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Questions and Answers
Which of the following modifications to the pedicle flap were made by Hattler?
Which of the following modifications to the pedicle flap were made by Hattler?
What is the primary function of applying pressure after suturing the pedicle flap?
What is the primary function of applying pressure after suturing the pedicle flap?
What is the primary advantage of the double-papilla repositioned flap described by Cohen and Ross?
What is the primary advantage of the double-papilla repositioned flap described by Cohen and Ross?
What is the recommended treatment for the donor site after a pedicle flap procedure?
What is the recommended treatment for the donor site after a pedicle flap procedure?
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What can increase the risk of failure for the pedicle flap procedure?
What can increase the risk of failure for the pedicle flap procedure?
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What is the primary goal of the pedicle flap procedure?
What is the primary goal of the pedicle flap procedure?
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Which of the following is NOT a benefit of the pedicle flap procedure?
Which of the following is NOT a benefit of the pedicle flap procedure?
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What is the most important factor in determining the success of the pedicle flap procedure?
What is the most important factor in determining the success of the pedicle flap procedure?
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What is the recommended suture placement in relation to the cementoenamel junction (CEJ) when suturing a coronally repositioned flap?
What is the recommended suture placement in relation to the cementoenamel junction (CEJ) when suturing a coronally repositioned flap?
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What type of suture technique is recommended for the papilla regions and reliving incisions?
What type of suture technique is recommended for the papilla regions and reliving incisions?
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What is the primary purpose of applying gentle pressure after suturing the flap?
What is the primary purpose of applying gentle pressure after suturing the flap?
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Which of the following factors can make it difficult to suture a coronally repositioned flap with optimal tension?
Which of the following factors can make it difficult to suture a coronally repositioned flap with optimal tension?
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What is the primary treatment modality used in conjunction with a coronally advanced flap for large recession defects?
What is the primary treatment modality used in conjunction with a coronally advanced flap for large recession defects?
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What is the main reason for avoiding excessive tension when suturing a coronally advanced flap?
What is the main reason for avoiding excessive tension when suturing a coronally advanced flap?
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Which of the following is considered the gold standard treatment for recession defects?
Which of the following is considered the gold standard treatment for recession defects?
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Which of the following is a potential outcome of using a coronally advanced flap for recession defects?
Which of the following is a potential outcome of using a coronally advanced flap for recession defects?
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What type of recession defect is shown in Figures 1e-g?
What type of recession defect is shown in Figures 1e-g?
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Which of the following is NOT a characteristic of the laterally repositioned pedicle flap technique?
Which of the following is NOT a characteristic of the laterally repositioned pedicle flap technique?
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What is the primary goal of the laterally repositioned pedicle flap technique?
What is the primary goal of the laterally repositioned pedicle flap technique?
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What is the significance of the one-week post-surgery observation in Figures 1e-g?
What is the significance of the one-week post-surgery observation in Figures 1e-g?
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What is the main reason why grafting of a Miller’s Class III recession defect of this size is unlikely to provide full coverage?
What is the main reason why grafting of a Miller’s Class III recession defect of this size is unlikely to provide full coverage?
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What is the purpose of the second surgical procedure with a coronally repositioned flap mentioned in the text?
What is the purpose of the second surgical procedure with a coronally repositioned flap mentioned in the text?
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What is the primary factor determining the thickness of the flap used in the double-papilla flap technique?
What is the primary factor determining the thickness of the flap used in the double-papilla flap technique?
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What is the primary purpose of using citric acid to treat the root surface before a surgical procedure?
What is the primary purpose of using citric acid to treat the root surface before a surgical procedure?
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What is the significance of measuring the width of the recession defect before raising the donor tissue?
What is the significance of measuring the width of the recession defect before raising the donor tissue?
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Which of the following factors is NOT considered critical in determining the success of a periodontal plastic surgery procedure?
Which of the following factors is NOT considered critical in determining the success of a periodontal plastic surgery procedure?
