March 03, 2017


The Mindset for Treatment Strategies in the Era of Evidence Based Medicine



Markus Hürzeler

Break Down

The patient's desire is always the treatment strategy which fits the patient best. The preference of the clinician should not overly influence this decision. Today, in symposiums and seminars the term "evidence-based-dentistry" is becoming more and more popular. It seems that only the clinician who is current with the literature can be a good dentist. But there are other factors which should be taken into consideration for the right treatment option for each specific clinical situation. It is the wishes and the expectations of the patient plus what can be realistically achieved.

In addition, it is obvious that the media and the internet also influence the opinion of our patients toward many directions. Sometimes patients show up in your office and want their teeth replaced by dental implants because they have heard that implants are better then natural teeth.

Here is where I would like to start my lecture. We need to be careful with what we state. There is no doubt dental implants are great tools but are they better then our natural teeth? I think today we should still put the emphasize on maintaining teeth as long as possible. We should educate ourselves in the techniques to save teeth. If we need to place dental implants then we should perform the treatment with a thoughtful biological approach.

After this philosophic approach I would then like to discuss with you clinical cases and how to perform surgeries in a predictable way. I would like to address specifically the "incision-free" flap elevation (tunnelling technique). Flap elevation without detachment of the papillary tissues and without vertical releasing incisions contributes to accelerated blood supply and uneventful wound healing. Moreover, it seems obvious that avoiding any kind of visible incisions on the tissue surface allows for an improved aesthetic outcome due to a minimized risk of post-operative scar tissue formation. For these reasons, tunnelling flap procedures have developed into a versatile clinical tool that may be today regarded as a genuine and promising alternative in mucogingival therapy in the aesthetic zone.

Learning Objectives:

  • The current evidence about the different treatment options
  • Advantages and disadvantages of the clinical concepts
  • How to avoid failures in the aesthetic zone

About the Speaker

  • 1984 Dental Degree (DMD) from the University of Zurich, Switzerland, Center for Dental and Oral Medicine
  • 1984 – 1986 Postgraduate Student at the Department of Preventive Dentistry and Periodontology, University of Zurich, Center for Dental and Oral Medicine (Director: Prof. Dr. F. Lutz)
  • 1986 – 1989 Postgraduate Student at the Department of Fixed and Removable Prosthodontics and Dental Material Sciences, University of Zurich, Center for Dental and Oral Medicine (Director: Prof. Dr. P. Schärer, MS), and Postgraduate Student at the Department of Preventive Dentistry and Periodontology, University of Zurich, Center for Dental and Oral Medicine (Director: Prof. F. Lutz)
  • 1989 - 1991 Associate Professor and Lecturer at the Department of Fixed and Removable Prosthodontics and Dental Material Sciences, Albert-Ludwigs- University of Freiburg i. Br., Germany (Director: Prof. Dr. J.R. Strub)
  • 1991 - 1993 Visiting Associate Professor at the Department of Periodontics, University of Texas Health Science Center at Houston, USA (Director: Prof. Dr. R. Caffesse)
  • 1993 -1997 Associate Professor and Vice Chairman at the Department of Fixed and Removable Prosthodontics and Dental Material Sciences, Albert-Ludwigs- University of Freiburg i. Br., Germany (Director: Prof. Dr. J.R. Strub)
  • 1997 – 2008 Partner in a Private Practice oriented in Periodontology and Implantology in Munich (Prof. Hürzeler, Prof. H. Wachtel and Dres. W. Bolz and O. Zuhr); Founder of the IPI: Center for Dental Education in Periodontology and Implantology in Munich (Prof. Hürzeler, Prof. H. Wachtel and Dres. W. Bolz and O. Zuhr); Founder of Dental Online College: Internet Platform for Dental Education in Munich (Prof. Hürzeler, Prof. H. Wachtel and G Dres. W. Bolz and O. Zuhr)
  • 1996 "Privatdozent" (Associate Professor) of the Albert-Ludwigs-University Freiburg i. Br., Germany after finalzing the "Habilitation" (venia legendi) in Dental Medicine
  • 2002 Adjunct Professor of the Albert-Ludwigs-University Freiburg i.Br., Germany in Dental Medicine since 1993 Clinical Associate Professor of the University of Texas Health Science Center at Houston, USA since 1997 Associate Professor of the Albert-Ludwigs University Freiburg i. Br., Germany Department of Preventive Dentistry and Periodontology (Director: Prof. Dr. E. Hellwig)
  • since 2008 Founder of the Private Clinic (Huerzeler/Zuhr) oriented in Periodontology and Implantology in Munich with his Partner Dr. O. Zuhr
  • since 2010 Founder and Lecturer of the Dental Education Center (Huerzeler/Zuhr) in Munich with his Partner Dr. O. Zuhr