ITI Melbourne Evening Seminar with Prof. Terry Walton & Dr. Alex Khominsky

Lecture 1: Prof. Terry Walton

'Papilla Preservation Before Restoration Around Single Implant-supported Crowns'

Achieving ‘ideal’ aesthetics with implant supported single crowns is a major challenge. Various aesthetic scores have been developed to render assessments objective. However, there is often a disconnect between what clinicians and patients perceive to be ‘ideal’.

The colour of teeth and soft tissues and the form of papilla have been shown to have most effect on patient satisfaction. Clinicians rely on technical support to achieve excellent tooth characteristics - but the clinician maintains or develops papilla form.

How this is best and most consistently achieved is both controversial and challenging. Various protocols relating to implant placement timing, graft utilisation, socket shielding, provisionalization and emergence profile development techniques, are advocated by researchers and opinion leaders alike. Prof. Walton has developed a protocol that preserves papilla and establishes the emergence profile at extraction, followed by delayed Type 2 implant placement with minimal or no grafting. This approach reduces morbidity, requires fewer appointments, is significantly less expensive for patients and is less technique-sensitive for clinicians.

Learning objectives

• Recognize the limitations of aesthetic scores.
• Recognize the efficiency, effectiveness and efficacy of current papilla preservation/restoration techniques.
• Critique a proposed alternative protocol for papilla preservation.

Lecture 2: Dr. Alex Khominsky

Papilla Preservation and Reconstruction: The Final Aesthetic Frontier?

The interdental papilla is essential for aesthetic success, yet its loss remains one of the greatest challenges in periodontal and implant therapy. This lecture explores the causes of papilla loss, evidence-based strategies for preservation, and the predictability of contemporary reconstructive techniques, providing clinicians with practical guidance and realistic expectations for managing complex aesthetic cases.

Learning Objectives:

• Understand the aetiology of papilla loss.
• Can we preserve the papilla?
• Can we reconstruct the papilla?