Periodontal Plastic Surgery Flashcards
What are the consequences of recession?
Dentine hypersensitivity Esthetics Inadequate oral hygiene Root caries susceptibility Tooth abrasion Fear of tooth loss (won't happen, but pts have that fear)
What are the indications of recession treatment?
Esthetic concerns Tooth sensitivity (#1 reason) Oral hygiene improvement Root caries risk Increasing defect
Pedicle Graft
A soft tissue graft that is rotated or otherwise repositioned to correct an adjacent defect
What are the different type of flaps used in a Pedicle graft?
Lateral sliding flap
Double Papilla Flap
Coronally positioned Flap
Steps for a Lateral Sliding Flap
Remove existing marginal tissue
The adjacent tissue is reflected - usually by partial-thickness dissection
The tissue flap is then moved over to cover the defect and sututred
Advantages in a Lateral Sliding Flap
Good Blood supply
Usually only minor post-op discomfort
Good esthetics and color match
Predictable root coverage is possible
Disadvantages in a Lateral Sliding Flap
Recession is possible at the donor site
Less than ideal predictability
Limited applicability - it’s not often that you have sufficient tissue adjacent to recession area
Double Papilla Flap
Make 2 new papillas, elevate them, and then bring them over the defect
Variation of lateral sliding flap
When is it best to use a Coronally Positioned Flap
Miller I classification - because the defect has not gone past the MGJ
What are the advantages to a coronally positioned flap?
One-stage surgery Can be used in treatment of multiple defects Relatively simple Good blood supply Good root coverage Average predictability
What are the disadvantages to a Coronally Positioned Flap
Esthetic compromises
Questionable long-term stability
Vestibular shortening
What is it about that makes Connective Tissue Grafts distinct?
Graft gets blood supply from both the bed and the overlying tissues
What are the advantages of a CT graft?
One-stage surgery Excellent esthetics Good blood supply *Excellent predictability *Excellent long term stability of result
What are the disadvantages of a CT graft?
Two surgical sites
Donor site limitations
Technically demanding
T/F - The root should be conditioned prior to treatment?
False
