phase ii periodontal therapy 5th 19-4.… · 1. gingival curettage •definition : •the term...
TRANSCRIPT
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Phase II Periodontal Therapy
principals of periodontal
surgery 12/4/2020 -امراض لثة -الفرقة الخامسة
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1. Gingival Curettage
2. Excisional new attachment procedure
(ENAP)
3. Gingivectomy
Gingival Surgical Techniques
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1. Gingival Curettage
• Definition :
• The term "gingival curettage" implies
directing an operative instrument against
the gingival wall of the periodontal pocket
in order to remove the ulcerated epithelium
covering the sulcus.
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1. Gingival Curettage
• The curettes is used to scraping of the gingival
wall of a periodontal pocket to separate diseased
soft tissue.
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1. Gingival Curettage
• TYPES
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1. Gingival Curettage
• II. Surgical curettage,
• III. Chemical curettage,
• IV. ultrasonic curettage.
• V. Laser Tx
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1. Gingival Curettage
• INDICATIONS
1. ?
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1. Gingival Curettage
• However,
the need for curettage to
eliminate the inflamed
granulation tissue appears
to be questionable.
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2. Excisional new attachment procedure (ENAP)
• A surgical procedure in which the sulcular and junctional epithelium is resected. The aim of the procedure is to remove the diseased tissue and allow healing of the dentogingival and periodontal attachments.
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2. Excisional new attachment procedure (ENAP)
• advantages over traditional subgingival curettage is the definitive, clean excision of the junctional epithelium and the subjacent tissue with a greater probability of new clinical attachment
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2. Excisional new attachment procedure (ENAP)
• Indications
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2. Excisional new attachment procedure (ENAP)
• Contraindictions
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2. Excisional new attachment procedure (ENAP)
• Advantages
• Disadvantages
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3. Gingivectomy
• gingivectomy means “excision of the gingiva.”
By removing the pocket wall,
• gingivectomy provides visibility and accessibility
for complete calculus removal and the thorough
smoothing of the roots
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3. Gingivectomy
• Types:
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3. Gingivectomy
Step 1. bleeding points:
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3. Gingivectomy
• Step 2. The primary incision on the facial and
lingual surfaces:(Kirkland knives or a scalpel blade 12 or 15)
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3. Gingivectomy
• Step 3. the secondary incision interproximal soft
tissue is separated from the interdental periodontium by a using an
Orban knife
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3. Gingivectomy
• Step 4. The incised tissues are carefully
removed by means of a curette or a scaler
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3. Gingivectomy
• Step 5. Cover the area with a surgical pack
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3. Gingivectomy
• Indications:
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3. Gingivectomy
• Contraindications to gingivectomy
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• Gingivoplasty is similar to gingivectomy, but its
objective is different.
• Gingivectomy is performed to eliminate periodontal
pockets, and it includes reshaping as part of the
technique.
• Gingivoplasty is a reshaping of the gingiva to create
physiologic gingival contours with the sole purpose of
recontouring the gingiva in the absence of pockets
Gingivoplasty
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Classification of Flaps
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Periodontal Incisions