Junior and Senior Faculty Awards from the Harvard School of Dental Medicine.
– Teaching Fellowship from the American Academy of Periodontology.
– Research interests: use of innovative concepts, technologies and biomaterials to enhance intraoral soft and hard tissue formation, especially by incorporating the tissue engineering concept to repair and regenerate soft and hard tissue volume for patients requiring dental implants to replace missing teeth.
– Diplomat of the American Board of Periodontology.

Despite advancements in dentistry, the reality of tooth loss persists, particularly among geriatric and medically compromised patients. This vulnerable population will also suffer from functional decline and age-related pathologies. Thus, preserving and restoring teeth and oral function will be crucial, and the loss of teeth significantly hinders chewing ability because prosthodontic treatments cannot fully restore masticatory performance. It’s worth noting that the retention of natural teeth is linked to a longer life expectancy. This presentation will introduce the role of growth factors and dental lasers in periodontics and how different specialists in dentistry could work together to keep teeth and implants for life.

– Received DDS degree from University of Detroit Mercy, USA in 1995.
– Received Certificate in Hospital Dentistry from Johns Hopkins Hospital, USA in 1996.
– Received MHCM (Master in Health Care Management) from Harvard School of Public Health in 2008.
– Received MS, Certificate in Periodontics, from Mayo Clinic, USA in 1999.
– Adjunct Clinical Professor, University of Michigan Dental School, USA.
– Private Practice in Periodontics and Implant Surgery.
– Diplomate, American Board of Periodontology.
– AAP President 2023-2024.

The American Academy of Periodontology aims to be a collaborative partner for all periodontists worldwide. Current initiatives and opportunities for collaboration will be discussed.

– Received BDS degree from Otago University, New Zealand in 1985.
– Received MDS degree from Otago University, New Zealand in 1992.
– Fellowship from Royal Australasian College of Dental Surgeons in 2001.
– Received PhD degree from Otago University, New Zealand in 2005.
– Membership in Royal Society of New Zealand (MRSNZ) in 2012.
– Received Prof. title from Otago University in 2015.
– Received BA degree from Otago University in 2024.
– Director of the Sir John Walsh Research Institute, Associate Dean for Research, and Head of Periodontology at Otago University Faculty of Dentistry.
– Regimental Colonel of the Royal New Zealand Dental Corps, and Honorary Dental Surgeon to the Governor General of NZ.

We have developed a bovine bone xenograft (OMB) doped with antibacterial lipoic-capped silver-nanoparticles (AgNP), for alveolar ridge preservation after tooth extraction. In 4 sheep, mandibular premolar teeth were extracted; each also received two 8.5x4mm deep circular defects in the femoral epicondyle of both posterior legs. Sites were filled either OMB, OMB+AgNP, BioOss® xenograft or left unfilled, and covered with a resorbable collagen membrane. Two sheep each were euthanised after 8 and 12 weeks. Samples were analysed using non-demineralised resin-embedded histology.

Results: OMB+/-AgNP demonstrated equivalent bone fill to each other and to BioOss®; all grafted sites showed more bone fill than un-grafted controls. Mandibular socket and femur sites were comparable. Results were not statistically compared in this pilot study. Conclusions. Both modified OMB BBXs showed equivalent results to commercially available BBX (BioOss®). The addition of AgNP did not impair bone healing. This pilot study supports progressing to larger-scale preclinical trials.

Objectives:
– Grafting materials and Guided bone regeneration.
– Novel antimicrobial approaches to oral infection.
– Histomorphometric analysis in animal model.

– Professor Emeritus at the University of Adelaide, Australia.
– Past President of the International Academy of Periodontology, the Asian Pacific Society of Periodontology, and RACDS Division of Periodontics.
– Associate Editor of the Journal of Periodontal Research, Periodontology 2000.
– Editor of the Journal of the International Academy of Periodontology and the Australian Dental Journal.
– Received the Straumann/IADR Award for Periodontal Regenerative Medicine and the IADR Distinguished Scientist Award for Research in Periodontal Disease.
– Focussed on the use of stem cells for periodontal regeneration and periodontal/systemic health interrelationships.
– Author of over 350 scientific articles.

