Several os seous defects are seen c, the flap returned to its original position covering the entire interdental spaces. Guided tissue regeneration and papilla preservation with. Instead of placing the semilunar incision over the root surface, this incision is placed in the interdental region. Case 2 was a surgical incision flap with preservation of papillae on the posterior region of tooth 46 with inlay restoration. Mar 25, 2017 flap design and suturing for periodontal regeneration of a furcation grade 2 and an intrabony defect. The flap is designed with simplified papilla preservation 4746, modified papilla. The other pedicle flap which was undeepithelialized was kept in position to cover the previous flap. The aim of this article was to describe an abrams techniques modification.
Rezende, sebastiao luiz aguiar greghi and euloir passanezi. This case report demonstrates complete reconstruction of the papilla following a semilunar coronally repositioned papilla technique with 6 months followup. Duodenal papilla definition of duodenal papilla by. Postoperative evaluation was done after a week in a month interval for three months. A conventional papilla preservation technique 2 b modified papilla preservation 3 c simplified papilla preservation flap4 d whales tail technique a conventional papilla preservation flap takei et al. The papilla base flap, consisting of the papilla base incision and two. First, vertical incisions were made using 15c scalpel blade hufriedy, leimen, germany. This was the modified and simplified papilla preservation technique. In part 1 of this surgical instructional video series, dr.
It includes sulcular incisions around each tooth with the lingualpalatal. Simplified papilla preservation technique dentistry. The incision forms a semilunar arc between the mesial line angles of the teeth adjacent to the papilla to be. Pdf papilla preservation flap as aesthetic consideration. The recipient site of the interdental space where the papilla is to be created provides a small surface area for either free grafting or pedicle grafting in terms of blood supply for the donor tissue. Surgical site was protected with tin foil figure 6, and periodontal dressing was given with coepack. This pdf is available for free download from a site hosted by. Evaluation for both cases were obtained by incision papilla preservation of primary closure was perfect, good aesthetic results, minimal gingival recession and the interdental papillae can be maintained properly. Comparison of longterm papilla healing following sulcular full thickness flap and papilla base flap in endodontic surgery. Ambedkar institute of dental sciences and hospital, patna, bihar, india. A new surgical approach for interproximal regenerative procedures.
Jul 19, 2016 this video, from cambridge academy of dental implantology, demonstrates implant placement utilizing a palacci flap closure to preserve the papilla. Pdf interimplant papilla preservation in the esthetic zone. The paper presented various surgical and nonsurgical approaches to restore the same. Papilla healing following sulcular full thickness flap in. The papilla base incision consisted of a shallow first incision at the base of the papilla and a sec. When the interdental areas are too narrow to permit the preservation of flap. When several interproximal spaces were part of the flap, the distal papilla of the operated tooth was the test site. A modified papilla preservation technique, 22 years later. A splitthickness papillary flap was elevated by means of an orban or buck knife.
To avoid maxillary anterior softtissue loss, papilla preservation flap surgery was done. Papilla preservation flap periodontal disease click to. Minimally invasive surgical techniques in periodontal. Pierpaolo cortellini giovanpaolo pini prato maurizio s. In conclusion, periodontal flap surgery on the anterior region or regions that require high aesthetic value could be addressed with papilla preservation incision. The labial ridge had previously been regenerated using biooss. Jul 03, 20 the minimally invasive surgical technique mist, cortellini and tonetti 2007a, 2007b is based on the elevation of very short buccal and lingual flaps that include the defectassociated interdental papilla. It is designed to achieve an adequate attached gingiva than can be gotten from the zone of attached keratinized gingiva andor coverage of a radicular surface of a tooth. Rangoonwala college of dental sciences and research centre, pune 411 001, india. Double papillary flap a treatment for gingival recession. The patients were treated for interdental papilla reconstruction with a partial thickness flap.
Progress in gingival papilla reconstruction thomas han dds. Comparison of longterm papilla healing following sulcular. This procedure simplified papilla preservation flap, sppf was designed to provide surgical access to interproximal bony defects while preserving interdental soft tissues, even in narrow. Surgical periodontal flap with conventional incision will result. Kasaj 0108 preoperative probing pocket depth ppd at the distal aspect of tooth 11 was 7 mm. Papilla preserving modified roll technique for stage 2. Surgical periodontal flap with conventional incision will result in gingival recession and loss of interdental papillae after treatment. Palacci flap closure to preserve the papilla osseonews. No adjunct guided tissue regeneration was attempted. The flap was extended mesially and distally to the involved tooth to be surgically treated. Guided tissue regeneration and papilla preservation with the wales tail flap.
