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Questions and Answers
Why is the two-stage surgical technique not preferred by patients in periodontal plastic surgery?
What is the purpose of a double sling suture in periodontal plastic surgery?
What unfavorable condition at the site of gingival recession may require the two-stage surgical technique in periodontal plastic surgery?
What modification was introduced in a recent case report to improve esthetic outcomes in periodontal plastic surgery?
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How was root coverage achieved in the two-stage surgical procedure described in the text?
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What was reported as the percentage of root coverage achieved using the two-stage technique described in the text?
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Why was a modified two-stage surgical procedure introduced in a recent case report mentioned in the text?
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What is the purpose of interrupting sutures along vertical-releasing incisions in periodontal plastic surgery?
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What additional condition could render a two-stage technique indispensable according to the text?
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What difference in appearance was noted between the grafted area and adjacent soft tissue post-surgery?
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Study Notes
Mucogingival Therapy
- Mucogingival therapy involves procedures for correcting defects in the morphology, position, and/or amount of soft tissue and underlying bone support around teeth and implants.
- The term "mucogingival surgery" was introduced by Friedman in 1957 and included surgical procedures to preserve gingival tissue, remove aberrant frenal or muscle attachments, and increase the depth of the vestibule.
Periodontal Plastic Surgery
- Periodontal plastic surgery is a term introduced by Miller in 1993 and accepted by the international scientific community in 1996.
- It is defined as "surgical procedures performed to prevent or correct anatomic, developmental, traumatic or disease-induced defects of the gingiva, alveolar mucosa or bone".
- The term includes various soft- and hard-tissue procedures aimed at:
- Gingival augmentation
- Root coverage
- Correction of mucosal defects at implants
- Crown lengthening
- Gingival preservation at ectopic tooth eruption
- Removal of aberrant frena
- Prevention of ridge collapse associated with tooth extraction
- Augmentation of the edentulous ridge
Patient Biotype and Keratinized Tissue
- Patient biotype might influence the increase in keratinized tissue after surgery.
- Patients with a more apical position of the mucogingival line may experience a greater increase of keratinized tissue height after coronally advanced flap surgery.
Root-Surface Modifications
- Pini Prato et al. (157) evaluated the outcomes of two different methods of root-surface modifications (root-surface polishing compared with root planing) used in combination with a coronally advanced flap for the treatment of single-type gingival recessions.
- The authors observed an apical shift of the gingival margin occurring in 39% of the patients treated in both groups, showing a progressive worsening of the gingival recessions with time.
- The results also showed a tendency of the keratinized tissue width to decrease over time.
Two-Stage Technique
- The two-stage technique has been reported to achieve a percentage of root coverage ranging from 65% to 72%.
- However, this procedure is not well accepted by patients due to the two surgical stages.
- A modified two-stage surgical procedure has been introduced to improve the esthetic outcome and reduce the patient's morbidity.
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Description
Explore the topic of periodontal plastic surgery as discussed in Volume 68 of Periodontology 2000. Learn about mucogingival therapy, procedures for correcting defects in soft tissue and bone support around teeth and implants, and more.
