REGISTRATION FORM
CROWN LENGTHENING WORKSHOPS
NAME
ADDRESS
CITY STATE ZIP
PHONE FAX
NAME ON CARD CARD NUMBER VCODE#
EXP. DATE SIGNATURE
❐ TUITION $2695 • PAST PARTICIPANT/AGD MEMBER $2295� Enclosed is my check payable to Perio Institute: $ ______________ (U.S. Funds)
Please Charge to: � ❐ Visa � ❐ Mastercard � ❐ American Express � ❐ Discover
Tuition: $2695. (U.S. FUNDS)
Cancellation Policy:
MAIL OR FAX FORM WITH PAYMENT TO:Perio Institute, 7829 Center Blvd SE #300, Snoqualmie, WA 98065
MAIN (800) 327-3746FAX (425) 292-0768
EMAIL [email protected]
70% refunded if cancelled 14 days prior to course start date. No refund for non-attendance. Any course fees withheld may be used toward any future courses taken with the Perio Institute. Participants will not be compensated by Perio Institute for any costs, damages, or potential earnings lost when workshop cancellations are caused at any time due to events outside of Perio Institute’s control.
Visit: www.perio.com for more information or to register online!
“Continuing Education with a Difference”
MAIN (800) 327-3746 FAX (425) 292-07687829 CENTER BLVD SE #300 • SNOQUALMIE • WA 98065WWW.PERIO.COM
INTENSIVE “HANDS-ON”CADAVER WORKSHOP
A 2 DAYCADAVER WORKSHOP
AGD National SponsorFAGD/MAGD Credit 10/18/11-10/18/15
Perio Institute, Inc. is an ADACERP-recognized provider
ademyof General Dentistry
Program Approval forContinuing EducationFAGD/MAGD Approved
CROWNLENGTHENING
We would like to thank Alvelogro for donating theinstruments for this course. In return for this donationa representative from Alvelogro will be present. PerioInstitute does not receive any further financial benefitbeyond the donation.
TORONTO • NOV 15 & 16, 2013
Receive
$ .Discountif you mention
this letter
Receive
$400400.Discountif you mention
this letter
TORONTO • NOV 15 & 16, 2013
Cosponsored by the ON AGD & Perio Institute!
Discounts for past participants and
AGD Members
Your credit card will not be charged until
2 weeks prior to the course.
REGISTER EARLY
1. Case examples of Functional and Anterior Crown Lengthening, as well as a
2. Surgical videos of both posterior and anterior crown lengthening will be
shown to illustrate the procedures you are learning.
3. Then, hands on exercises for Posterior and Anterior Crown Lengthening are
done on frozen human cadaver heads including doing the osseous surgery
appropriate selection of sutures explained.
4. You will have the opportunity to dissect critical anatomic structures such as
the greater palatine and mental foramina.
5. A special treatment planning session will be included. Participants will have
the opportunity to email photos and X-rays to Dr. Kohner. He will select some
to be discussed during the workshop.
DAY ONE – LEVEL 1
• Understand the requirements for Anterior Esthetic Crown Lengthening to correct uneven, or excessive, gingival display levels.• Learn to make predictable, hassle free impressions EVERY time,
• See how Functional Crown Lengthening will solve issues of crowns falling
• Review surgical anatomy and how bone is the key element.• Review Biologic Width, its concepts and applications.• After reviewing the above information, plus doing the cadaver hands-on exercises,
of the surgical procedures yourself. Practicing on the realistic anatomy of the human cadavers will enhance that experience.
LEARNING OBJECTIVES
CONTENT AREAS
WORK SHOP FACULTY
COURSE INFORMATION
DATE & LOCATION:TORONTO • NOV 15 & 16, 2013Location to be chosen closer to course date. We hold all our courses at a hotel near the major airport.
TIME:7:30 am - 8:00 am Registration & Breakfast8:00 am - 5:00 pm Lecture & “Hands-On” WorkshopLunch will be provided on both days
COUR SE FEE:$2695 for each course (U.S. Funds)
PERIO INSTITUTE AND THE BC AGD STNESERP
14 C.E. HOUR COURSE
TORONTO • NOV 15 & 16, 2013
We will show with slides, videos, and hands-on exercises using both pigs and cadaver heads, how these techniques can solve everyday problems.
Visit www.perio.com for more information or to register online!
7:30 AM – REGISTRATION8:00 AM - 5:00 PM – COURSE
Your credit card
will not be charged until
2 weeks prior to the event.
REGISTEREARLYCROWN
LENGTHENINGA 2 DAY
CADAVER WORKSHOP
Dr. James Kohner, DDS Dr. James Kohner, DDS, is originally from Cleveland, Ohio. He graduated from The Ohio State University, and Case Western Reserve University Dental School, then obtained his certification in Periodontics from the Boston University School of Graduate Dentistry. He currently lives in Scottsdale, Arizona. Dr. Kohner is an experienced teacher who hasresented courses on Crown Lengthening and Soft Tissue Grafting to a wide range of audiences, including many state associations, all over the U.S. and in 8 foreign countries, and has presented at the AmericanAcademy of Periodontology meetings for many years. He has been teaching for the Perio Institute since 2003, and is a Visiting Professor in Periodontics at the Harvard School of Dental Medicine.He is a current member of both the American Dental Association and the American Academy of Periodontology, and a professional member of the National Speakers Association.