Drs. Thomas Gemmi & Estelle Guillou at WDI 2026 on osteoimmunology, Protected Bone Regeneration, and clinical decision-making beyond technique
At Wrocław Dental Implantology Days 2026, Dr. Thomas Gemmi and Dr. Estelle Guillou will deliver both a lecture and a hands-on workshop dedicated to contemporary bone regeneration. In this in-depth conversation, they explain why implant dentistry is shifting from technique-driven protocols toward biologically guided decision-making — and why understanding osteoimmunology may be the key to predictable augmentation outcomes.
At WDI 2026, you will deliver both a lecture and a hands-on workshop focused on bone regeneration. In your opinion, why is there currently such a strong emphasis on the biological foundations of augmentation rather than on surgical technique alone?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Today, we have more bone augmentation techniques than ever before, and they are obviously more sophisticated. But having so many options can sometimes push us to focus too much on technique and not enough on the biology behind it.
On a daily basis, the success of bone or soft tissue regeneration is not only about surgical skills. It is about how the patient’s tissues respond. Once you understand how bone, the immune system, and soft tissues work together, you realize that biology has to guide every surgical decision. When you respect that biological logic, procedures become easier, more predictable, and more reliable.
Osteoimmunology is increasingly discussed in the context of bone regeneration. Do you see it as a temporary trend, or rather as a true paradigm shift in implant dentistry?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Osteoimmunology is a relatively new discipline, and like anything new, it naturally attracts a lot of attention. It can be seen as the latest trend. But the truth is, it is not really new at all. The biology behind it — how inflammation, the immune system, blood supply, and bone interact — has been part of clinical practice for years and has often been applied intuitively by experienced clinicians.
What is new is that we now have a name and a clear framework to describe these processes. This helps us understand them better and translate them into more rational and predictable clinical decisions.
Osteoimmunology does not change biology. It clarifies it. It helps explain why some patients heal better than others, why a perfectly executed procedure can still fail, and why controlling inflammation is essential. In this sense, it is not a break from past concepts but a natural evolution — which is why it has become such an important topic in modern implant dentistry.
Many clinicians use similar augmentation techniques, yet achieve very different outcomes. From your experience, what most often determines the success or failure of bone regeneration?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Different outcomes occur because every patient is different. “The best technique is the one that works in your own hands.” Nevertheless, it is not about using the most sophisticated protocol — it is about understanding the protocol.
Any bone regeneration technique, simple or complex, must follow the same biological and surgical principles. When you understand the biology, adapt your technique to each patient, and keep things simple, the results become more predictable. Success is not about complexity — it is about translating a philosophy into action.
In your view, can overlooking the patient’s immune response be one of the key reasons for unpredictable outcomes in vertical and horizontal bone augmentation?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Yes, overlooking the patient’s immune response can clearly contribute to unpredictable outcomes in both vertical and horizontal bone augmentation. I wouldn’t say it is the only — or the main — reason, but it definitely plays an important role.
The patient’s immune response and level of inflammation directly affect healing, vascularization, and bone formation. When this biological aspect is ignored, even a perfectly planned and perfectly executed procedure can fail. This is something we all observe in daily practice.
That being said, understanding and respecting the immune response does not replace the fundamental rules of bone regeneration. “Protection” is the key word. Space maintenance and proper soft tissue management remain mandatory.
In other words, immune response and inflammation control are not a magic solution, but they are key contributors to predictability.
In the workshop description, you emphasize translating osteoimmunology into predictable GBR protocols. What type of clinical thinking do you aim to develop in participants?
Dr. Thomas Gemmi and Dr. Estelle Guillou: This workshop is about applying biology to each clinical situation, at every step of the surgery — not simply following predefined techniques. It is not about adding another protocol, but about understanding how to use biological principles, convert them into clinical actions for horizontal and vertical bone augmentation, and create the right conditions for predictable healing.
During the workshop you will address PRF protocols, rational antibiotic use, and biomaterial selection. In which of these areas do you most often see routine decisions that, in reality, should be far more deliberate?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Routine decisions often arise from habit. Most of the time, the same biomaterial or the same antibiotic is used simply because it feels familiar and makes daily practice easier. This routine can quickly turn into convenience.
However, we must never forget that every patient is biologically different. Biology must remain the main guide when choosing a surgical technique, a biomaterial, or an antibiotic.
In the end, everything comes back to one simple and essential question — a question everyone should be able to answer at any step, for any decision: “Why?”
The WDI program places strong emphasis on soft tissue management. What role do soft tissues play in the long-term stability of major bone augmentations?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Soft tissues are often described as the carpet over the bone. They reflect and protect what is happening underneath. You can perform a perfectly executed bone augmentation procedure, but if soft tissues are not well managed, long-term stability will be compromised.
Volume, quality, and tension-free closure are critical. In the end, bone success also depends on soft tissue health. Soft tissues are not secondary — they are both the mirror and the protection of regenerated bone.
In the workshop you also address treatment in anatomically challenging areas, such as the mental nerve region. Why is careful planning in these cases becoming increasingly important today?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Planning is a key step in any surgical procedure — from a simple extraction to complex horizontal or vertical bone augmentation. It allows us to anticipate potential difficulties, avoid mistakes, and establish a clear step-by-step surgical strategy.
That is why it is absolutely essential, regardless of the complexity of the procedure.
In your lecture you present lateral mandibular regeneration step by step. What distinguishes your approach as a biological concept rather than simply another regenerative technique?
Our lecture will focus on Protected Bone Regeneration, which represents a different approach from traditional Guided Bone Regeneration.
The FAST system is a tool — very ergonomic and easy to use — but still just a tool. It happens to align perfectly with our philosophy.
Vertical bone augmentation in the posterior mandible is one of the most challenging procedures. It is technically demanding and biologically complex. The FAST system respects all the biological principles of bone augmentation we believe in.
We do not claim that one bone augmentation technique is better than another. Ultimately, it is about keeping biology first.
Are the advanced regenerative procedures you discuss reserved only for highly experienced implantologists, or also for clinicians who want to better structure their approach to challenging cases?
Dr. Thomas Gemmi and Dr. Estelle Guillou: Again, it is not about learning a single gesture — it is about integrating a different treatment philosophy into everyday practice.
Some procedures are considered advanced because they involve higher technical and biological demands. Understanding why each step is performed and how biology guides the surgery is already a major part of performing it well. This applies to everyone.
Success comes from understanding — not only from experience.
In your opinion, what will participants experience during your lecture and workshop at WDI that they cannot gain from publications or online content?
Dr. Thomas Gemmi and Dr. Estelle Guillou: I would not say that our lecture or workshop offers something that cannot be found in books or online. But we often learn the most from failure.
What truly matters is the opportunity to discuss and exchange with colleagues. Analyzing real cases, sharing experiences, and discussing complications provides practical insights you can apply the very next day — something publications alone cannot offer.
If you were to encourage implant clinicians to attend WDI 2026 in one sentence — what would you say?
Dr. Thomas Gemmi and Dr. Estelle Guillou: We’re coming — why aren’t you?