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What is the recommended minimum thickness for split thickness pedicle flaps raised for periodontal plastic surgery procedures?
What is the recommended minimum thickness for split thickness pedicle flaps raised for periodontal plastic surgery procedures?
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What is the primary function of the split thickness pedicle flaps raised during periodontal plastic surgery procedures?
What is the primary function of the split thickness pedicle flaps raised during periodontal plastic surgery procedures?
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Why is it important to consider carrying out a frenectomy before or as part of periodontal plastic surgery?
Why is it important to consider carrying out a frenectomy before or as part of periodontal plastic surgery?
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Which of the following agents has been suggested to help promote healing response post-surgery, but has not shown significant improvement in clinical studies?
Which of the following agents has been suggested to help promote healing response post-surgery, but has not shown significant improvement in clinical studies?
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What is the primary role of the graft tissue in periodontal plastic surgery procedures?
What is the primary role of the graft tissue in periodontal plastic surgery procedures?
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What is the significance of the depth of the vestibule in periodontal plastic surgery?
What is the significance of the depth of the vestibule in periodontal plastic surgery?
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What is the name of the procedure described in the content?
What is the name of the procedure described in the content?
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Where are the incisions placed in the coronally advanced flap?
Where are the incisions placed in the coronally advanced flap?
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Which of the following steps is NOT a part of the coronally advanced flap procedure?
Which of the following steps is NOT a part of the coronally advanced flap procedure?
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What is the purpose of de-epithelializing the intact part of the papilla?
What is the purpose of de-epithelializing the intact part of the papilla?
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According to the content, what is the aim of the coronally advanced flap procedure?
According to the content, what is the aim of the coronally advanced flap procedure?
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What does the content say about the effect of smoking on the healing process after this procedure?
What does the content say about the effect of smoking on the healing process after this procedure?
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What is the purpose of the split-thickness pedicle flap?
What is the purpose of the split-thickness pedicle flap?
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What is the significance of the periosteum being released during the procedure?
What is the significance of the periosteum being released during the procedure?
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What is a significant factor influencing the outcome of root coverage procedures?
What is a significant factor influencing the outcome of root coverage procedures?
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Which classification is referenced for marginal tissue recession?
Which classification is referenced for marginal tissue recession?
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What percentage of complete and mean root coverage is observed in recession defects less than 4 mm?
What percentage of complete and mean root coverage is observed in recession defects less than 4 mm?
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What have studies shown regarding the treatment of patients with advanced periodontal disease?
What have studies shown regarding the treatment of patients with advanced periodontal disease?
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What technique shows variability in mean root coverage achieved?
What technique shows variability in mean root coverage achieved?
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What is the significance of using citric acid application in treatment?
What is the significance of using citric acid application in treatment?
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What aspect of mucogingival therapy is highlighted in the literature?
What aspect of mucogingival therapy is highlighted in the literature?
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What was the objective of the systematic review mentioned?
What was the objective of the systematic review mentioned?
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Flashcards
Graft thickness
Graft thickness
The graft should be thick enough to prevent necrosis.
Citric acid treatment
Citric acid treatment
Citric acid is used to remove the smear layer on the root surface pre-surgery.
Recession defect height
Recession defect height
Height is less critical than width in surgical planning for recessions.