Periodontal treatment in post antibiotic era will incorporate significantly reduced, if not elimination of, antibiotic use for the management of the periodontal diseases. In their place, the development of novel antimicrobial and, importantly, inflammation modulatory biologics, that can be incorporated into sophisticated or simple delivery systems will be used as adjuncts to conventional periodontal therapy. The use of these adjuncts would be based on current understanding of the pathogenesis of periodontitis and the central role that inflammation plays in this process. This should not diminish the rational use of antimicrobial (non-antibiotic) agents as well.

Treatments could be made on the basis of a personalized approach to specifically target the microbial biofilm, the inflammatory response, or both, depending on the clinical findings and individual features of each case. Thus, a more holistic approach to management of the periodontal diseases will evolve and move our treatment focus from a mono-therapy anti-bacterial approach to one that considers more of the underlying causes and ramifications of periodontal inflammation.

In the future, the use of antibiotics will become redundant as viable alternatives for their replacement become available. This, together with novel local delivery vehicles will forge a new future in the post antibiotic era.

– Received BDS degree from University of Malaya, Malaysia in 1995.
– Received MClinDent in Periodontology with Distinction from University College of London, UK in 2005.
– Received Cert. in Periodontology from the European Federation of Periodontology in 2005.
– Senior Consultant in Periodontics, Ministry of Health, Malaysia.
– President, Malaysian Society of Periodontology.

Hereditary gingival fibromatosis (HGF) is a rare disorder characterized by a benign, non-hemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. HGF usually begins during the transition from primary to permanent teeth, other than disrupting the eruption of permanent teeth and functional derangement of the dentition, it can have a negative psychological effects to a young patient due to impaired aesthetic.

As it does not resolve spontaneously, both periodontal and orthodontic aspects need to be considered which may involve multiple surgical intervention and orthodontic movement which prove to be challenging. This lecture will discuss the Periodontic-Orthodontic management of a clinical case of HGF covering the various surgical approach, timing of extraction and orthodontic movement.

Objectives:
– Understanding the clinical characteristics of Hereditary Gingival Fibromatosis (HGF).
– Discuss management of HGF involving periodontic-orthodontic approach using a clinical case.
– Discuss briefly recurrence rate and psychological effects of condition.

– Received DDS degree from Ege University, School of Dentistry, Türkiye.
– Attended Periodontology Program of Graduate Study at Ege University and awarded a PhD degree at Periodontics.
– Visiting Professor in the Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy and in the Department of Oral Health Sciences, Periodontology and Oral Microbiology, KU Leuven, Belgium.
– Invited Professor in Post-Graduate Program in Periodontology and Implantology, University of Porto, Portugal.
– Board member & Treasurer of Turkish Society of Periodontology.
– Member of European Federation of Periodontology, Italian Society of Periodontology and Implantology, Turkish Academy of Esthetic Dentistry.
– Honorary member of Croatian Academy of Aesthetic Dental Medicine.
– Research interests: mono/multi-center clinical research and development in periodontology, with special emphasis to plastic-periodontal surgery, guided bone/tissue regeneration and esthetic implant therapy.

Periodontal treatments involving cause-related therapy, resective and regenerative periodontal surgeries have been well documented over the last 30 years. In the era of esthetics, clinicians are seeking for optimal results by avoiding invasive treatments. Recent developments in regenerative techniques and adoption of microsurgery in periodontal and peri-implant tissue reconstruction minimize the tissue trauma/loss, and this led to an increase in the expectations of the patients. However, the clinical excellence does not only depend on the clinical skills or practice settings.

Treatment outcome is influenced by combination of many factors. For clinical success, treatment steps and protocols should be embraced by patient and clinician. In this lecture, the requirements for periodontal/peri-implant tissue reconstruction and health will be discussed in greater details.

– Received BDS degree from Liaquat Medical College, Hyderabad, Pakistan in 1991.
– Received Prof. title from National Academy of Medical Sciences in 2010.
– Chief Consultant Dental Surgeon, National Academy of Medical Sciences, Nepal.

