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Full-thickness Flaps (full-thickness + flap)
Selected AbstractsOpen flap debridement with or without intentional cementum removal: a 4-month follow-upJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005Antonio Wilson Sallum Abstract Objectives: The aim of this study was to investigate the influence of cementum removal on periodontal repair. Material and Methods: Forty subjects with chronic periodontitis and presenting, at least, two proximal sites in anterior teeth (upper or lower) with probing depth 5 mm were selected. After oral hygiene instructions and ultrasonic supragingival instrumentation, the subjects were randomly assigned for one of the following groups: CIC, scaled with Gracey curettes; CIUS, scaled with ultrasonic device; CDC, calculus deattachment with Gracey curettes and brushing with saline solution; and CDUS, calculus deattachment with ultrasonic device and brushing with saline solution. Full-thickness flaps were reflected and the instrumentation was performed with a clinical microscope. Probing depth (PD), relative gingival margin level (RGML) and relative attachment level (RAL) were registered at five experimental periods: baseline and 30, 60, 90 and 120 days postoperative. Results: All the approaches were able to markedly reduce the PD values from the baseline to the other evaluation periods (p<0.0001). The increase in RGML values was statistically significant only for the CDUS group. There were no statistically significant differences between the baseline and postoperative values in all groups for the RAL changes. The changes in RAL were statistically significant only among the groups CDC and CDUS (p<0.0001). Conclusion: The conventional scaling and root planing and the calculus deattachment were effective in reducing the probing depth values, regardless of the instrumentation method. [source] Ridge alterations following tooth extraction with and without flap elevation: an experimental study in the dogCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2009Mauricio G. Araújo Abstract Background: Different approaches were advocated to preserve or improve the dimension and contour of the ridge following tooth extraction. In some of studies, socket ,flapless extraction' apparently had a successful outcome. Aim: The objective of the present experiment was to compare hard tissue healing following tooth extraction with or without the prior elevation of mucosal full-thickness flaps. Material and methods: Five mongrel dogs were used. The two second mandibular premolars (2P2) were hemi-sected. The mesial roots were retained. By random selection the distal root in one side was removed after the elevation of full-thickness flaps while on the contralateral side, root extraction was performed in a flapless procedure. The soft tissue wound was closed with interrupted sutures. After 6 months of healing, the dogs were euthanized and biopsies were sampled. From each experimental site, four ground sections , two from the mesial root and two from the healed socket , were prepared, stained and examined in the microscope. Results: The data showed that the removal of a single tooth (root) during healing caused a marked change in the edentulous ridge. In the apical and middle portions of the socket site minor dimensional alterations occurred while in the coronal portion of the ridge the reduction of the hard tissue volume was substantial. Similar amounts of hard tissue loss occurred during healing irrespective of the procedure used to remove the tooth was, i.e. flapless or following flap elevation. Conclusion: Tooth loss (extraction) resulted in marked alterations of the ridge. The size of the alveolar process was reduced. The procedure used for tooth extraction , flapless or following flap elevation , apparently did not influence the more long-term outcome of healing. [source] Tissue modeling following implant placement in fresh extraction socketsCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006Mauricio G. Araújo Abstract Objective: To study whether osseointegration once established following implant placement in a fresh extraction socket may be lost as a result of tissue modeling. Material and methods: Seven beagle dogs were used. The third and fourth premolars in both quadrants of the mandible were used as experimental teeth. Buccal and lingual full-thickness flaps were elevated and distal roots were removed. Implants were installed in the fresh extraction socket. Semi-submerged healing of the implant sites was allowed. In five dogs, the experimental procedure was first performed in the right side of the mandible and 2 months later in the left mandible. These five animals were sacrificed 1 month after the final implant installation. In two dogs, the premolar sites on both sides of the mandible were treated in one surgical session and biopsies were obtained immediately after implant placement. All biopsies were processed for ground sectioning and stained. Results: The void that existed between the implant and the socket walls at surgery was filled at 4 weeks with woven bone that made contact with the SLA surface. In this interval, (i) the buccal and lingual bone walls underwent marked surface resorption and (ii) the height of the thin buccal hard tissue wall was reduced. The process of healing continued, and the buccal bone crest shifted further in the apical direction. After 12 weeks, the buccal crest was located>2 mm apical of the marginal border of the SLA surface. Conclusion: The bone-to-implant contact that was established during the early phase of socket healing following implant installation was in part lost when the buccal bone wall underwent continued resorption. [source] | ||||||||||