Conventional and modified papilla preservation flap ppf. The papilla amplification flap for the treatment of a localized periodontal defect associated with a palatal groove. A new surgical approach for interproximal regenerative procedures. Esthetic considerations for the interdental papilla this pdf is available for free download from a site hosted by medknow publications. To avoid maxillary anterior softtissue loss, papilla preservation flap surgery was done. Modified papilla preservation technique can be used in singlerooted teeth and lower molars without neighboring tooth 24. Does the papilla preservation flap technique induce soft. This video, from cambridge academy of dental implantology, demonstrates implant placement utilizing a palacci flap closure to preserve the papilla. This procedure simplified papilla preservation flap, sppf was designed to provide surgical access to interproximal bony defects while preserving interdental soft tissues, even in narrow interdental spaces and posterior teeth.
Several articles have been devoted to flap designs and surgical techniques to maintain full papillary form and preserve the soft tissues during. The preserved papilla can be incorporated into the facial or the lingual palatal lap b, the reflected flap exposes the underlying bone. A modification of the papilla preservation technique has been applied to achieve primary closure of the interproximal tissue over barrier membranes placed coronal to the alveolar crest. Surgical management of wide intrabony defect underlying. Papillary retention flap design for pocket reduction. B modified papilla preservation flap cortellini et al. The aim of this article was to describe an abrams techniques modification. Does the papilla preservation flap technique induce soft tissue. A minimally invasive surgical approach for periodontal regeneration. Papilla preservation flaps for periodontal regeneration of. Minimally invasive techniques for regenerative therapy. In detail, the purpose of pbi is to obtain access to the periapical lesion without mobilizing the interdental papilla, thus preserving that tissue for flap repositioning and. Simplified papilla preservation technique dentistry. The flap is mobilized through the interdental space from palatal to buccal.
This paper describes a case where the whales tail flap was used associated to autologous osseous graft and bovine collagen membrane in an. This particular flap design could be considered a modification of the papilla preservation flaps proposed in periodontal conservative and regenerative surgery, 14. Widman flap and the simplified papilla preservation flap. Modified papilla preservation technique linkedin slideshare. Papilla preservation flap surgery was the ideal choice in relation to the two central incisor teeth, as these teeth presented wide interdental spacing with a broad interproximal d semilunar.
Pdf a modified papilla preservation technique, 22 years. This study aims to evaluate the early postoperative healing of papillary incision wounds and its association with 1 patientsiterelated factors and technical surgical aspects as well as with 2 6month clinical outcomes following buccal single flap approach sfa in the treatment of intraosseous periodontal defects. A novel surgical procedure specifically designed to access interdental spaces in the regenerative treatment of deep intrabony defects is presented. D schematic drawing of the application of a papilla preservation flap for the management of the defect. Pierpaolo cortellini giovanpaolo pini prato maurizio s. The paper presented various surgical and nonsurgical approaches to restore the same. A horizontal incision is traced in the buccal gingiva of the interdental space at the base of the papilla, and the papilla.
The labial ridge had previously been regenerated using biooss. Periodontal regenerative emdogain surgery with papilla. This was the modified and simplified papilla preservation technique. This is the first report to describe the use of this flap associated to autogenous bone graft. Modified whales tail technique for the management of bone. The papilla base flap, consisting of the papilla base incision and two releasing incisions, was used to expose the bone. Several os seous defects are seen c, the flap returned to its original position covering the entire interdental spaces. The flap is designed with simplified papilla preservation 4746, modified papilla. Early postoperative healing following buccal single flap. Abrams roll flap, performed at the implant second surgical stage, allows for the correction of small horizontal defects by enhancing the buccal soft tissue thickness and improves the buccal soft tissue profile. Introduction gtr predictable significant amount of attachment and bone gains at 1 year lack of primary closure, flap dehiscence, membrane exposure occurs in 70% 80% of. Primary closure over the membrane was obtained in all treated sites using the modified preservation technique.