Periodontal surgeries aim to restore and maintain the health and aesthetics of the periodontium. Among the critical aspects of successful periodontal surgery is the preservation of the interdental papilla. The contour of the interdental tissues, as well as the color and texture of the keratinized tissues, are essential elements of anterior esthetics. Preservation techniques, such as careful flap design, minimally invasive approaches, and meticulous handling of soft tissues are essential to minimize trauma and maintain blood supply to the papilla.

This presentation aims to highlight the significance of papilla preservation in periodontal surgery, the techniques, and their impact on the overall success of the procedure. Furthermore, the impact of patient-specific factors and anatomical considerations on papilla preservation outcomes is also addressed. By prioritizing papilla preservation and employing evidence-based techniques, periodontists can enhance treatment outcomes and patient satisfaction in periodontal surgery.

Objectives:
– To understand papilla preservation flap surgical technique.
– To learn how to maintain papilla form.
– To learn how to preserve soft tissue in esthetic areas.

– Received DDS degree from Faculty of Odonto-Stomatology, University of Medicine and Pharmacy, Ho Chi Minh City in 1990.
– Received MSc degree from University of Pharmacy and Medicine, Ho Chi Minh City in 1998.
– Received PhD degree in Maxillofacial Surgery at 108 Institute of Clinical Pharmaceutical and Medical research in 2011.
– Received MSD degree specializing in Orthodontics, Munster University, Germany in 2014.
– Vice Dean, Faculty of Dentistry, Head of Department of Oral Pathology and Maxillofacial Surgery, Pham Ngoc Thach Medical University, HCMC from 2017 to 2019.
– Dean of Faculty of Dentistry, Head of Department of Oral Pathology and Maxillofacial Surgery, Head of Department of Orthodontics and Pedodontics, Van Lang University, HCMC.
– Chairman of the Ethics Committee in Biomedical Research, Van Lang University.

Smile aesthetics are closely related to smile lines and smile arcs. Gummy smile, where more than 2 mm of gums are exposed when smiling, is an aesthetic issue that many patients concerned about. Gummy smile are associated with delay passive eruption and are successfully resolved with crown lengthening solution.

However, crown lengthening is not the only solution to treat a gummy smile because gummy smile is caused many different etilologies that need many other solutions to treat it successfully. This presentaiotn analyzes the different causes of gummy smile and corresponding treatment solutions, in which many cases require integrated treatment through many illustrative clinical cases.

– Received DDS degree from the University of the East-Manila, Philippines in 2016.
– Received MDS in Periodontology degree from the University of Hong Kong in 2021.
– Recognized Specialist by the Philippine Society of Periodontology and European Federation of Periodontology.
– Private practice and specialist consultant in multiple clinics in Metro Manila, Philippines.

Periodontal disease is an inflammatory condition of the periodontium characterized by attachment loss, and ultimately, tooth loss. Tooth loss is the initiating event of masticatory dysfunction, which may only be noticeable to the patient once a substantial amount has occurred. A significant concern that comes with this dysfunction is the difficulty in its diagnosis, and the limitations it poses on restoration and rehabilitation. The presence of masticatory dysfunction is the delineating factor between a diagnosis of Stage III and Stage IV Periodontitis.

However, being the ambiguous concept that it is, it creates gray areas in both diagnosis and treatment, and subsequently, implementation in the clinical practice that present research continuously aims to decode. Recently, a guideline on the diagnosis and management of these cases has been published demonstrating current evidence which includes clinical investigations that may make it more applicable to the daily practice.

Objectives:
– To give a brief revision on the current classification of periodontitis.
– To discuss the criteria that are unique to the Stage IV classification
– To present the proposed framework on treatment sequence for management of Stage IV cases.
– To emphasize the key concepts in setting treatment goals and management of Stage IV cases.
– To introduce current evidence on the clinical application for the diagnosis of masticatory dysfunction.