More demanding in narrow interproximal spaces necrosis7. Papilla preservation flap intrasulcular incisions at facial and proximal side. Indication sheet pdr1 periodontal regeneration literature. Pdf papilla preservation flap as aesthetic consideration in. Papilla preservation flap surgery was the ideal choice in relation to the two central incisor teeth, as these teeth presented wide interdental spacing with a broad interproximal d semilunar. Abrams roll flap, performed at the implant second surgical stage, allows for the correction of small horizontal defects by enhancing the buccal soft tissue thickness and improves the buccal soft tissue profile. The flap design may also be dictated by the aesthetic concerns of the area of surgery.
Papilla preservation and tunneling technique in root coverage part 1 description. In the last decade, esthetics has become a major concern in periodontal therapy. Dr ehab rashed remove periapical root infection,preserve the papilla, bone graft the site then place dental implant along with ctg. Papilla preservation flap as aesthetic consideration in periodontal flap surgery flap surgery is treatment for periodontal disease with alveolar bone destruction. Papilla preserving modified roll technique for stage 2 soft tissue augmentation sangeeta dhir department of periodontology and oral implantology, dr. One of the most difficult and elusive goals for the periodontist in the esthetic aspect of periodontal therapy is the reconstruction of the interdental. Gtr predictable significant amount of attachment and bone gains at 1 year lack of primary closure, flap dehiscence, membrane exposure occurs in 70% 80% of cases. A novel surgical approach for the management of soft tissues in regenerative procedures. Surgical reconstruction of interdental papilla using.
Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during. Esthetic considerations for the interdental papilla. The preserved papilla can be incorporated into the facial or the lingual palatal lap b, the reflected flap exposes the underlying bone. The patient was advised to refrain from brushing at the grafted site for 3 weeks. Papilla preserving modified roll technique for stage 2 soft. It was brought in practice by cortellini as minimally invasive surgical technique. Early postoperative healing following buccal single flap. Interdental papilla reconstruction combining periodontal and. The interdental papillary reconstruction was fairly successful. Noncontained intrabony defect treated with the simplified papilla preservation flap in conjunction with straumann emdogain and a particulate bone grafting material prof.
To overcome the disadvantage of conventional papilla preservation technique takei et al. Pdf simultaneous removal of multiple adjacent teeth in the anterior maxilla often leads to collapse of the labial bony plate as well as flattening of. Mar 12, 2017 the preserved papilla can be incorporated into the facial or the lingual palatal lap b, the reflected flap exposes the underlying bone. A palacci papilla regenerating flap is used the flap is closed with atraumatic compression sutures. Discipline of periodontics, bauru dental school, brazil. This study aims to evaluate the early postoperative healing of papillary incision wounds and its association with 1 patientsiterelated factors and technical surgical aspects as well as with 2 6month clinical outcomes following buccal single flap approach sfa in the treatment of intraosseous periodontal defects.
Papilla preservation flap as aesthetic consideration in. Interdental papilla reconstruction combining periodontal. Jan 29, 20 modified papilla preservation technique can be used in singlerooted teeth and lower molars without neighboring tooth 24. Apr 24, 2018 dr barbagallo g psaila a, durso u, longo a guided tissue regeneration of interproximal angular intrabony defect with simplified papilla preservation technique resume a procedure of guided tissue regeneration applied for the resolution of an angular defect mesial to 1. Adobe acrobat reader is required to view pdf files.
Combined with periosteal releasing incisions, these preserved the soft tissue blood supply and allowed flap advancement where necessary following implant placement and horizontal ridge augmentation figs 1a to 1c, 2a, and 2b. Inter dental papilla loss, black triangle, papilla reconstruction. This procedure simplified papilla preservation flap, sppf was designed to provide surgical access to interproximal bony defects while preserving interdental soft tissues, even in narrow interdental spaces. Periodontal regenerative technologies are applied to improve short and longterm clinical outcomes of periodontally compromised teeth, presenting with deep pockets and reduced periodontal support.