Guided tissue regeneration and papilla preservation with. This case report aims towards assessment of papilla preservation flap in the treatment of a 27 year old female with generalized chronic moderate periodontitis leading to pathological migration in anterior esthetic. Specific surgical approaches have been reported to obtain primary flap closure to preserve interdental tissue, the papillapreservation technique, modified papillae. Papilla preservation flap periodontal disease click to. The distal extensions of the incision were continued as intrasulcular incisions on the buccal, interdental and palatal aspect of the central incisors, separating the. Pdf a modified papilla preservation technique, 22 years later. Interdental papilla reconstruction combining periodontal. The flap design may also be dictated by the aesthetic concerns of the area of surgery. The simplified papilla preservation flap a novel surgical approach for the management of soft tissues in regenerative procedures presenter. Root coverage using double papilla preservation flap. Papilla preservation flap takei 1985 allows maintenance of intact interdental papilla in contrast to papilla splitting techniques. The other pedicle flap which was undeepithelialized was kept in position to cover the previous flap. It was brought in practice by cortellini as minimally invasive surgical technique.
Preservation of good blood supply to the flap is another important consideration. When the interdental areas are too narrow to permit the preservation of flap. Longterm evaluation period after the use of papilla preservation technique, revealed stable results, although a partial exposure of the buccal root surface of some teeth did occur. Clinical research joe volume 42, number 8, august 2016 papilla preservation flap technique 1191. A palacci papilla regenerating flap is used the flap is closed with atraumatic compression sutures.
The same procedure was performed in the control group but with no barrier membrane. Depending on how the interdental papilla is managed, flaps can either split the papilla conventional flap or preserve it papilla preservation. Case 2 was a surgical incision flap with preservation of papillae on the posterior region of tooth 46 with inlay restoration. A higher gingival blood flow to different parts of the periodontium might have an essentially positive. Modifications in the conventional papilla preservation flap technique can be appropriately used with coronally displaced flap along with bone graft and barrier membrane. Esthetic considerations for the interdental papilla. Modified papilla preservation flap mppf primary intrasulcular incision fig. Modified papilla preservation flap cortellini et al. The whales tail flap technique is designed to preserve interdental tissue in guided tissue regeneration. Fifteen patients with deep intrabony interproximal defects were treated. In 1995 and 1999, cortellini described a modification to the conventional papilla preservation flap. The techniques include papilla preservation flap 23, modified papilla preservation 24, and simple papilla preservation flap 25 to prevent inadvertent papillary loss as a result of flap. Interrupted suturing 50 vicryl was done across the medial area of the two papilla flaps figure 5. Wide intrabony defect treated with the modified papilla.
Flap design and suturing for periodontal regeneration of a furcation grade 2 and an intrabony defect. Evaluation for both cases were obtained by incision papilla preservation of primary closure was perfect, good aesthetic results, minimal gingival recession and the interdental papillae can be maintained properly. This procedure simplified papilla preservation flap, sppf was designed to provide surgical access to interproximal bony defects while preserving interdental. No adjunct guided tissue regeneration was attempted. Surgical site was protected with tin foil figure 6, and periodontal dressing was given with coepack. The medial extensions of both the semilunar incisions excised only the base of the frenal attachment, preserving the continuity of the flap. A modified papilla preservation technique, 22 years later. This limitation was addressed in the whales tail technique, by elevation of a large buccal flap, which allowed the preservation of a significant amount of soft. A novel surgical approach for the management of soft tissues in regenerative procedures.
The comparison of papilla preservation technique and. Conventional papilla preservation technique free download as powerpoint presentation. Pdf clinical efficacy of papilla preservation flaps with. More demanding in narrow interproximal spaces necrosis7. Palacci flap closure to preserve the papilla osseonews. Fortythree intraosseous defects in 35 patients were accessed with a. Comparison of gingival blood flow during healing of. The technique involves the preservation of the entire papilla, thus eliminating any potential loss of height as a result of the surgical or healing process.