– Received BDS degree (Hon) from The University of Hong Kong.
– Received MDS degree in Periodontology (Distinction) from The University of Hong Kong.
– Clinical assistant professor, The University of Hong Kong.
– Fellow of the Hong Kong Academy of Medicine (Dental Surgery).
– Fellow of the College of Dental Surgeons of Hong Kong in the Specialty of Periodontology.
– Membership in Periodontics, Royal College of Physicians and Surgeons of Glasgow.
– Specialty Membership in Periodontics, Royal College of Surgeons of Edinburgh, UK.
– Council member of the Hong Kong Society of Periodontology and Implant Dentistry.

The clinical judgment of whether to retain periodontally compromised molar through comprehensive periodontal therapy or to extract and replace them with dental implants involves a multifaceted decision-making process that extends beyond the scientifically reported efficacy of the two treatment modalities. This decision has to factor in multi-level elements, including but not exhaustive of the subject, dentition, and site-associated risk factors; periodontal, restorative, endodontic, and occlusal considerations; the strategic value of tooth in dentition; patient’s economics and predilection; and the clinician’s skill and level of training.

This presentation will evaluate the existing modern approaches, efficacy, and cost efficiency related to treatment and maintenance of periodontally compromised molars. Furthermore, we will delve into the biological ramifications stemming from the ultimate loss of these molars and examine the strategies and implications associated with rehabilitating these residual ridges with dental implants. The significance of considering both patient and site-level factors when planning tooth extraction and formulating implant rehabilitation protocols will be highlighted.

Objectives:
– Appraise the current evidence in the contemporary strategies, predictability, and cost effectiveness in the retention of periodontally compromised molars in the life course of periodontal patients.
– Predict alveolar healing patterns and sinus pneumatization following loss of periodontally compromised molars and comprehend the challenges associated with implant rehabilitation.
– Discuss the efficacy of alveolar ridge preservation in periodontally compromised molar extraction sites.

– Received BDS degree from University of Newcastle Upon Tyne, UK in 2011.
– Received PhD degree from Yonsei University School of Dentistry, Korea in 2018.
– Clinical assistant professor at Department of periodontology, Yonsei University Dental Hospital, Korea.

There are several advantages of using an allogenic bone block for vertical bone regeneration. Firstly, very good stability can be obtained at the surgical site after fixation of the block. Secondly, there is no donor site morbidity which is a complication when harvesting autogenous block bones. Thirdly, there is no need for the fixation of the barrier membrane for stability which can be a technically demanding procedure. However, the number of studies on vertical bone augmentation using the allogenic bone block is low. In this presentation, clinical cases of vertical ridge augmentation using irradiated allogenic cortico-cancellous bone will be shown including radiographic and histological evidence.

Objectives:
– Clinical indications of vertical bone augmentation using the allogenic block bone.
– How to achieve appropriate fixation of the block bone.
– The appropriate combination of regenerative materials when using the block bone.
– The amount of vertical bone gain that can be expected using the allogenic bone block
– Histological appearance of the regenerated bone using the allogenic block bone.

– Received BDS degree from Government Dental College, Bangalore, India in 1980.
– Received MDS degree from Government Dental College, Bangalore, India in
1985.
– Received Prof. title from Government Dental College, Bangalore,
India in 2000.
– Former Dean and Director, Professor and Head Department of
Periodontology.

Periodontitis is a multi-factorial chronic inflammatory condition which affects the supporting tissues of the tooth. Periodontal disease and diabetes have bi-directional relationship. The host response against periodontal pathogens results in release of various inflammatory mediators which may have profound effects on systemic condition notably Type 2 Diabetes Mellitus. Netrin-1 are the laminin-like secreted neuronal guidance protein which acts as a guidance cue in the developing central nervous system.

They function either chemo-attractive or chemo-repulsive through DCC and UNC-15 receptor respectively. MCP-1 has a significant role in the pathophysiology of several diseases as a critical modulator of monocyte chemotaxis and T-lymphocyte differentiation. This study was designed to evaluate the levels of Netrin-1 and MCP-1 in Gingival Crevicular Fluid (GCF) and serum in Stage III Grade B Periodontitis, T2DM and Obesity.

