Con

tinu

ing

Den

tal E

duca

tion

UN

C S

choo

l of

Den

tist

ryC

ampu

s B

ox 7

45

0C

hape

l Hill

, N

C 2

75

99

-74

50

ww

w.d

enti

stry

.unc

.edu

/ce/

cde

AD

VAN

CIN

G K

NO

WLE

DG

E I

N D

EN

TIS

TRY

THE 4th ANNUAL

MATTHEW WOODPROSTHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic Treatments

THE 4th ANNUAL MATTHEW WOOD PROSHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic TreatmentsFriday, December 4, 2015 Course Code (16-PR-002)

**Please make additional copies for each person registering**Registration Deadline: Wednesday, November 25, 2015

Dentists $695 ❏ Specialty _____________________________________________________________

Team Members $395 ❏ RDH ❏ DAI ❏ DAII ❏ Other ______________________________

Email ______________________________________ @ ________________________________________

First Name ______________________________ Last Name___________________________ Jr./Sr.

Preferred Name ______________________________________________________________________

❏ Male ❏ Female Self-identify _______________________________________________________

❏ I am an alumnus/alumna of UNC School of Dentistry: ❏ DDS ❏ RDH ❏ DA ❏ Post Doc

Employer ________________________________________________________________________________

Mailing Address __________________________________________________________________________

City ________________________________________ State ______________ Zip __________________

County in NC ____________________________________________________________________________

Daytime Phone (_____) _______________________ Fax (_____) _______________________________

Register On-line with a Credit Card at www.dentistry.unc.edu/ce/cde

❑ I have special dietary needs, please explain: ____________________________________________

❑ I have special needs, please contact me.

The University of North Carolina School of dentistry cautions continuing dental education participants that there are potential risks of using limited knowledge when incorporating new techniques and procedures into the practice of dentistry, especially when the continuing education course has not provided supervised clinical experience and/or competency tests in the techniques or procedures.

Dental education institutions have an obligation to disseminate new knowledge related to dental practice. In so doing, some presentations may include controversial materials or commercial references. Sponsorship of a continuing education course by the University of North Carolina does not necessarily imply endorsement of a particular philosophy, procedure, or product by this institution.

ADA STATEMENT:The University of North Carolina at Chapel Hill is committed to equality of educational opportunity and does not discriminate against applicants, students, or employees on the basis of race, color, religion, sex, national origin, age, disability, veteran’s status, or sexual orientation. If you require reasonable accommodations for a disability in order to participate fully in this continuing education activity, please call (919) 537-3400 no later than November 20, 2015 or attach a note to your registration form.

By providing my information, I consent to receive communication via mail, email, fax, and phone from the University to North Carolina Continuing Dental Education office. The Continuing Dental Education office will not share your information with anyone.

NONP

ROFIT

ORG

US P

OSTA

GE

PAID

CH

APEL

HILL

, NC

PERM

IT #

177

FRIDAY, DECEMBER 4, 2015Location: UNC SCHOOL OF DENTISTRY

DR. MATTHEW WOOD Keynote SpeakerDR. MONISH BHOLA

SPONSORED BYThe University of North Carolina Department of Prosthodontics

TH

E 4

th A

NN

UA

L

MA

TT

HE

W W

OO

DP

RO

ST

HO

DO

NT

ICS

SY

MP

OS

IUM

Com

preh

ensi

ve P

erio

dont

al a

nd P

rost

hodo

ntic

Tre

atm

ents

FR

IDA

Y,

DE

CE

MB

ER

4,

2015

_______ REGISTRATION

2015_MatthewWood.indd 1 9/28/2015 3:05:12 PM

Complex prosthodontic and implant therapies often require extensive periodontal and surgical treatments. This symposium will present two of the advanced surgical techniques including 1) Managing the Micro and Macro-Esthetics: Implants to Lip Repositioning and 2) Implant Esthetic Complications and Infections: Surgical and Prosthetic Solutions. This symposium will discuss in detail the current evidence for managing various types of sockets and biotypes for implant placement in the esthetic zone. The concept of dual-zone grafting with and without immediate placement to gain bone and soft tissue

height will be discussed. Additionally, guidelines for the LipStaT® to treat patients with a “gummy smile” will be presented in depth. Latest guidelines will be presented for implant placement to prevent unique esthetic implant complications. Learn the latest about soft tissue biotype, Implants and Grafting including updated Guidelines on Esthetic Treatment Planning. Learn the Prevention and Management of Implant Infections, the etiology and classification of Peri-Implant Disease and the clinical presentation of various types of Implant Infections including Retro-Grade Peri-implantitis.

