Perio Plastic surgery Flashcards
plastic surgery
that concerns relations between
mucogingival tissues and attached gingiva,
alveolar mucosa, frenulum, muscle
attachment and vestibule.
Mucogingival surgery
What are the 3 phenotypes of gingiva?
Thin scalloped
Thick scalloped
Thick flat
- Apical shift of the gingival margin, associated
with attachment loss - Etiology-different conditions, pathologies
– Toothbrush abrasion
– Frenal attachment
– Intrasulcular restorative margin placement*
– Orthodontics-dependent upon direction and bucco-
lingual soft tissue thickness
Recession
If there are 3mm recession sites, what % increase in recession?
67%
If there are 4mm recession sites, what % increase in recession
98%
Miller classification:
–Marginal recession not extending to
the mucogingival junction
–No loss of interdental bone or soft
tissue
–100% root coverage possible
Class 1
Miller classification:
–Marginal recession extends to or
beyond the mucogingival junction
–No loss of interdental bone or soft
tissue
–100% root coverage possible
Class 2
Miller classification:
– Marginal tissue extends to or beyond the
mucogingival junction
– Loss of interdental bone and/or soft tissue
is apical to the CEJ, but coronal to most
apical extent of recession
– Partial but not total root coverage is
possible (50-70%)
- Class III
Miller classification:
–Marginal tissue extends to or beyond
the mucogingival junction
–Loss of interdental tissue extends to
the apical extent of recession
–Root coverage cannot be anticipated
Class IV
- Advantages
– Root coverage on single or multiple teeth?
– Abundant donor tissue available - Disadvantages
– Color**
– Type of attachment?
– Second surgical site
Autogenous gingival graft (Free gingival graft)
What is the wound healing process around free gingival graft? 5 steps and what days?
– Plasmatic circulation (2-4 days)
– Revascularization (2-8 days)
– Organic Union (4-10 days)
– Epithelialization (10-14 days)
– Keratinization (21-180 days)