The “PUPA” technique in Implant Aesthetics

Some great moments so far at the Aesthetic Conference in Vienna, the first one for me being introduced to the PUPA technique for increasing papilla height by laterally squeezing the papilla. We’ve known about using composite resin ok a provisional crown to guide papillary regeneration but the PUPA technique (push up papillary augment) uses a convex zirconia temporary abutment to create lateral pressure on the gum tissue.
Amazing stuff!


Also looking at failure rated of all ceramic work over the last 5, 10 and 15 years. Studies are showing lots of failures of zirconia crowns and bridges with the layering ceramic delaminating. This can be reduced by ensuring that the layering ceramic is fully supported, so as much zirconia as possible.
Looking at chemically bonding air abraded Zirconia to tooth structure. Studies are showing that we can get a better enamel and dentine bond strength to zirconia than to metals, IF the zirconia is handled properly. Maryland zirconia frameworks with Lithium Disilicate Emax layering can be a really aesthetic long term solution to missing tooth.

Oh, and in the world of composites, much more cusp covering in posterior teeth, get rid of a margin being occluded on, the better the integrity.

More to follow……