Se ha denunciado esta presentación.
Utilizamos tu perfil de LinkedIn y tus datos de actividad para personalizar los anuncios y mostrarte publicidad más relevante. Puedes cambiar tus preferencias de publicidad en cualquier momento.
Good Afternoon
IVth Year
Good Afternoon
IVth Year
Periodontal Plastic Surgery
Presented By :
Dr. Abhishek Gaur
BDS, MDS, (Ph.D)
Department of Periodontics
R. R. Dental Coll...
Miller (1993)
Periodontal plastic surgery, treatment
of problems associated with the
amount of gingiva and recession type
...
PERIODONTAL PLASTIC
SURGERY
(WORKSHOP 1996 )
•Gingival augmentation
•Root coverage
•Correction of mucosal defects at impla...
Objectives
1.To understand some of the different types of grafts used
in Periodontal Plastic Surgery (Mucogingival Surgery...
Indications
• Gingival Augmentation
• Free Gingival Graft
• Connective Tissue Graft
• Root Coverage
• Coronally positioned...
When is Grafting Needed ?
How much keratinised gingiva is needed ?
• Bowers 1963 – felt that gingival health could be main...
•Is the recession progressing ?
•Is the tooth treatment planned for orthodontic care or
prosthetic treatment ?
•Is there r...
Free Gingival Auto-Grafts
Indications
• To increase keratinised tissue around teeth, implants or crowns.
• To increase ker...
•Classic “Gum Graft”
•Will increase keratinised gingiva
•Results in “Tire Patch” look.
•Classic “Gum Graft”
•Will increase...
Connective Tissue
Graft
Advantages
• Very predictable for root
coverage
• Smaller donor site (than FGG)
• Smaller recipien...
ProcedureProcedureProcedure
CTG ? Not-Indicated ?
•All exposed dentin is gingival recession.
•Abfraction.
•Tissue at or near the CEJ.
•Gingival hyperp...
Does Tooth-brushing
‘too hard’
causes
gum recession ?
Does Tooth-brushing
‘too hard’
causes
gum recession ?
Not really….
•Tooth-brushing and gingival recession. Litonjua, LA, et al. Int
Dent J 2003 53(2) a literature review showed...
Does It Hurt ???
• The common perception is that Connective Tissue
Grafting is VERY PAINFUL!!
• This is often the patient’...
Reality
•In 20 years of performing CT grafts, very few patients ever
complain about significant pain afterwards.
•Most are...
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Periodontal Plastic Surgery
Próxima SlideShare
Cargando en…5
×
Próxima SlideShare
What to Upload to SlideShare
Siguiente
Descargar para leer sin conexión y ver en pantalla completa.

