Lorenzana Periodontics and Dental Implants

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Lorenzana Periodontics and Dental Implants Dr. Eduardo R. Lorenzana is a Board-Certified Specialist in Periodontics, Oral Plastic Surgery, Dent Eduardo R. in Biology.

Lorenzana, DDS, MS, is a Diplomate (Board Certified) of the American Board of Periodontology and maintains a private practice limited to Periodontics and Dental Implants based in San Antonio, Texas. Dr. Lorenzana is a 1992 graduate of Southern Methodist University in Dallas, Texas, where he earned his B.S. He graduated in 1996 from Baylor College of Dentistry with his D.D.S. degree, followed by a Certificate in Periodontics and Masters in Oral Biology also from Baylor College of Dentistry- TAMUS in Dallas, Texas in 1999. Dr. Lorenzana holds academic appointments at BCD-TAMUS as an Adjunct Assistant Professor in the Graduate Periodontics Department and at The University of Texas Health Science Center at San Antonio (UTHSCSA) Dental School as a Clinical Assistant Professor in the Department of Restorative Dentistry. Dr. Lorenzana is a Fellow in the International Team for Implantology (ITI) and is President of the Texas Society of Periodontists. He lectures nationally and internationally on oral plastic surgery, dental implants, and dental implant aesthetics and has been voted a Texas Monthly top Periodontist and Implant Surgeon by his colleagues every year since the inception of the award.

Periodontal endoscopy presentation at the October SA District Dental Society General Membership meeting with Perio View ...
10/14/2026

Periodontal endoscopy presentation at the October SA District Dental Society General Membership meeting with Perio View 👁️

It is always an honor to be asked to share your work and view points on modern minimally invasive periodontal therapy with your friends and colleagues from your home dental society. 🙏🏼

Thank you to the SADDS Board of Directors, especially President Dr. Sarah Tovar for the invitation. So good to see friends old and new such as Dr. Warren Branch, Dr. Joan Dreher (Joan Dreher), Dr. Roger Campos, Dima F Kalakech, Sandra Nairooz, DDS MSD, Carlos Escobar Palma, and Silie. 🤗

But I was most proud to share this moment with Regina, my perio partner in crime and hygiene superwoman endoscopy expert secret weapon. 😎 She does 95% of our endoscopy cases and is the reason for our continued success with this technology. 🏅

We have been using periodontal endoscopy in our practice for over 10 years now, the last two years using the latest technology offered by Perio-View. It has been a huge step up in quality, community and support. We thoroughly enjoyed having PV co-founder and COO Karen Aguilar with us the last couple of days as well!! 🤗

I am thrilled to see that more colleagues are embracing the future of periodontal therapy - Keller Periodontics & Associates | New Braunfels TX and Houssam Alghadban here in SA/New Braunfels. 💪🏼

As my good friend, Dr. Tom Wilson recently said, “if you just remove all the calculus, wonderful things can happen.“ 🤩

Amen.

Some nights you just want to be a fly on the wall, with a century-plus of combined periodontal and implant experience ha...
10/10/2026

Some nights you just want to be a fly on the wall, with a century-plus of combined periodontal and implant experience hashing it out in one room. 🪰

Last night’s San Antonio ITI Study Club welcomed Dr. Thomas G. Wilson, Jr. North Dallas Dental Health, the first Chair of ITI Section USA, to present his latest work on peri-implantitis and metallosis, the accumulation and deposition of microscopic titanium particles and metal ions in the gum tissue and bone surrounding a dental implant, and the focus of Dr. Wilson’s most recent work. 📚

I first met Tom in 1996 as a first-year resident at Baylor College of Dentistry (now Texas A&M College of Dentistry). His office is where I first saw Emdogain used. He was an early champion of immediate implants, and with Dr. Frank Higginbottom he introduced ITI International to me and the rest of the “Baylor Boys”: Jason Gillespie Dr. Will Martin | Prosthodontist Nathan Hodges Dr. Brody Hildebrand, Tommy Ding, Scott Keith and more.