Objectives:
– To estimate the levels of Netrin-1 and MCP-1 in GCF and serum in periodontally healthy subjects, Stage III Grade B periodontitis subjects, with and without Type 2 Diabetes Mellitus and Obesity.
– To find out association between Netrin-1 and MCP-1 levels in GCF and serum in periodontally healthy subjects, Stage III Grade B periodontitis subjects, with and without Type 2 Diabetes Mellitus and Obesity.
– To compare and correlate between the levels of Netrin-1 and MCP-1 in GCF and serum in periodontally healthy subjects, Stage III Grade B periodontitis subjects, with and without Type 2 Diabetes Mellitus and Obesity.
– To explore the possibility of using Netrin-1 and MCP-1 as a marker of inflammation in Stage III Grade B periodontitis and relating with clinical parameters.

– Received BDS degree from Faculty of Dentistry, Universitas Indonesia in 2009.
– Received DDS degree from Faculty of Dentistry, Universitas Indonesia in 2011.
– Received Specialist in Periodontology degree from Faculty of Dentistry, Universitas Indonesia in 2014.
– Consultant of Periodontal Reconstruction and Dental Implant, Collegium of Periodontology Indonesia from 2021.
– Received PhD degree from Faculty of Dentistry, Universitas Indonesia in 2024.
– Lecturer of Periodontology Department, Faculty of Dentistry, Universitas Indonesia.

Recently, the development of injectable scaffolds for tissue engineering has been growing interest. To develop a novel scaffold for periodontal hard and soft tissue regeneration, bone graft pastes consisting of nano-hydroxyapatite, chitosan, and gelatin (nHA/KG) and also a crosslinked collagen/gelatin (Col/Gel) hydrogel has been designed. In vitro studies on physical, chemical, and biological characteristics were analyzed.

For nHA/KG paste, the viscosity characteristics resemble the gel phase. PO43-, CO32-, -OH, Amide I, and II functional groups were detected in nHA/KG paste. Increasing the collagen concentration in the hydrogel (Col-Gel) 1:2 showed the best degradability rate. 3D culture studies of MC3T3E-1 and MRC-5 on nHA/KG paste and HGFs on Col/Gel showed the percentage of cell viability >70%. Up-regulated expression of ALP, OCN, RUNX2, and COL1 were exhibited by nHA/KG pastes. Similar results were also found on COL1 expression by HGFs with Col-Gel. Both nHA/KG pastes and Col/Gel hydrogel are potentially injectable scaffolds for periodontal regenerative therapy.

Objectives:
To analyze the differences in the characteristics of nHA/KG bone graft paste and crosslinked collagen/gelatin hydrogel (Col-Gel) in periodontal tissue regeneration.

– Received BDS degree from the National University of Singapore in 1998.
– Received MDS degree in Periodontology from National University of Singapore in 2005.
– Received Dr. Med. Dent. from the University of Berne, Switzerland in 2008.
– Former Consultant, National Dental Centre, Singapore.
– Specialist Periodontist, Founding Partner, The Dental Studio, Singapore.
– Received IADR Book Prize in 2005 and André Schroeder Research Prize in 2015.

Life-long maintenance of natural teeth and prevention of premature tooth loss may in the long run, cost less for the patient in many aspects. For periodontally susceptible patients, this may not be an easy task as it requires a life-long commitment.

However, the good news is; periodontal therapy is highly predictable and well supported by scientific evidence. The lecture will explore the factors that influence the success of periodontal therapy, and the steps that can be taken to maintain teeth and implants in periodontally susceptible patients. Adjunctive use of local antibiotics for patients undergoing supportive periodontal therapy and the available evidence will also be examined.

– Received DDS degree from University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam in 1994.
– Received Master of Science in Periodontology from International Medical College, Munster, Germany in 2016.
– Received Certificate of Master Clinician in Implant Dentistry from gIDE institute and Loma Linda University, Los Angeles, USA in 2018.
– Lecturer, Head of Periodontics and Implant Dentistry Department, Faculty of Dentistry, Van Lang University, Ho Chi Minh City, Vietnam.

Crown lengthening surgery improves smile aesthetics and enhances the patient’s quality of life. With nearly 50 years of development, crown lengthening surgery is the most commonly applied esthetic periodontal treatment in dentistry today.

