The management of gingival recession and its sequelae is based on a thorough assessment of the etiological factors and the degree of tissue involvement. Department of prosthodontics, jaipur dental college. Gingival recession is a common condition in the adult population and is related to several undesirable conditions such as unaesthetic appearance, root caries, and hypersensitivity. Download periodontal surgery a clinical atlas naoshi sato. Introduction implant dentistry has been the fastest growing treatment modality in dentistry for the past 20 years. One of the chief goals of periodontal plastic surgery is establishment of ideal pink esthetics through the reconstruction of gingival recessions. Post operative view at 1 month following the surgical excision of the hyperplastic tissue and nonsurgical debridement of the lower incisors it was noted that there was an overall improvement in the gingival. The pouch and tunnel technique for management of multiple. The methods of gingival tissue displacement can be broadly classified as nonsurgical and surgical techniques, with nonsurgical being the more commonly practiced method. With the introduction of soft tissue lasers these problems can now be addressed more easily. Tissue management, gingival retraction and hemostasis. The pseudo pathology term idiopathic subgingival amalgam hypertrophy is used in the title for shock effect and as a scare tactic to catch the attention of our readers.
Pdf gingival tissue management in restorative dentistry. Soft tissue biology and management in implant dentistry yeung stephen c h faculty of dentistry, university of sydney, sydeny, westmead centre for oral health, westmead hospital, westmead, australia 1. Gingival retraction can be achieved in several ways, not just by using any physical material but also by using certain chemicomechanical materials which can help achieve retraction. Soft tissue biology and management in implant dentistry. David ricketts, in advanced operative dentistry, 2011. This article will describe an approach for diagnosing four. Classic gingival surgery primarily deals with the treatment of pockets i. With fixed orthodontic appliances and patients improper oral hygiene practices can compromise the orthodontic include.
Surgical areas were covered with a periodontal pack and post operative instructions were given. Today, the goal of dentistry is not simplest to dispose of oral disorder, however to enhance function and esthetics. William gilmore, dds, msd doctor leer is an instructor of operative dentistry, and doctor gilmore is professor and chairman of the department of operative dentistry, indiana university school of dentistry, indianapolis, 46202. Current management of the occlusion in operative dentistry is very much based on what is regarded as good clinical practice and will depend upon whether single individual restorations are placed or whether extensive work means that all or most of the occlusal surfaces are being restored.
The width of attached gingival tissue in the patients increased significantly from a mean of 0. Management of gingival tissue during indirect impression. Surgical management of druginduced gingival juniper publishers. Contained within the inner gingival connective tissue are gingival fibroblasts, which play a crucial role in tissue repair and the inflammatory response. Tissue management includes placing the gingival tissues away from the.
Soft tissue considerations for optimizing implant esthetics. In todays world of adhesive dentistry, the 2 main enemies of adhesive resin procedures are moisture saliva and blood. Laserassisted gingival tissue procedures in esthetic dentistry ernesto a. A training program saturday morning, february 22, 2020 minnesota licensed dental assistants and dental hygienists may place nonsurgical retraction material for gingival displacement under direct supervision, after successfully completing an accredited course. Forced eruption as well as several surgical techniques may be used to achieve and. Oct 30, 2019 one of the chief goals of periodontal plastic surgery is establishment of ideal pink esthetics through the reconstruction of gingival recessions. Series 1, number 3 3 figure 8 illustration of bone sounding. One of the challenging procedures is management of the gingival tissues and. Surgical management using free grafts and guided tissue regeneration m. Management of periodontal tissues for restorative dentistry starr, clifford b. It is quite common to note chronic inflammatory gingival overgrowths during andor post orthodontic treatment.
Sep 14, 2017 the key to success is effective soft tissue management, and the goal of soft tissue management has been to provide healthy gingival tissues covering sound, smooth restorative margins. This outer epithelial layer is keratinized, forming a protective layer around the tooth. Gingival recession is defined as the apical displacement of the gingival margin from the cementoenamel junction cej. Conventional versus laser gingivectomy in the management. Too often the surgeonrestorative dentist team ignores the soft tissues, and compromised results are attained at the expense of an unhappy patient.