After the lecture, the real show began. Tom perched on a table and went back and forth with David Cochran and Brian Mealey, the room hanging on every word. 🥊

That’s what makes the ITI, the ITI. 🌎

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Special thanks as always to Shirley Kraft Shirley Kraft for all the arrangements!!! 😘

Tuesday Tribulations ⚠️ Case 01: The Cost of Non-Original Parts ☠️You spend months meticulously managing a site, only to...
09/15/2026

Tuesday Tribulations ⚠️
Case 01: The Cost of Non-Original Parts ☠️

You spend months meticulously managing a site, only to have a third-party clone part threaten the entire case.

The Situation:
The patient had an existing #9 implant in function for 4 years. She fractured endo treated #8. CBCT analysis showed inadequate spacing for two adjacent implants.

Our Clinical Protocol:
🔴 Extracted #8 and performed ridge preservation (PRF and tuberosity soft tissue graft).
🔴 Fabricated a custom provisional to perfectly contour the emergence profile.
🔴 Created a customized impression post to capture the exact soft tissue architecture for the restorative dentist.

The Failure:
Despite sending perfect tissue contours, the lab fabricated the final bridge using a non-original abutment and a non-original screw. ☠️

Original Straumann US screws use a specific geometry and taper designed to protect the internal threads of the implant body. The clone part lacked this engineering. When the dentist torqued the bridge, the screw underwent a catastrophic shear fracture, leaving the threaded portion cold-welded deep inside the implant body. 😬

The Tribulation and Rescue:
The doctor called me understandably stressed out. While I ordered the official Straumann Screw Retrieval Kit to attempt a rescue, the patient was provisionalized with an Essix retainer

🟢 The Management: Over the course of 3 stressful hours, the cold-welded fragment was meticulously drilled out following Straumann protocol.
🟢 The Re-Tap: Carefully re-threaded the internal component of the implant to restore mechanical integrity.
🟢 The Outcome: The implant was successfully salvaged and restored using OEM components. It has now been in function for 6 years. 🏆

The Take-Home Message:
It doesn’t matter which implant system you prefer to place. It is IMPERATIVE to use original parts for every single step of the process. Saving a few dollars on third-party components introduces hidden liabilities that risk catastrophic mechanical failure, cost hours of chair time, and subject the patient to unnecessary stress and trauma.

What is your protocol for verifying that your labs are using genuine OEM parts? 🤔

14-year long-term follow up ridge preservation ⏳Bread 🍞 & butter 🧈 approach for the win 🙌🏼If this isn’t my first case wi...
09/12/2026

14-year long-term follow up ridge preservation ⏳
Bread 🍞 & butter 🧈 approach for the win 🙌🏼

If this isn’t my first case with Osteogenics TXT-200, it is one of the first. I can tell because I did not have the 25 x 30 mm size on hand for this situation. 🤦🏻‍♂️

The patient presented in 2011 upon referral from her general dentist to try to save a previously hemisected lower left molar 18. Upon examination, it was discovered that 18 was hopeless, and the distal root of 19 was endodontically compromised and undergoing external root resorption as well. The patient was advised to remove both 18 and 19 and transition to an implant supported restoration.

The patient did not expect to hear 19 required removal, and was unprepared for the recommendation. Therefore, she decided to only remove 18. However, she was advised to see an endodontist for evaluation of 19 and forego any grafting of site 18 until she was cleared by endo or 19 was removed. Endodontist felt 19 was non-salvageable and recommended removal. 🏥

10 months later (2012) our patient scheduled for extraction and grafting of 19. Following careful removal of 19, it was discovered that 18 site had not experienced any repair whatsoever. Both sockets were degranulated thoroughly and irrigated with 10% clindamycin solution before grafting with Keystone Dental Group/Dental Implants/Biomaterials/Digital Tools DynaBlast allograft putty and (2) Cytoplast TXT-200 Singles adapted over the graft. Sutures were 4.0 Cytoplast suture. 🦴