However, there are still limitations, affecting the prognosis and results of crown lengthening surgery, including: unnatural crown shape, red inflamed gums, asymmetric smile lines, gingival recession, loss of gingival papillae, or recurrence, …

The presentation will analyze the existing problems of esthetic crown lengthening surgery, and introduce new comprehensive solutions, including digital applications in diagnosis, planning and surgery, combining with surgical technique modifications, leading to optimal and long-lasting aesthetic results for patients.

– Received DDS degree from Faculty of Dentistry, Chulalongkorn University, Thailand in 2006.
– Received MSc degree in Periodontics from Faculty of Dentistry, Chulalongkorn University, Thailand in 2009.
– Received PhD degree from Tokyo Medical and Dental University, Japan in 2014.
– Assistant Professor, Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Thailand.

Supracrestal connective tissue attachment (SCTA), previously known as “biologic width,” is vital to the gingiva near the periodontal ligament (PDL). Recent research shows that violating the SCTA causes inflammation, loss of periodontal support tissues, and an apical shift of the junctional epithelium.

The supracrestal gingival connective tissue fibers, located near the gingival sulcus, are exposed to diverse microorganisms in dental plaque biofilms. This proximity suggests that supracrestal gingival connective tissue-derived mesenchymal stem cells (SG-MSCs) might help maintain tissue homeostasis. SG-MSCs have emerged as promising for periodontal tissue regeneration. They showed the highest cell proliferation rates among marginal gingival tissue-derived MSCs (MG-MSCs) and PDL-MSCs, with similar gene expression profiles to PDL-MSCs.

Although SG-MSCs have slightly lower osteogenic differentiation potential than PDL-MSCs, their accessibility and resource availability make them good candidates for periodontal regeneration. Understanding SG-MSCs’ molecular properties is crucial for their therapeutic use in periodontal tissue regeneration and homeostasis.

– Received DMD degree from the Semmelweis University, Budapest, Hungary in 1990.
– Received postgraduate training at the Universities Münster, Germany and Royal Dental College Aarhus, Denmark.
– Received Ph.D degree from the University of Saarland, Homburg, Germany.
– Head of the Department of Periodontology and Program Director of the EFP accredited postgraduate program at the Radboud University in Nijmegen, the Netherlands from 2004 to 2008.
– Professor and Chairman of the Department of Periodontology of the University of Bern, Switzerland from 2008.
– President of the Periodontal Research Group of the IADR from 2009-2010.
– Past president of the Swiss Society of Periodontology.
– President, European Federation of Periodontology (EFP) from 2018-2019.
– President, International Academy of Periodontology (IAP).

– Received DDS degree from National Defense Medical Center, Taiwan in 2007.
– Received DScD degree in Periodontology from University of Pennsylvania, USA in 2019.
– Received Assistant Prof. title from National Defense Medical Center in 2021.
– Former Physician in Charge, dental department of Tingjou branch, Tri-Service General Hospital, Taiwan.
– Director, oral diagnosis and oral pathology program, National Defense Medical Center, Taiwan.

Dental implants having been applied to restore the lost dentition for more than fifty years, nevertheless, the time required from implant insertion to functional restoration still takes four to six months for osteointegration. Besides, once exposed to the oral environment, the poorly circulated bone surround implant is more prone to uncoupled bone loss and unresolved immune response induced by oral microbial challenge due to poorly vascularized peri-implant structure in comparison with periodontal structures generated from transplanted tooth.

Thus, how to rapidly replace missing teeth with bio-inductive dental implants remains a crucial and unresolved issue. Recent study found the topological signals may induce epigenetic changes in the attached stromal cells, lead to remodeling of the chromatin and activate genes that favor osteogenic differentiation. Our findings further demonstrate that laser-modified titanium surface not only provides topological cues for osteogenesis on gingival stromal cells but also enhance exosome production to promote coupled angiogenesis.

Objectives:
Laser-modified titanium surface provides topological cues for gingival stromal cells which promotes osteogenesis and coupled angiogenesis.