Saturday morning, february 22, 2020minnesota licensed dental assistants and dental hygienists may place nonsurgical retraction material for gingival displacement under direct supervision, after successfully completing an accredited course. Soft tissue management, therefore, is not an endtherapy for patients with bone loss. With this idea in mind clinicians must carefully analyze a number of factors related to the patients face, smile, teeth, and gingiva during the planning phase of esthetic cases. Periodontal plastic surgery is defined as the surgical procedures performed to correct or eliminate anatomic, developmental or traumatic deformities of the gingiva or alveolar mucosa. Further, indepth studies are needed to establish the link between drugs and gingival enlargement for prevention and improved treatment. Gingival enlargements generalised pocket dentistry. Surgical management of druginduced gingival overgrowth. Chan3 verifiable cpd paper condition of root surface presence of calculus, caries, contaminated cementum or restorations on root surface prominent fraenal attachments depth of vestibule. Thus the effective management of gingival enlargement needs a thorough diagnosis and then its disparate management. Surgical areas were covered with a periodontal pack and postoperative instructions were given. Proper tissue management is a key factor in accurately duplicating subgingival margins. Regarding management of gingival tissues, the goal is to ensure that the. Individualized treatment plan for gingival enlargement.
Download pdf periodontal surgery a clinical atlas naoshi sato. This practical handson course will give you or your clinical staff the knowledge and skills to confidently perform gingival retraction. Management of periodontal tissues for restorative dentistry. Strassler, dmd, fadm, fagd professor, division of operative dentistry department of endodontics, prosthodontics and operative dentistry university of maryland dental school 650 west baltimore street baltimore, maryland 21201 email. One of the primary goals of a long term successful restorative therapy is to establish a physiologic periodontal climate that facilitates. Tissue management includes placing the gingival tissues away from the preparation margins so that impression can be made, combined with providing for. Tissue management, gingival retraction and hemostasis oral.
Current management of the occlusion in operative dentistry is very much based on what is regarded as good clinical practice and will depend upon whether single individual restorations are placed or whether extensive work means that all or most of the occlusal. Tissue management for restorative dentistry dentistry today. Three patients corresponding to a total of 8 sites participated in the study. Treatment planning softtissue risk assessment in esthetic.
The key to success is effective soft tissue management, and the goal of soft tissue management has been to provide healthy gingival tissues covering sound, smooth restorative margins. Left out tissue tags and any beads of granulations tissue were removed to attain a smooth surface figure 2. Periodontal plastic surgery is now an important tool in the armamentarium of the clinician treating gingival recessions, and practitioners at all levels will find. Bds, fcps operative dentistry, assistant professor department of. Management of gingival tissue during indirect impression procedures jerry h. Forced eruption as well as several surgical techniques may be used to achieve and maintain adequate biologic width. Tissue management tissue management in restorative dentistry j. One of the primary goals of a long term successful restorative therapy is to establish a physiologic periodontal climate that facilitates the maintenance of periodontal health. Download thousands of dental books pdf latest books.
Gingiva anatomically divided into marginal gingiva attached gingiva interdental gingiva gingival sulcus biological width 3. Softtissue management around implantsupported restorations continues. Various surgical techniques can be used in combination with autogenous soft tissue. Original article reconstruction of attached soft tissue. The patients, who ranged in age from 20 to 47 years mean 27. Bleeding was controlled with a sterile gauze pressure pack. Gingival recession management a clinical manual adrian. Pdf on jun 1, 2015, s sreedhara and others published gingival tissue management in restorative dentistry find, read and cite all the research you need on researchgate. This chapter aims to provide an overview of the causes, features and management of generalised gingival swellings, which involve the free andor attached gingiva and may also extend to the nonkeratinised lining oral mucosa.
Tissue management includes placing the gingival tissues away from the preparation margins so they can be impressed combined with providing for hemostasis when the gingival tissues are susceptible to bleeding. Following are the few techniques to retract the gingival tissue which are divided into three types based on the type of. Tissue management, gingival retraction and hemostasis 2 continuingeducation credits howard e. Pdf on jun 1, 2015, s sreedhara and others published gingival tissue management in restorative dentistry find, read and cite all the research you need on. Soft tissue management around implantsupported restorations continues. Recent advances on gingival tissue management in restorative. Download pdf gingival recession management dencyclopedia. The word curettage is used in periodontics to mean the scraping of the gingival wall of a periodontal pocket to remove diseased soft tissue. Operative dentistry an overview sciencedirect topics. The underlying bone loss and bony defects are not affected or resolved by soft tissue procedures other than limited marginal tissue shrinkage. The prepared finish lines should be clearly duplicated on the cast for the good fit of the prosthesis. Management of gingival hyperpigmentation 2 case reports.
