REGISTRATION FORM

CROWN LENGTHENING WORKSHOPS

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❐ 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 INFO@PERIO.COM

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.