– Received BDSc degree (Honours) from the University of Queensland Dental School in 1993.
– Received PhD degree University of Queensland Dental School in 2000.
– Senior Lecturer in Periodontology at the University of Queensland from 2003 to 2006.
– Chair and Professor of Periodontology at the Griffith University School of Dentistry and Oral Health in 2006.
– Federal President of Australasian Osseointegration Society (AOS).
– Dean, the University of Queensland School of Dentistry in Brisbane, Australia.

P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization and participation for patient management. This lecture explores how the concepts of P4 medicine can be incorporated into the management of periodontal diseases. The proposed model of P4 Periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management.

The role of “big data” in future P4 Periodontics is discussed and the concepts of a treat-to- target focus for treatment outcomes is proposed as part of personalized periodontics. Personalized periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging.

Objectives:
– Understand the 4 pillars of P4 Medicine.
– Recognize how P4 Medicine concepts align with the 2018 Classification of Periodontal Diseases.
– Appreciate how P4 medicine concepts can be incorporated into periodontal disease management.

– Received BDS degree from Fiji School of Medicine in 2007.
– Received MPH degree from Fiji National University in 2015.
– Received DClinDent (perio) from University of Otago, New Zealand in 2020.
– Assistant Prof. in Periodontics at Fiji National University since 2021.
– Former Lecturer in Fiji National University since 2009.

Objective: To compare key markers of bone remodelling in a sheep tooth extraction model for sockets left to heal naturally or grafted with the bovine-derived xenograft Bio-Oss® covered with a collagen Bio – Gide® membrane.

Design: Right side premolar teeth were removed from thirty Romney – cross ewes. Standardised sockets in each sheep were randomly allocated treatments, a grafted test and an empty control. At 4-, 8- and 16-weeks sheep were euthanized, and tissue collected (N = 10/group). RANK, RANKL and OPG immunohistochemical analysis was performed (n = 3). RANK, RANKL, OPG, COL1A1, TIMP3, SP7 and MSX2 mRNA expression levels were determined using RT2 -qPCR assays (n = 3).

Results: Histologically, more new woven bone was observed in the test group at all time points. Strong RANK and RANKL expression was found in both groups; at all time points with stronger RANK staining in the test group at 8 and 16 weeks. Strong OPG staining was localized to both osteoblasts and connective tissues. RANK receptor mRNA was expressed at a lower level in the test group (− 4.26-fold; p = 0.02) at 4 weeks and SP7 at 16 weeks (− 2.89-fold; p = 0.04). COL1A1 and TIMP3 mRNA expression increased significantly over time in the control group (p = 0.045, F = 5.4 and p = 0.003, F = 42.2 respectively).

Conclusion: Socket healing over time was comparable. The sheep tooth extraction model was found to be suitable for the evaluation of changes in the alveolar bone at the molecular level.

Learning Objectives:
– To determine the expression of RANK/RANKL/OPG during healing in a grafted and ungrafted tooth extraction socket.
– To understand the expression of markers of healing in a grafted and ungrafted tooth extraction socket

– Received DDS and PhD degree from Peking University School and Hospital of Stomatology in 1999.
– Received Prof. title from Peking University School and Hospital of Stomatology in 2013.
– Former Vice Chairman of Department of Periodontology, Peking University School and Hospital of Stomatology.
– Vice Dean of Peking University School and Hospital of Stomatology.

The keratinized mucosa width (KMW) is an essential components of the peri-implant soft tissue phenotype. Less than 2 mm of KMW was found to be associated with local discomfort upon oral hygiene performance and increased risk for the onset of peri-implant diseases.

Several soft tissue augmentation procedures have been developed to increase peri-implant KMW and prevent biological complications around dental implants. Currently, the autogenous free gingival graft (FGG) is considered the clinical standard to gain KMW and thickness at implant sites, presenting favorable outcomes over time.

Theoretically, soft tissue augmentation could be performed at any time before/during/after implant treatment. It was once commented that the therapeutic approach to increase KMW was indicated and was most predictable before insertion of the dental implant.

The presentation aimed to discuss the effects and timing of autogenous soft tissue grafting for keratinized tissue augmentation at implant sites.