8

Compartir

Descargar para leer sin conexión

Periodontal Plastic Surgery

Descargar para leer sin conexión

Periodontal Plastic Surgery

Libros relacionados

Gratis con una prueba de 30 días de Scribd

Ver todo

Audiolibros relacionados

Gratis con una prueba de 30 días de Scribd

Ver todo

Periodontal Plastic Surgery

  1. 1. Good Afternoon IVth Year Good Afternoon IVth Year
  2. 2. Periodontal Plastic Surgery Presented By : Dr. Abhishek Gaur BDS, MDS, (Ph.D) Department of Periodontics R. R. Dental College & Hospital Umarda, Udaipur (RAJ.)
  3. 3. Miller (1993) Periodontal plastic surgery, treatment of problems associated with the amount of gingiva and recession type defects to also include correction of ridge form and soft tissue esthetics. Miller (1993) Periodontal plastic surgery, treatment of problems associated with the amount of gingiva and recession type defects to also include correction of ridge form and soft tissue esthetics.
  4. 4. PERIODONTAL PLASTIC SURGERY (WORKSHOP 1996 ) •Gingival augmentation •Root coverage •Correction of mucosal defects at implants •Crown lengthening •Gingivectomy •Removal of aberrant frenulum •Prevention of ridge collapse associated with tooth extractions. •Augmentation of the edentulous ridge PERIODONTAL PLASTIC SURGERY (WORKSHOP 1996 ) •Gingival augmentation •Root coverage •Correction of mucosal defects at implants •Crown lengthening •Gingivectomy •Removal of aberrant frenulum •Prevention of ridge collapse associated with tooth extractions. •Augmentation of the edentulous ridge
  5. 5. Objectives 1.To understand some of the different types of grafts used in Periodontal Plastic Surgery (Mucogingival Surgery) 2.To understand the indications for the different types of mucogingival surgeries. 3.To show some examples of one of the most common grafting procedures, the FGG and CTG. 4.To understand when a condition would not benefit from Mucogingival Surgery ObjectivesObjectives 1.To understand some of the different types of grafts used in Periodontal Plastic Surgery (Mucogingival Surgery) 2.To understand the indications for the different types of mucogingival surgeries. 3.To show some examples of one of the most common grafting procedures, the FGG and CTG. 4.To understand when a condition would not benefit from Mucogingival Surgery
  6. 6. Indications • Gingival Augmentation • Free Gingival Graft • Connective Tissue Graft • Root Coverage • Coronally positioned flap • Semilunar flap • Laterally positioned flap • Double papilla flap • Free Gingival Graft • Connective Tissue Graft • Guided Tissue Regeneration using allograft IndicationsIndications • Gingival Augmentation • Free Gingival Graft • Connective Tissue Graft • Root Coverage • Coronally positioned flap • Semilunar flap • Laterally positioned flap • Double papilla flap • Free Gingival Graft • Connective Tissue Graft • Guided Tissue Regeneration using allograft
  7. 7. When is Grafting Needed ? How much keratinised gingiva is needed ? • Bowers 1963 – felt that gingival health could be maintained with a narrow zoned of KG (<1mm) but some was required for healing. • Lang & Loe 1968 – suggested 2mm. • Maynard and Wilson 1979 – 5mm of KG with 3mm attached when sub-gingival restorations are planned. • Kennedy 1985 – over a 6 year period, patients with inconsistent OH saw recession with thin tissue. Bottom Line : some attached gingiva is necessary for health, but patients with good OH can maintain thin AG. When is Grafting Needed ?When is Grafting Needed ? How much keratinised gingiva is needed ? • Bowers 1963 – felt that gingival health could be maintained with a narrow zoned of KG (<1mm) but some was required for healing. • Lang & Loe 1968 – suggested 2mm. • Maynard and Wilson 1979 – 5mm of KG with 3mm attached when sub-gingival restorations are planned. • Kennedy 1985 – over a 6 year period, patients with inconsistent OH saw recession with thin tissue. Bottom Line : some attached gingiva is necessary for health, but patients with good OH can maintain thin AG.
  8. 8. •Is the recession progressing ? •Is the tooth treatment planned for orthodontic care or prosthetic treatment ? •Is there root sensitivity ? •Is there difficulty cleaning the root surface by the patient ? •Is there an esthetic concern ? When is Grafting Needed ?When is Grafting Needed ?When is Grafting Needed ?
  9. 9. Free Gingival Auto-Grafts Indications • To increase keratinised tissue around teeth, implants or crowns. • To increase keratinised tissue under removable prostheses. • To increase vestibular depth. Disadvantages • Difficult to achieve root coverage. • High esthetic demand. • Large, uncomfortable donor site. • Graft site, slow uncomfortable healing. Free Gingival Auto-GraftsFree Gingival Auto-Grafts
  10. 10. •Classic “Gum Graft” •Will increase keratinised gingiva •Results in “Tire Patch” look. •Classic “Gum Graft” •Will increase keratinised gingiva •Results in “Tire Patch” look.
  11. 11. Connective Tissue Graft Advantages • Very predictable for root coverage • Smaller donor site (than FGG) • Smaller recipient site (than FGG) • Less soreness overall (than FGG) • Uses patient’s own tissue • Excellent esthetics • Can cover multiple, large recessions even on teeth with a previous restorations Disadvantages • Two surgical sites • Technique sensitive • Bleeding from palate (potential) Connective Tissue Graft Advantages • Very predictable for root coverage • Smaller donor site (than FGG) • Smaller recipient site (than FGG) • Less soreness overall (than FGG) • Uses patient’s own tissue • Excellent esthetics • Can cover multiple, large recessions even on teeth with a previous restorations Disadvantages • Two surgical sites • Technique sensitive • Bleeding from palate (potential)
  12. 12. ProcedureProcedureProcedure
  13. 13. CTG ? Not-Indicated ? •All exposed dentin is gingival recession. •Abfraction. •Tissue at or near the CEJ. •Gingival hyperplasia adjacent to normal gingival contours. CTG ? Not-Indicated ? •All exposed dentin is gingival recession. •Abfraction. •Tissue at or near the CEJ. •Gingival hyperplasia adjacent to normal gingival contours.
  14. 14. Does Tooth-brushing ‘too hard’ causes gum recession ? Does Tooth-brushing ‘too hard’ causes gum recession ?
  15. 15. Not really…. •Tooth-brushing and gingival recession. Litonjua, LA, et al. Int Dent J 2003 53(2) a literature review showed no direct relationship between toothbrushing and gingival recession. •Trauma from toothbrushing may contribute to recession in a minor way, but other more important factors should be treated first. •Abrasion of the hard surfaces of the teeth are likely caused by abrasives in the toothpaste. Not really…. •Tooth-brushing and gingival recession. Litonjua, LA, et al. Int Dent J 2003 53(2) a literature review showed no direct relationship between toothbrushing and gingival recession. •Trauma from toothbrushing may contribute to recession in a minor way, but other more important factors should be treated first. •Abrasion of the hard surfaces of the teeth are likely caused by abrasives in the toothpaste.
  16. 16. Does It Hurt ??? • The common perception is that Connective Tissue Grafting is VERY PAINFUL!! • This is often the patient’s perception. • This perception is usually the result of hearsay from friends and relatives. • The origins probably go back to the days of the Free Gingival Grafts. Does It Hurt ??? • The common perception is that Connective Tissue Grafting is VERY PAINFUL!! • This is often the patient’s perception. • This perception is usually the result of hearsay from friends and relatives. • The origins probably go back to the days of the Free Gingival Grafts.
  17. 17. Reality •In 20 years of performing CT grafts, very few patients ever complain about significant pain afterwards. •Most are pleasantly surprised at how little pain they had. •Very little post-opp. bleeding, swelling or bruising. Of course, everyone’s pain threshold is different… Does It Hurt ???Does It Hurt ??? Reality •In 20 years of performing CT grafts, very few patients ever complain about significant pain afterwards. •Most are pleasantly surprised at how little pain they had. •Very little post-opp. bleeding, swelling or bruising. Of course, everyone’s pain threshold is different…
  • YungHungChung

    Jun. 19, 2020
  • ShibinMohammed5

    Mar. 28, 2020
  • BhargavKatipalli

    Mar. 15, 2020
  • RituparnaSaha15

    Apr. 27, 2019
  • ahmedfergany5

    Apr. 1, 2019
  • madonnaadel942

    Feb. 28, 2019
  • siddiquisuman

    Jul. 13, 2018
  • OmarMukhtar5

    Jun. 8, 2018

Periodontal Plastic Surgery

Vistas

Total de vistas

2.251

En Slideshare

0

De embebidos

0

Número de embebidos

5

Acciones

Descargas

48

Compartidos

0

Comentarios

0

Me gusta

8

×