Dr. Monish Bhola is a Diplomate of the American Board of Periodontology. He received his D.D.S. from University of Detroit Mercy School of Dentistry and his certificate and M.S.D. in Periodontics and Implantology from Indiana University School of Dentistry. Dr. Bhola is the former Director of Post-Graduate Periodontics and has been practicing Clinical Periodontics and Implant Dentistry for the past eighteen years. His areas of interest include dental implants, oral plastic surgery and advanced bone and soft tissue grafting for teeth and implants. He is the author and developer of the new

and innovative LipStaT® procedure for correcting a gummy smile.

Dr. Bhola is a world renowned speaker and educator. He lectures and conducts several training courses in periodontics and implantology for dentists and specialists from all over the world and has several publications in leading dental journals. He is the recipient of the prestigious Bud and Linda Tarrson Fellowship award given by the American Academy of Periodontology Foundation and is a member of the OKU Nu Nu Chapter, a National Honor Dental Society.

Sompop Bencharit, DDS, MS, PhD, FACP Assistant Professor in Prosthodontics and Pharmacology

The program will be held at the UNC School of Dentistry. Registration will begin at 8:00am. The program will be held from 8:30am – 4:00pm.

The UNC School of Dentistry is located at the corner of Manning Drive and South Columbia Street in Chapel Hill.

The registration fee is $695 for dentists and $395 for RDH and team members.The registration fee includes course materials, CE credit and all meals listed inthe agenda. All registrations must be received by Wednesday, November 25, 2015.

UNC Continuing Dental Education designates this activity for up to 6 hours of CDE credit.

UNC CDE recommends that you do not make air travel arrangements prior to receiving a receipt of payment or confirmation. UNC CDE is not responsible for any travel-related costs.

Register by Mail: Attention: Registration, UNC Continuing Dental Education, Campus Box 7450, Chapel Hill, NC 27599-7450Questions: Call us at (919) 537-3400 or email us at cde@dentistry.unc.edu

_______ CANCELLATION AND REFUND A registration refund, less a $50 fee, will be issued for cancellations received by Wednesday, November 25, 2015. Cancellations must be received in writing either by fax 919-537-3098 or email to cde@dentistry.unc.edu. The cancellation request must include: the name of the activity, name of the person registered, name of the person requesting the cancellation, and the reason for the cancellation. No refunds will be issued after Wednesday, November 25, 2015. The UNC School of Dentistry Continuing Dental Education Program cannot be responsible for the refund of any part of the registration fee as a result of emergencies, unforeseen circumstances, or events beyond its control after the cancellation date.

The University reserves the right to cancel or postpone any course due to unforeseen cir-cumstances. In the event of cancellation or postponement, the University will fully refund registration fees but is not responsible for any related costs or expenses to participants, including cancellation fees assessed by hotels, airlines, rental car or travel agencies.

_______ CONFLICT OF INTEREST In accordance with the ADA CERP Standard V., everyone involved in planning or presenting this educational activity will be required to disclose any relevant financial relationships with commercial interests and this information will be made available to participants at the start of the activity. As a continuing education provider, UNC School of Dentistry is responsible for ensuring the content, quality and scientific integrity of all continuing dental education activities for which credit is provided. The School is also responsible for taking steps to protect against and/or disclose any conflict of interest of the faculty/instructors presenting those courses.

Special dietary requirements will be honored whenever possible. Please be sure to notify our office in writing of your special need no later than Friday, November 20, 2015.

This continuing education program is presented by the University of North Carolina at Chapel Hill School of Dentistry and the Department of Dental Ecology. The UNC Continuing Dental Education program is an ADA CERP Recognized Provider. UNC CDE’s term of recognition is May 1, 2015 through June 30, 2019. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp.