One membrane was removed at 8 weeks and the second membrane was removed 4 weeks later. At 5 months the site was re-entered and a 4.8 x 10 Straumann US Bone Level RC SLActive implant placed uneventfully. At 6 weeks a solid abutment was placed and the patient referred to Dr. Brian Hale (San Antonio, TX) for restoration. ✅

14 years later, the patient continues regular SPT with us. No bone remodeling/bone loss has been observed and the original restoration is still in function. 🏆

The DynaBlast + Cytoplast combination has been our go-to approach in cases where the socket shows 50% or less bone loss.

🍞& 🧈

🤩3 yr follow-up on a tuber tunnel CTG for the 🙌🏼I find that when I am working on a recession on a maxillary canine or ...
08/24/2026

🤩
3 yr follow-up on a tuber tunnel CTG for the 🙌🏼

I find that when I am working on a recession on a maxillary canine or central incisor, the size of the tooth generally allows me sufficient access to create a tunnel through the gingival margin without additional incisions, flaps, or vestibular perforations. It takes patience, skill, and attention to detail. 🧐

In this case, the existing band of KG allows for the selection of most any type of graft for this situation. Since it was available, I opted for tuberosity tissue for a minimally invasive, gold standard autogenous solution. 🥇

The key with tuberosity tissue is to keep the graft thickness between 1 to 1.5 mm. Three years of follow-up documents excellent tissue integration with no tissue overgrowth. This is a routine application in our practice. 👍🏼

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Join us at the 2026 International Society of Periodontal Plastic Surgeons meeting October 28 in Seattle! It is ALWAYS a sold-out event so so sign up TODAY at www.ispps.org 🎯

Mucogingival Monday. (Re)building KG, vestibule, peri-implantitis resolution with an FGG. 👷🏼‍♂️🛠️A 46-year-old female pa...
08/17/2026

Mucogingival Monday. (Re)building KG, vestibule, peri-implantitis resolution with an FGG. 👷🏼‍♂️🛠️

A 46-year-old female patient was referred for peri-implantitis around implant #29. Her history: tumor removal in 1992, reconstruction with a hip graft and implants, final restoration in 1998. Excellent compliance — 3-month cleanings with prosth, diligent home care. 📜

Charting showed localized PDs >7mm and inflamed, reactive tissue around #29, with no keratinized gingiva or vestibular depth throughout the quadrant. 🧐

Bilateral FGGs were harvested and connected with Osteogenics 7.0 Resorba PGA suture into one continuous graft. Donor sites were managed with laser coagulation, collagen tape, and PeriAcryl. After implantoplasty and EDTA, EMD application (Straumann US Prefgel, Emdogain), the graft was secured with Osteogenics 6.0 Glycolon suture. 🪢

At 5 months: full resolution of inflammation, abundant KG, and a reconstituted vestibule. Patient reports home care is now easy and comfortable. 💪🏼

Adequate KG is considered “critical” functionally (Roccuzzo 2016), immunologically (Zigdon & Machtei 2008), and esthetically (Rojo 2020) — see ITI International Treatment Guides 12 & 13 for more. 📚

I avoid FGGs when I can — they’re invasive and uncomfortable for patients. But with no KG, no vestibule, a tough to clean site, and progressive bone loss, this was really the only option. 🎯

Would you have chosen the same? 🎙️

08/16/2026

A little inspiration from Leif Wennerstrom documentary on Paramount+ 📺

Grew up on RATT n’ roll 80s LA metal…caught them in the Invasion of Your Privacy tour with wait for it… Bon Jovi opening 😱 Insane double bill!!