Tetracycline hydrochloride
Tetracycline hydrochloride
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Prominent frenal attachments
Prominent frenal attachments
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Split thickness flaps
Split thickness flaps
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Frenectomy
Frenectomy
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Grafted tissue nourishment
Grafted tissue nourishment
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Vertical relieving incision
Vertical relieving incision
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Coronally advanced flap
Coronally advanced flap
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Split thickness pedicle flap
Split thickness pedicle flap
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De-epithelialization
De-epithelialization
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Graft tissue preparation
Graft tissue preparation
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Root coverage
Root coverage
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Incisions around recession defect
Incisions around recession defect
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Minor enameloplasty
Minor enameloplasty
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Pedicle flap
Pedicle flap
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Donor tissue
Donor tissue
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Full thickness flap
Full thickness flap
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Vascularization
Vascularization
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Secondary intention healing
Secondary intention healing
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Double-papilla repositioned flap
Double-papilla repositioned flap
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Suturing and pressure application
Suturing and pressure application
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Miller’s Class III recession
Miller’s Class III recession
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Lateral repositioned pedicle flap
Lateral repositioned pedicle flap
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Single tooth recession defects
Single tooth recession defects
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Double papilla flap
Double papilla flap
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Coronally repositioned flap
Coronally repositioned flap
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Post-surgery recovery
Post-surgery recovery
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Suturing Technique
Suturing Technique
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CEJ (Cementoenamel Junction)
CEJ (Cementoenamel Junction)
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Interrupted Sutures
Interrupted Sutures
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Periodontal Dressing
Periodontal Dressing
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Tension-Free Flap
Tension-Free Flap
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Root Coverage Outcome
Root Coverage Outcome
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Connective Tissue Graft
Connective Tissue Graft
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Mucogingival grafting
Mucogingival grafting
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Gingival recession defect size
Gingival recession defect size
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Root coverage percentage
Root coverage percentage
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Miller classification
Miller classification
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Laterally repositioned flap
Laterally repositioned flap
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Evidence based mucogingival therapy
Evidence based mucogingival therapy
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Long-term effect of treatment
Long-term effect of treatment
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Study Notes
Gingival Recession: Surgical Management using Pedicle Grafts
- Gingival recession is the apical displacement of the gingival margin from the cemento-enamel junction (CEJ).
- Most patients have aesthetic or sensitivity complaints.
- Periodontal plastic surgery corrects recession defects.
- Surgical options aim for aesthetic improvement, reduced sensitivity, better plaque control, and preventing further recession.
Miller's Classification of Gingival Recession
- Class I: Recession does not reach the mucogingival junction, no interdental bone loss.
- Class II: Recession reaches or extends past the mucogingival junction, no interdental bone loss.
- Class III: Recession reaches or extends past the mucogingival junction, with some interdental attachment loss or tooth malposition.
- Class IV: Recession reaches or extends past the mucogingival junction, with significant bone and/or soft-tissue loss, and/or severe tooth malposition.
Factors Affecting Surgical Outcome
- Root Surface: Calculus, caries, contaminated cementum, or restorations should be removed.
- Frenal Attachments: Prominent frenums can exert tension, leading to surgical failure.
- Vestibule Depth: Shallow vestibules are contraindicated for pedicle grafts.
- Tissue Type: Thin gingival biotypes have poorer outcomes.
- Recession Defect Size: Narrow defects have better outcomes compared to wide ones. The width, rather than the height, is critical.
- Thickness of Flaps: Flaps need sufficient thickness (≥1mm) to nourish grafted tissue and ensure successful healing.
- Smoking: Smoking compromises healing.
- Oral Hygiene: Patients with active periodontal disease should not undergo surgery.
Surgical Techniques (Pedicle Grafts)
- Pedicle Grafts: Donor tissue adjacent to the recession defect is repositioned over the exposed root.
- Laterally Repositioned Pedicle Flap: Donor tissue is repositioned over the exposed root
- Double Papilla Repositioned Flap: Tissue from both sides of the recession defect is moved over exposed roots for multiple-tooth defects.
- Coronally Repositioned Flap: Tissue apical to the recession defect is repositioned coronally over the exposed root .
Contraindications
- Smoking: Complicates healing and negatively affects outcomes.
- Poor Oral Hygiene and active periodontal disease hinder successful grafting.
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Description
Test your knowledge on the surgical management of gingival recession using pedicle grafts. This quiz covers Miller's classification, surgical options, and factors affecting treatment outcomes. Understand how periodontal plastic surgery can improve aesthetics and sensitivity in patients.