8:00 – 8:30 AMRegistration and Continental Breakfast

8:30 – 8:40 AMCourse overview and Introduction of the Keynote SpeakerDR. SOMPOP BENCHARIT: COURSE DIRECTOR

8:40 – 10:00 AMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IDR. MONISH BHOLA

10:00 – 10:15 AMMorning Break

10:15 – 12:00 PMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IIDR. MONISH BHOLA

12:00 – 1:00 PMLunch

1:00 – 2:30 PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IDR. MONISH BHOLA

2:30 – 2:45 PMAfternoon Break

2:45 – 4:00PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IIDR. MONISH BHOLA

At the completion of this activity, participants should be able to:

• Describe the management of micro and macro-esthetics from restorative to surgical approaches

• Explain and discuss the current concepts on placement and restoration of dental implants in esthetic zone

• Compare and contrast techniques in soft tissue management for dental implants

• Identify basic protocols and guidelines for management of implant complications

_______ ACTIVITY DESCRIPTION _______ KEYNOTE SPEAKER _______ REGISTRATION FEE & CREDIT

_______ AGENDA ____________________ UNC FACULTY ____________________

__________________ TIME & LOCATION __________________

_______ OBJECTIVES

2015_MatthewWood.indd 2 9/28/2015 3:05:13 PM

Complex prosthodontic and implant therapies often require extensive periodontal and surgical treatments. This symposium will present two of the advanced surgical techniques including 1) Managing the Micro and Macro-Esthetics: Implants to Lip Repositioning and 2) Implant Esthetic Complications and Infections: Surgical and Prosthetic Solutions. This symposium will discuss in detail the current evidence for managing various types of sockets and biotypes for implant placement in the esthetic zone. The concept of dual-zone grafting with and without immediate placement to gain bone and soft tissue

height will be discussed. Additionally, guidelines for the LipStaT® to treat patients with a “gummy smile” will be presented in depth. Latest guidelines will be presented for implant placement to prevent unique esthetic implant complications. Learn the latest about soft tissue biotype, Implants and Grafting including updated Guidelines on Esthetic Treatment Planning. Learn the Prevention and Management of Implant Infections, the etiology and classification of Peri-Implant Disease and the clinical presentation of various types of Implant Infections including Retro-Grade Peri-implantitis.

Dr. Monish Bhola is a Diplomate of the American Board of Periodontology. He received his D.D.S. from University of Detroit Mercy School of Dentistry and his certificate and M.S.D. in Periodontics and Implantology from Indiana University School of Dentistry. Dr. Bhola is the former Director of Post-Graduate Periodontics and has been practicing Clinical Periodontics and Implant Dentistry for the past eighteen years. His areas of interest include dental implants, oral plastic surgery and advanced bone and soft tissue grafting for teeth and implants. He is the author and developer of the new

and innovative LipStaT® procedure for correcting a gummy smile.

Dr. Bhola is a world renowned speaker and educator. He lectures and conducts several training courses in periodontics and implantology for dentists and specialists from all over the world and has several publications in leading dental journals. He is the recipient of the prestigious Bud and Linda Tarrson Fellowship award given by the American Academy of Periodontology Foundation and is a member of the OKU Nu Nu Chapter, a National Honor Dental Society.

Sompop Bencharit, DDS, MS, PhD, FACP Assistant Professor in Prosthodontics and Pharmacology

The program will be held at the UNC School of Dentistry. Registration will begin at 8:00am. The program will be held from 8:30am – 4:00pm.

The UNC School of Dentistry is located at the corner of Manning Drive and South Columbia Street in Chapel Hill.

The registration fee is $695 for dentists and $395 for RDH and team members.The registration fee includes course materials, CE credit and all meals listed inthe agenda. All registrations must be received by Wednesday, November 25, 2015.

UNC Continuing Dental Education designates this activity for up to 6 hours of CDE credit.

UNC CDE recommends that you do not make air travel arrangements prior to receiving a receipt of payment or confirmation. UNC CDE is not responsible for any travel-related costs.