Huge Warren DeMartini fan. 🤩 Belongs on the Mount Rushmore of the 80s rock era. The riffs are timeless ⏳

Especially this one: Round and Round from Out of the Cellar 🎧

🎸 EVH Gear Wolfgang
🔈 MESA/Boogie Badlander
🙏🏼 Custom pedalboard by interstellarguitars_

I’m a much better periodontist than guitarist. Trust me on that. 😉

Last week’s trip to LSU Health School of Dentistry still on my mind… a phenomenal couple of days with my ITI Internation...
08/14/2026

Last week’s trip to LSU Health School of Dentistry still on my mind… a phenomenal couple of days with my ITI International brother Alejandro Treviño and LSU Prosthodontics and LSU Perieaux residents. 🐅

Fun to be back in the residents’ seminar room talking oral plastic surgery and dental implants in the esthetic zone: planning, techniques and complications. 📚

Brought to mind this case where we combined two things I enjoy most: anterior esthetic crown lengthening and dental implants. ♥️♥️

Proper planning with ITI International Esthetic Risk Assessment in these cases is so very important because the decision to crown lengthen or not crown lengthen has a profound impact on the three-dimensional position of the dental implant. A difference of 2 to 3 mm may as well be a difference of 2 to 3 miles when it comes to esthetics. Note how the sculpting of the alveolar ridge at the recipient site matches the sculpting to establish proper biologic width around the teeth. 🔪

It is critical to discuss this option with patients upfront and no better time to begin the discussion than with the restorative dentist. A message we discussed in depth with the prosth residents. 💪🏼

Huge thank you as always to Jason Gillespie for the masterful restorative work! 🎨

I ♥️ tunneling. 🪏🕳️Absolutely it is technique sensitive. It requires patience, skill and care. 🫶🏼But in the mandibular a...
08/03/2026

I ♥️ tunneling. 🪏🕳️

Absolutely it is technique sensitive. It requires patience, skill and care. 🫶🏼

But in the mandibular anterior it offers some undeniable advantages. 99.99% of the time I tunnel at least the midline papilla to prevent damage to the blood supply to the area and reduce the possibility of flap retraction. In this case, the three middle papillae were tunneled with the only papilla access incisions peripherally between 22/23 and 26/27. 🔪

Combined with a tuberosity CTG modified into an extended continuous trifold design, the patient was provided with a minimally invasive, high quality graft with long-term documented root coverage and esthetics. ⏳

A win-win, palate-free autogenous alternative the patient was relieved to receive. 😅


🎨

I’ve been wanting to post this case we just completed, where a free gingival graft was modified to expand its coverage i...
07/14/2026

I’ve been wanting to post this case we just completed, where a free gingival graft was modified to expand its coverage in an edentulous site. Extractions and GBR were already in place but the soft tissue situation was inadequate for the planned implant-supported restorations. The foundation still needed work. 🏛️

Several approaches to expanding FGG coverage have been proposed. This is perhaps the oldest, first published by Rateitschak et al in 1985 as a “mesh graft.” More recent approaches have been published by De Greef et al 2024 (Expanded Mesh FGG), and Urban et al 2015 (strip gingival graft + xenogeneic collagen matrix) which I have shared previously, among others.📚

While I am always looking for less invasive options, such as tuberosity grafts or free CTGs, it is tough to argue with these results! 🤩

The donor site was addressed with laser to stop bleeders, collagen tape plus tissue adhesive, and a Elemental stent with topical lidocaine jelly applied prn. ❤️‍🩹

With the foundation properly set, three Straumann US implants were placed with a surgical guide and restored after 6 weeks healing by Dr Alan Layton (San Antonio). The result is a happy patient and an improved long-term prognosis.⏳

Address

3519 Paesanos Pkwy, Ste 103
San Antonio, TX
78231

Opening Hours

Monday 10am - 2pm
Tuesday 8:30am - 5pm
Wednesday 8:30am - 5pm
Thursday 8:30am - 5pm
Friday 8:30am - 2pm

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