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PERIODONTOLOGY
AND
IMPLANTOLOGY
Introduction
The term ,Mugogingival
surgery (MGS) was coined
by Friedman, for surgical
alterations in relation to
gingival oral mucosa
Gingival recession
Gingival recession is
defined as exposure of
the root surface due to
a displacement of the
gingival margin apical
to the cemento-enamel
junction*
2.Esthetics
3.Sensitivity symptoms
Ref :Kassab MM, Cohen RE. The etiology and prevalence of gingival recession.
J Am Dent Assoc 2003;134:220-5.
The Disease
Understanding Gingival
recession and its
staging is a must before
peeping into its Surgical
correction
Lets me remind you PD
Millers Classification
REF: Miller Jr PD. A classification of marginal tissue recession.
Int J Periodontics Restorative Dent 1985;18:444-53.
Root Correction
procedures
Its fact that class III
and IV recession cases
have poor prognosis.
Most of the Root
coverage is
implemented for I,II
sometimes III classes.
Courtesy:
Decision Making in Aesthetics: Root coverage Revisited
PHILIPPE BOUCHARD, JACQUESMALET & ALAIN
BORGHETTI J Periodontology 2000
Sub-epithelial
connective tissue graft
Langer & langer 1985
introduced this method.
Indicated when large defects
with good vestibular health
and gingival thickness is
seen.
Here the donor tissue is
sandwiched between flaps.
Nelson 1987, proposed a
variant subpediclle
connective tissue flap to
improve blood circulation
quality.
Steps:
1. elevate partial thickness
flap carefully
2. Root palnning
3. Obtain graft
4. Palcement in recipient site
and suture with resorbalbe
material
5. Cover graft with outer
part of flap and suture
interdentally
6. Care of donor site and
dressing at surgical site
GTR membranes
Pini-Parto et al.:Guided tissue
regeneration GTR
membranes used for large
defects root coverage
Tinti-vencenzi proposed
titanium membranes to
create additional space
beneath flap.
Second surgery is not required
in case of bio-resorbable
material
Steps:
1.
2.
3.
4.
5.
GTR membrane
2.
1.
3.
4.
7.
Contents
Root surface
modification agents
Additive treatments
AIM: to order to improve the biological link between the
root surface and the covering soft tissues.
Prognosis??
Prediction of outcome of root
coverage procedures is
based on millers class
defect treated
ClassI , Complete root
coverage achieved
class II, Complete root
coverage may be achieved
Class III Complete root
coverage never achived
, Class IV Any root coverage
not pridicted
REF: Decision-making in aesthetics: root coverage revisited PHILIPPE BOUCHARD,
JACQUESMALET & ALAIN BORGHETTI J Periodontology 2000
Conclusion
Patients general
health, evaluation of
gingival and periodontal
status and
requirements as per
degree of defect must
be understood prior to
choosing one amongst
the various Root
Coverage procedures
AESTHETICS are prime concern in modern world, sensitivity how ever is
the next,,,
INFORMATION :
1. TEXTBOOK OF PERIODONTOLOGY Femin A .Carranza 10,11 th editions
2 Ref :Kassab MM, Cohen RE. The etiology and prevalence of gingival recession.J Am
Dent Assoc 2003;134:220-5
3. REF: Miller Jr PD. A classification of marginal tissue recession. Int J Periodontics
Restorative Dent 1985;18:444-53.
4 Care report: Use of Coronally placed flaps in Root coverage with bridge flap method.
Pushpendra Kumar Verma1, Ruchi Srivastava2, TP Chaturvedi., IMS,BHU.
5. Review of Tunnel technique in perodontic plastic surgery Dr David Garber,DMD
Maurice,Salama,DMD Henry salama,DMD 10-7-2008
6. :Bouchard P, Nilveus R, Etienne D. Clinical evaluation of tetracycline HCl conditioning
in the treatment of recessions.. J Periodontol 1997 68: 262269
7. Decision-making in Aesthetics: Root coverage Revisited : PHILIPPE BOUCHARD,
JACQUESMALET & ALAIN BORGHETTI J Periodontology 2000
IMAGE REF: Care report: Use of Coronally placed flaps in Root coverage with bridge flap
method.Pushpendra Kumar Verma1, Ruchi Srivastava2, TP Chaturvedi., IMS,BHU
IMAGES:.
1. Review of Tunnel technique in perodontic plastic surgery Dr David Garber,DMD
Maurice,Salama,DMD Henry salama,DMD 10-7-2008
2. *:Bouchard P, Nilveus R, Etienne D. Clinical evaluation of tetracycline HCl conditioning
in the treatment of recessions.. J Periodontol 1997 68: 262269
3 .Decision-making in Aesthetics: Root coverage Revisited : PHILIPPE BOUCHARD,
JACQUESMALET & ALAIN BORGHETTI J Periodontology 2000
4. AND NOT BUT NOT THE LEAST WWW.Google.com.....