Register by Mail: Attention: Registration, UNC Continuing Dental Education, Campus Box 7450, Chapel Hill, NC 27599-7450Questions: Call us at (919) 537-3400 or email us at cde@dentistry.unc.edu

_______ CANCELLATION AND REFUND A registration refund, less a $50 fee, will be issued for cancellations received by Wednesday, November 25, 2015. Cancellations must be received in writing either by fax 919-537-3098 or email to cde@dentistry.unc.edu. The cancellation request must include: the name of the activity, name of the person registered, name of the person requesting the cancellation, and the reason for the cancellation. No refunds will be issued after Wednesday, November 25, 2015. The UNC School of Dentistry Continuing Dental Education Program cannot be responsible for the refund of any part of the registration fee as a result of emergencies, unforeseen circumstances, or events beyond its control after the cancellation date.

The University reserves the right to cancel or postpone any course due to unforeseen cir-cumstances. In the event of cancellation or postponement, the University will fully refund registration fees but is not responsible for any related costs or expenses to participants, including cancellation fees assessed by hotels, airlines, rental car or travel agencies.

_______ CONFLICT OF INTEREST In accordance with the ADA CERP Standard V., everyone involved in planning or presenting this educational activity will be required to disclose any relevant financial relationships with commercial interests and this information will be made available to participants at the start of the activity. As a continuing education provider, UNC School of Dentistry is responsible for ensuring the content, quality and scientific integrity of all continuing dental education activities for which credit is provided. The School is also responsible for taking steps to protect against and/or disclose any conflict of interest of the faculty/instructors presenting those courses.

Special dietary requirements will be honored whenever possible. Please be sure to notify our office in writing of your special need no later than Friday, November 20, 2015.

This continuing education program is presented by the University of North Carolina at Chapel Hill School of Dentistry and the Department of Dental Ecology. The UNC Continuing Dental Education program is an ADA CERP Recognized Provider. UNC CDE’s term of recognition is May 1, 2015 through June 30, 2019. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp.

8:00 – 8:30 AMRegistration and Continental Breakfast

8:30 – 8:40 AMCourse overview and Introduction of the Keynote SpeakerDR. SOMPOP BENCHARIT: COURSE DIRECTOR

8:40 – 10:00 AMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IDR. MONISH BHOLA

10:00 – 10:15 AMMorning Break

10:15 – 12:00 PMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IIDR. MONISH BHOLA

12:00 – 1:00 PMLunch

1:00 – 2:30 PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IDR. MONISH BHOLA

2:30 – 2:45 PMAfternoon Break

2:45 – 4:00PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IIDR. MONISH BHOLA

At the completion of this activity, participants should be able to:

• Describe the management of micro and macro-esthetics from restorative to surgical approaches

• Explain and discuss the current concepts on placement and restoration of dental implants in esthetic zone

• Compare and contrast techniques in soft tissue management for dental implants

• Identify basic protocols and guidelines for management of implant complications

_______ ACTIVITY DESCRIPTION _______ KEYNOTE SPEAKER _______ REGISTRATION FEE & CREDIT

_______ AGENDA ____________________ UNC FACULTY ____________________

__________________ TIME & LOCATION __________________

_______ OBJECTIVES

2015_MatthewWood.indd 2 9/28/2015 3:05:13 PM

Complex prosthodontic and implant therapies often require extensive periodontal and surgical treatments. This symposium will present two of the advanced surgical techniques including 1) Managing the Micro and Macro-Esthetics: Implants to Lip Repositioning and 2) Implant Esthetic Complications and Infections: Surgical and Prosthetic Solutions. This symposium will discuss in detail the current evidence for managing various types of sockets and biotypes for implant placement in the esthetic zone. The concept of dual-zone grafting with and without immediate placement to gain bone and soft tissue

height will be discussed. Additionally, guidelines for the LipStaT® to treat patients with a “gummy smile” will be presented in depth. Latest guidelines will be presented for implant placement to prevent unique esthetic implant complications. Learn the latest about soft tissue biotype, Implants and Grafting including updated Guidelines on Esthetic Treatment Planning. Learn the Prevention and Management of Implant Infections, the etiology and classification of Peri-Implant Disease and the clinical presentation of various types of Implant Infections including Retro-Grade Peri-implantitis.