Pdf a modified papilla preservation technique, 22 years. Insufficient blood supply is the major limiting factor in all the surgical papilla reconstructive and regeneration techniques. Jan 29, 20 simplified papilla preservation technique 1. The clinical predictability of this procedure is fairly. The double papilla technique combines the esthetic results of pedicle graft with the predictability and usefulness of free gingival graft and is an effective and.
A partialthickness flap about 3 mm was reflected from the crest of the osseous dehiscence area till the alveolar mucosa in the apical for easy flap migration. Progress in gingival papilla reconstruction created date. In 1995 and 1999, cortellini described a modification to the conventional papilla preservation flap. Fortythree intraosseous defects in 35 patients were accessed with a. Tonettithe simplified papilla preservation flapa novel surgical approach for the management of soft tissues in regenerative procedures presenter. Modified whales tail technique for the management of bone. Therefore, preservation of these fibers and subjacent bone are important. Damodharan deepalakshmi, ramakrishnan swamy ahathya, sunitha raja, aravind kumar surgical reconstruction of lost interdental papilla. This case report aims towards assessment of papilla preservation flap in the. Surgical reconstruction of interdental papilla with buccal and palatal thickness flap and a connective tissue graft has also been presented7.
Interdental papilla reconstruction combining periodontal and orthodontic therapy in adult periodontal patients. Modified papilla preservation technique periodontology surgery. Surgical reconstruction of lost interdental papilla. Simplified papilla preservation technique free download as powerpoint presentation. Guided tissue regeneration and papilla preservation with the. Papilla preservation and tunneling technique in root. The papilla base flap, consisting of the papilla base incision and two releasing incisions, was used to expose the bone. Preservation of good blood supply to the flap is another important consideration. Edward pat allen describes in great detail root preparation, instrumentation, and flap management techniques utilized in settingup the root coverage of multiple adjacent recession defects. Pdf surgical reconstruction of the interdental papilla. The minimally invasive surgical technique mist, cortellini and tonetti 2007a, 2007b is based on the elevation of very short buccal and lingual flaps that include the defectassociated interdental papilla. After removal of the marginal tissue, tetracycline was applied to the exposed root surface for about 5 min for root biomodification.
Dr barbagallo g psaila a, durso u, longo a guided tissue regeneration of interproximal angular intrabony defect with simplified papilla preservation technique resume a procedure of guided tissue regeneration applied for the resolution of an angular defect mesial to 1. Modified papilla preservation technique can be used in singlerooted teeth and lower molars without neighboring tooth 24. Pdf the loss of interdental papillae may create esthetic and phonetic problems and facilitates food impaction. Papilla preservation flap takei 1985 allows maintenance of intact interdental papilla in contrast to papilla splitting techniques.
Depending on how the interdental papilla is managed, flaps can either split the papilla conventional flap or preserve it papilla preservation. Ebscohost serves thousands of libraries with premium essays, articles and other content including the simplified papilla preservation flap. Periodontal regenerative emdogain surgery with papilla. Using papillaesparing incisions in the esthetic zone to restore. Double papilla repositioned flap for the treatment of. The patient was followed 6 weeks for postoperative care. Modified papilla preservation technique slideshare. Esthetic considerations for the interdental papilla this pdf is available for free download from a site hosted by medknow publications. Pdf flap surgery is treatment for periodontal disease with alveolar bone destruction. Minimally invasive surgical technique mist in regenerative. The patient was followed 6 weeks for postoperative. Modified whales tail technique for the management of bonedefect in anterior teeth anu kuriakose, majo ambooken, jayan jacob, priya john department of periodontics, mar baselious dental college, kothamagalam, ernakulam, kerala, india. Efficacy of a new papilla generation technique in implant.
Root coverage using double papilla preservation flap. This case report aims towards assessment of papilla preservation flap in the treatment of a 27 year old female with generalized chronic moderate periodontitis leading to pathological migration in anterior esthetic. Scribd is the worlds largest social reading and publishing site. This video, from cambridge academy of dental implantology, demonstrates implant placement utilizing a palacci flap closure to preserve the papilla. Flap design and suturing for periodontal regeneration of a furcation grade 2 and an intrabony defect. B modified papilla preservation flap cortellini et al. Modified papilla preservation flap mppf primary intrasulcular incision fig. Interrupted suturing 50 vicryl was done across the medial area of the two papilla flaps figure 5. Surgical approach to treat periodontal defects with maxillary anterior dentition in an esthetically pleasing manner is possible only when papillary. Pdf a modified papilla preservation technique, 22 years later.
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