PERIODONTAL FLAP SURGERY – Discuss Dentistry

Re: PERIODONTAL FLAP SURGERY

tonyshori.perio — Sat, 19 Mar 2011 23:02:52 +0000

There some indications for flap surgery. if the pocket depth is around 2 to 3mm then there is no need of a flap surgery because it is maintainable by the patient.

Re: PERIODONTAL FLAP SURGERY

sushantpatel_doc — Sun, 20 Mar 2011 11:02:00 +0000

2 to 3 mm is called a clinical pocket and is normal because gingival sulcus in humans is not germ free..it becomes pathological when its more than 2-3mm and its then when flap surgery is indicated..

Re: PERIODONTAL FLAP SURGERY

tonyshori.perio — Mon, 21 Mar 2011 07:18:43 +0000

You need perform flap surgery if the pocket depth is 2 to 3 mm because it is maintianable by the patient only with proper brushing along with 1 mm of CAL loss

Re: PERIODONTAL FLAP SURGERY

Mon, 21 Mar 2011 10:34:31 +0000

The normal sulcular depth is three millimeters or less. Through much investigation and research, it has been determined that sulcular depths of three millimeters or less are readily self-cleansable with a properly used toothbrush or the supplemental use of other oral hygiene aids. When the sulcular depth is chronically in excess of three millimeters, regular home care is unable to properly cleanse the full depth of the sulcus, allowing food debris and microbes to accumulate. This poses a danger to the periodontal ligament (PDL) fibers that attach the gingiva to the tooth. If accumulated microbes remain undisturbed in a sulcus for an extended period of time, they will penetrate and ultimately destroy the delicate soft tissue and periodontal attachment fibers. If left untreated, this process may lead to a deepening of the sulcus, recession, destruction of the periodontium, and tooth loss.A gingival pocket presents when the marginal gingiva experiences an edematous reaction, whether due to localized irritation and subsequent inflammation, systemic issues, or drug induced gingival hyperplasia. Regardless of the etiology, when gingival hyperplasia occurs, greater than normal (the measurement in a pre-pathological state) periodontal probing measurements can be read, creating the illusion that periodontal pockets have developed. This phenomena is also referred to as a false pocket or "pseudopocket". The epithelial attachment does not migrate, it simply remains at the same attachment level found in health. The only anatomical landmark experiencing migration is the gingival margin in a coronal direction.

In a gingival pocket, no destruction of the connective tissue fibers (gingival fibers) or alveolar bone occurs. This early sign of disease in the mouth is completely reversible when the etiology of the edematous reaction is eliminated and frequently occurs without dental surgical therapy. However, in certain situations, a gingivectomy is necessary to reduce the gingival pocket depths to a healthy 1-3 mm.

As the original sulcular depth increases and the apical migration of the junctional epithelium has simultaneously taken place, pathosis has occurred. To have a true periodontal pocket, a probing measurement of 4 mm or more must be clinically evidenced. In this state, much of the gingival fibers that initially attached the gingival tissue to the tooth have been irreversibly destroyed.

Re: PERIODONTAL FLAP SURGERY

Tue, 22 Mar 2011 08:18:10 +0000

patients with chronic periodontitis can first manage with oral prophylaxis with deep scaling than recall after 10 – 15 days. check the periodontal pocket with using UNC 15 probe or properly marking probe. if pocket is 2-3 mm deep than it just required proper follow up of 2-3 month with proper oral hygiene instruction.
if more than 3-4 mm localized pocket can be treated using Local drug delivery (using Tetracycline fibers or chlorhexidine chip) which reduces the pocket depth of 1-2 mm. but LDD can be use after root planning with curretage of site where pocket is present.
if pocket is present generalized with 3-4 mm deep than best option is flap surgery with bone grafting if required this will give you good result.

Re: PERIODONTAL FLAP SURGERY

tonyshori.perio — Mon, 02 May 2011 07:10:27 +0000

Flaps reflected without vertical incisons are called as envelop flap.

Re: PERIODONTAL FLAP SURGERY

sushantpatel_doc — Mon, 02 May 2011 09:51:56 +0000

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