Dr. Monish Bhola is a Diplomate of the American Board of Periodontology. He received his D.D.S. from University of Detroit Mercy School of Dentistry and his certificate and M.S.D. in Periodontics and Implantology from Indiana University School of Dentistry. Dr. Bhola is the former Director of Post-Graduate Periodontics and has been practicing Clinical Periodontics and Implant Dentistry for the past eighteen years. His areas of interest include dental implants, oral plastic surgery and advanced bone and soft tissue grafting for teeth and implants. He is the author and developer of the new

and innovative LipStaT® procedure for correcting a gummy smile.

Dr. Bhola is a world renowned speaker and educator. He lectures and conducts several training courses in periodontics and implantology for dentists and specialists from all over the world and has several publications in leading dental journals. He is the recipient of the prestigious Bud and Linda Tarrson Fellowship award given by the American Academy of Periodontology Foundation and is a member of the OKU Nu Nu Chapter, a National Honor Dental Society.

Sompop Bencharit, DDS, MS, PhD, FACP Assistant Professor in Prosthodontics and Pharmacology

The program will be held at the UNC School of Dentistry. Registration will begin at 8:00am. The program will be held from 8:30am – 4:00pm.

The UNC School of Dentistry is located at the corner of Manning Drive and South Columbia Street in Chapel Hill.

The registration fee is $695 for dentists and $395 for RDH and team members.The registration fee includes course materials, CE credit and all meals listed inthe agenda. All registrations must be received by Wednesday, November 25, 2015.

UNC Continuing Dental Education designates this activity for up to 6 hours of CDE credit.

UNC CDE recommends that you do not make air travel arrangements prior to receiving a receipt of payment or confirmation. UNC CDE is not responsible for any travel-related costs.

Register by Mail: Attention: Registration, UNC Continuing Dental Education, Campus Box 7450, Chapel Hill, NC 27599-7450Questions: Call us at (919) 537-3400 or email us at cde@dentistry.unc.edu

_______ CANCELLATION AND REFUND A registration refund, less a $50 fee, will be issued for cancellations received by Wednesday, November 25, 2015. Cancellations must be received in writing either by fax 919-537-3098 or email to cde@dentistry.unc.edu. The cancellation request must include: the name of the activity, name of the person registered, name of the person requesting the cancellation, and the reason for the cancellation. No refunds will be issued after Wednesday, November 25, 2015. The UNC School of Dentistry Continuing Dental Education Program cannot be responsible for the refund of any part of the registration fee as a result of emergencies, unforeseen circumstances, or events beyond its control after the cancellation date.

The University reserves the right to cancel or postpone any course due to unforeseen cir-cumstances. In the event of cancellation or postponement, the University will fully refund registration fees but is not responsible for any related costs or expenses to participants, including cancellation fees assessed by hotels, airlines, rental car or travel agencies.

_______ CONFLICT OF INTEREST In accordance with the ADA CERP Standard V., everyone involved in planning or presenting this educational activity will be required to disclose any relevant financial relationships with commercial interests and this information will be made available to participants at the start of the activity. As a continuing education provider, UNC School of Dentistry is responsible for ensuring the content, quality and scientific integrity of all continuing dental education activities for which credit is provided. The School is also responsible for taking steps to protect against and/or disclose any conflict of interest of the faculty/instructors presenting those courses.

Special dietary requirements will be honored whenever possible. Please be sure to notify our office in writing of your special need no later than Friday, November 20, 2015.

This continuing education program is presented by the University of North Carolina at Chapel Hill School of Dentistry and the Department of Dental Ecology. The UNC Continuing Dental Education program is an ADA CERP Recognized Provider. UNC CDE’s term of recognition is May 1, 2015 through June 30, 2019. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp.

