BDS11004 Periodontal Surgery 2 PDF

BDS11004 Periodontal surgery 2 Date : 23 / 11 / 2017 Periodontal surgeries • Resective procedures • Periodontal regenerative procedures • Periodontal plastic surgery • Preprosthetic surgical procedures. • Surgical procedures for placement of implants and treatment of peri- implant disease. ...

BDS11004 Periodontal surgery 2 Date : 23 / 11 / 2017 Periodontal surgeries • Resective procedures • Periodontal regenerative procedures • Periodontal plastic surgery • Preprosthetic surgical procedures. • Surgical procedures for placement of implants and treatment of peri- implant disease. Endo-Perio lesions • The pulp tissue and the periodontium are closely related, where the disease of one tissue leads to the affection of the other • Differential diagnosis of periodontal-endodontic lesion can sometimes be difficult. • Proper diagnosis is essential for treatment Endo-Perio lesions Normal paths of communication between the periodontium and the pulp include • The apical foreman • The lateral canals • Accessory canals Endo-Perio lesions Alternative pathways to periodontal - endodontic affection include: • Vertical root fracture • Iatrogenic root canal perforation Endo-Perio lesions E-P lesions can be classified into: • Primary periodontal lesion • Primary periodontal lesion with secondary endodontic involvement • Primary endodontic lesions • Primary endodontic lesions with secondary periodontal involvement • True combined lesion Treatment? Periodontal plastic surgery • It is defined as a surgical procedure to current or eliminate anatomic, developmental or traumatic deformities of the gingiva or alveolar mucosa. The three objectives of periodontal plastic surgery include; • Problems associated with attached gingiva • Problems associated with short vestibule • Problems with aberrant frenum Minimally invasive surgery Periodontal plastic surgery • Gingival augmentation • Root coverage • Crown lengthening • Ridge augmentation • Esthetic surgical correction • Esthetic correction around implants • Surgical exposure for unerupted teeth • Reconstruction of papilla • Lip repositioning Microsurgery in periodontics Microsurgery in periodontics • Minimally invasive surgery is a surgical technique that uses smaller incisions to perform a surgical procedure that previously required larger incisions and achieves equal or superior results compared with the traditional surgical approach • This definition separates the description of the surgical procedure Microsurgery in periodontics Incorporates three main principals: • Passive wound closure • Reduced tissue closure • Improved motor skills Microsurgery in periodontics • Microsurgical triad includes: Illumination Surgical skill Magnification Microsurgery in periodontics Microsurgery in periodontics Loupes maybe • Simple • Compound • Prism Loupes in microsurgery • Loupes are a simple, small magnification device • Simple loupes are used for low-magnification because of high optical aberration. • Compound loupes are generally used for higher magnifications to control optical aberration. • Prismatic loupes use multiple lenses with prisms Loupes in microsurgery • Dental loupes usually take the form of a pair of glasses where they maybe flip-type, or insets within the lens of the glasses. • A typical magnification for use in dentistry is 2.5×, but dental loupes can be anywhere in the range from 2× to 8×. • Head mounted illumination is usually used with loupes to aid with vision. Microscopes in microsurgery • A more sophisticated form of magnification used is a microscope • Microscopes enhance precision, quality of work, and long-term dental health of the patient. • One of the primary goals in periodontics is microinvasive surgeries, minimizing risks and overall healing time. • Use requires practice Indication of microsurgery • Horizontal augmentation • Vertical augmentation • Guided tissue regeneration • Guided bone regeneration • Split thickness • Double papilla flaps • Repositioned flap • Connective tissue grafts Lasers in periodontics • Lasers are considered an addition to the dental field that has revolutionized treatment in the 20th century. • Lasers were introduced as an alternative to mechanical cutting devices but have now become an instrument of choice in many dental applications. • Its use in periodontal therapy, surgery, peri-implantitis presents an addition to already existing treatment protocols. Lasers in periodontics • Laser is the acronym of the words “Light Amplification by Stimulated Emission of Radiation.” • Laser emissions are unique in that they are • Monochromatic • Low divergence • Coherent • They maybe delivered as a continuous wave, gated-pulse mode, or free running pulse mode. Lasers in periodontics The modes of action of lasers on soft tissues include • Photothermal interaction • Photodynamic therapy • Biostimulation • Photoablation therapy Lasers in periodontics Lasers afford many advantages, among them are • Relatively bloodless surgical and post-surgical course • coagulate, vaporize, or cut tissue • Sterilize wound tissue • Minimal swelling and scarring • No sutures • Minimize mechanical trauma • Reduced surgical time • Decreased post-surgical pain • High patient acceptance However.. Factors affecting treatment results Local factors Systemic factors • Blood supply • Tissue handling • Hygiene • Etiologic factors • Infection • Age • Nutrition • Diabetes • Medication • Infection Periodontal surgery Before attempting periodontal surgery it is imperative to consider • The hoped for outcome • The alternative treatment options • The pros and cons of surgery • The technical limitations Factors affecting treatment results Local factors Systemic factors • Blood supply • Tissue handling • Hygiene • Etiologic factors • Infection • Age • Nutrition • Diabetes • Medication • Infection • Reading material • Carranza`s clinical periodontology, Newman, Takei, Klokkevold, Carranza (Part 2 section V) • Clinical periodontology and implant dentistry, Jan Lindhe and Niklaus P. Lang, volume 2 (41, 43, 47) Thank you