8:00 – 8:30 AMRegistration and Continental Breakfast

8:30 – 8:40 AMCourse overview and Introduction of the Keynote SpeakerDR. SOMPOP BENCHARIT: COURSE DIRECTOR

8:40 – 10:00 AMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IDR. MONISH BHOLA

10:00 – 10:15 AMMorning Break

10:15 – 12:00 PMManaging the Micro and Macro-Esthetics:Implants to Lip Repositioning IIDR. MONISH BHOLA

12:00 – 1:00 PMLunch

1:00 – 2:30 PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IDR. MONISH BHOLA

2:30 – 2:45 PMAfternoon Break

2:45 – 4:00PMImplants Esthetic Complications and Infections – Surgical and Prosthetic Solutions IIDR. MONISH BHOLA

At the completion of this activity, participants should be able to:

• Describe the management of micro and macro-esthetics from restorative to surgical approaches

• Explain and discuss the current concepts on placement and restoration of dental implants in esthetic zone

• Compare and contrast techniques in soft tissue management for dental implants

• Identify basic protocols and guidelines for management of implant complications

_______ ACTIVITY DESCRIPTION _______ KEYNOTE SPEAKER _______ REGISTRATION FEE & CREDIT

_______ AGENDA ____________________ UNC FACULTY ____________________

__________________ TIME & LOCATION __________________

_______ OBJECTIVES

2015_MatthewWood.indd 2 9/28/2015 3:05:13 PM

Con

tinu

ing

Den

tal E

duca

tion

UN

C S

choo

l of

Den

tist

ryC

ampu

s B

ox 7

45

0C

hape

l Hill

, N

C 2

75

99

-74

50

ww

w.d

enti

stry

.unc

.edu

/ce/

cde

AD

VAN

CIN

G K

NO

WLE

DG

E I

N D

EN

TIS

TRY

THE 4th ANNUAL

MATTHEW WOODPROSTHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic Treatments

THE 4th ANNUAL MATTHEW WOOD PROSHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic TreatmentsFriday, December 4, 2015 Course Code (16-PR-002)

**Please make additional copies for each person registering**Registration Deadline: Wednesday, November 25, 2015

Dentists $695 ❏ Specialty _____________________________________________________________

Team Members $395 ❏ RDH ❏ DAI ❏ DAII ❏ Other ______________________________

Email ______________________________________ @ ________________________________________

First Name ______________________________ Last Name___________________________ Jr./Sr.

Preferred Name ______________________________________________________________________

❏ Male ❏ Female Self-identify _______________________________________________________

❏ I am an alumnus/alumna of UNC School of Dentistry: ❏ DDS ❏ RDH ❏ DA ❏ Post Doc

Employer ________________________________________________________________________________

Mailing Address __________________________________________________________________________

City ________________________________________ State ______________ Zip __________________

County in NC ____________________________________________________________________________

Daytime Phone (_____) _______________________ Fax (_____) _______________________________

Register On-line with a Credit Card at www.dentistry.unc.edu/ce/cde

❑ I have special dietary needs, please explain: ____________________________________________

❑ I have special needs, please contact me.

The University of North Carolina School of dentistry cautions continuing dental education participants that there are potential risks of using limited knowledge when incorporating new techniques and procedures into the practice of dentistry, especially when the continuing education course has not provided supervised clinical experience and/or competency tests in the techniques or procedures.

Dental education institutions have an obligation to disseminate new knowledge related to dental practice. In so doing, some presentations may include controversial materials or commercial references. Sponsorship of a continuing education course by the University of North Carolina does not necessarily imply endorsement of a particular philosophy, procedure, or product by this institution.

ADA STATEMENT:The University of North Carolina at Chapel Hill is committed to equality of educational opportunity and does not discriminate against applicants, students, or employees on the basis of race, color, religion, sex, national origin, age, disability, veteran’s status, or sexual orientation. If you require reasonable accommodations for a disability in order to participate fully in this continuing education activity, please call (919) 537-3400 no later than November 20, 2015 or attach a note to your registration form.

By providing my information, I consent to receive communication via mail, email, fax, and phone from the University to North Carolina Continuing Dental Education office. The Continuing Dental Education office will not share your information with anyone.

NONP

ROFIT

ORG

US P

OSTA

GE

PAID

CH

APEL

HILL

, NC

PERM

IT #

177

FRIDAY, DECEMBER 4, 2015Location: UNC SCHOOL OF DENTISTRY

DR. MATTHEW WOOD Keynote SpeakerDR. MONISH BHOLA

SPONSORED BYThe University of North Carolina Department of Prosthodontics

TH

E 4

th A

NN

UA

L

MA

TT

HE

W W

OO

DP

RO

ST

HO

DO

NT

ICS

SY

MP

OS

IUM

Com

preh

ensi

ve P

erio

dont

al a

nd P

rost

hodo

ntic

Tre

atm

ents

FR

IDA

Y,

DE

CE

MB

ER

4,

2015

_______ REGISTRATION

2015_MatthewWood.indd 1 9/28/2015 3:05:12 PM

Con

tinu

ing

Den

tal E

duca

tion

UN

C S

choo

l of

Den

tist

ryC

ampu

s B

ox 7

45

0C

hape

l Hill

, N

C 2

75

99

-74

50

ww

w.d

enti

stry

.unc

.edu

/ce/

cde

AD

VAN

CIN

G K

NO

WLE

DG

E I

N D

EN

TIS

TRY

THE 4th ANNUAL

MATTHEW WOODPROSTHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic Treatments

THE 4th ANNUAL MATTHEW WOOD PROSHODONTICS SYMPOSIUM

Comprehensive Periodontal and Prosthodontic TreatmentsFriday, December 4, 2015 Course Code (16-PR-002)

**Please make additional copies for each person registering**Registration Deadline: Wednesday, November 25, 2015

Dentists $695 ❏ Specialty _____________________________________________________________

Team Members $395 ❏ RDH ❏ DAI ❏ DAII ❏ Other ______________________________

Email ______________________________________ @ ________________________________________

First Name ______________________________ Last Name___________________________ Jr./Sr.

Preferred Name ______________________________________________________________________

❏ Male ❏ Female Self-identify _______________________________________________________

❏ I am an alumnus/alumna of UNC School of Dentistry: ❏ DDS ❏ RDH ❏ DA ❏ Post Doc

Employer ________________________________________________________________________________

Mailing Address __________________________________________________________________________

City ________________________________________ State ______________ Zip __________________

County in NC ____________________________________________________________________________

Daytime Phone (_____) _______________________ Fax (_____) _______________________________

Register On-line with a Credit Card at www.dentistry.unc.edu/ce/cde

❑ I have special dietary needs, please explain: ____________________________________________

❑ I have special needs, please contact me.

The University of North Carolina School of dentistry cautions continuing dental education participants that there are potential risks of using limited knowledge when incorporating new techniques and procedures into the practice of dentistry, especially when the continuing education course has not provided supervised clinical experience and/or competency tests in the techniques or procedures.

Dental education institutions have an obligation to disseminate new knowledge related to dental practice. In so doing, some presentations may include controversial materials or commercial references. Sponsorship of a continuing education course by the University of North Carolina does not necessarily imply endorsement of a particular philosophy, procedure, or product by this institution.

ADA STATEMENT:The University of North Carolina at Chapel Hill is committed to equality of educational opportunity and does not discriminate against applicants, students, or employees on the basis of race, color, religion, sex, national origin, age, disability, veteran’s status, or sexual orientation. If you require reasonable accommodations for a disability in order to participate fully in this continuing education activity, please call (919) 537-3400 no later than November 20, 2015 or attach a note to your registration form.

By providing my information, I consent to receive communication via mail, email, fax, and phone from the University to North Carolina Continuing Dental Education office. The Continuing Dental Education office will not share your information with anyone.

NONP

ROFIT

ORG

US P

OSTA

GE

PAID

CH

APEL

HILL

, NC

PERM

IT #

177

FRIDAY, DECEMBER 4, 2015Location: UNC SCHOOL OF DENTISTRY

DR. MATTHEW WOOD Keynote SpeakerDR. MONISH BHOLA

SPONSORED BYThe University of North Carolina Department of Prosthodontics

TH

E 4

th A

NN

UA

L

MA

TT

HE

W W

OO

DP

RO

ST

HO

DO

NT

ICS

SY

MP

OS

IUM

Com

preh

ensi

ve P

erio

dont

al a

nd P

rost

hodo

ntic

Tre

atm

ents

FR

IDA

Y,

DE

CE

MB

ER

4,

2015

_______ REGISTRATION

2015_MatthewWood.indd 1 9/28/2015 3:05:12 PM