Physical displacing of the gingival tissue was one of the first. Postoperative view at 1 month following the surgical excision of the hyperplastic tissue and nonsurgical debridement of the lower incisors it was noted that there was an overall improvement in the gingival. Tissue management tissue management in restorative dentistry. A major focus in esthetic dentistry today is the need for an interdisciplinary approach.
Operative dentistry vo lume 29 number 3 pages 2460 ma yjune 2004 109385 periodicals operative dentistry indiana university school of dentistry, rm s411 1121 west michigan street indianapolis, in 462025186 usa mayjune 2004 volume 29 number 3 2460 operative dentistry, inc. Materials and methods a sample population of 20 patients females, 7 males with healthy gingival tissue 6 thick and 14 thin gingival phenotypes was studied. Laserassisted gingival tissue procedures in esthetic dentistry. In operative dentistry, there are many soft tissue procedures that can be done with a diode laser that can help make routine restorative procedures proceed more smoothly and efficiently. Surgical management of druginduced gingival overgrowth digo. Gingival tissue management1 dental implant courses by. At the same time the health of the gingival tissues is crucial for success as opposed to inflamed redundant. Munagala karthik krishna, lumbini pathivada, gopinath. Sometimes the overgrowths may even potentially complicate andor interrupt orthodontic treatment. Various surgical techniques can be used in combination with.
The dense connective tissue around implants could be reconstructed one month after the completion of surgical procedures, and the epithelial cuff around the implant neck established very well. Management of periodontal tissues for restorative dentistry management of periodontal tissues for restorative dentistry starr, clifford b. Gingival tissue management introduction an objective of restorative dental procedures is the placement of dental materials to restore teeth to proper form and function. Keep in mind soft tissue management is limited to the management of the inflamed gingival component of periodontitis. Pdf the prosthetic management of gingival aesthetics. Biological basis for soft tissue management in implant dentistry. Scaling and root planing may inadvertently include various. Series 2, number 3 treatment planning figure 1 undiagnosed altered passive eruption. This book is designed to serve as a clear and concise clinical manual that covers all aspects of the current management of gingival recession, with a particular focus on surgical techniques with the adjunctive use of autogenous tissues or soft tissue substitutes for recession coverage.
After completion of an implantsupported crown in site no. Download pdf periodontal surgery a clinical atlas naoshi. At the same time the health of the gingival tissues is crucial for. An amalgam overhang is defined as an extension of amalgam restorative material beyond the confines of a cavity preparation. A gold standard treatment approach for coverage of gingival recession with predictable esthetic outcomes is the transplantation of autogenous soft tissue grafts. Displacement of the gingival tissue is also important when dealing with the restoration of cervical lesions due to their proximity to the periodontal tissue. Oct 31, 20 the aim of this study was to evaluate the effectiveness of subepithelial connective tissue graft using pouch and tunnel technique as root coverage procedure. Tissue management tissue management in restorative. Surgical management of druginduced gingival overgrowth digo using a periodontal resective flap procedure. Oct 21, 2011 gingival recession is defined as the apical displacement of the gingival margin from the cementoenamel junction cej. Tissue management, gingival health, rubber dam, retraction cords. This book is designed to function a clear and concise clinical guide that covers all components of the modern control of gingival recession, with a particular cognizance on surgical strategies with the adjunctive use of autogenous tissues or smooth tissue substitutes for recession coverage. Improper oral hygiene leads to plaque accumulations and subsequent periodontal problems and caries6. Student workbook for illustrated dental embryology, histology and anatomy, 4th edition.
Gingival tissue management in restorative dentistry. Gingival tissue management1 dental implant courses by indian dental academy the indian dental academy is the leader in continuing dental education. Gingival zenith positions and levels of the maxillary. Once the amount of gingival tissue to be excised was demarcated, an external bevel incision was performed by using a scalpel blade no. The surgical treatment is the definitive therapy of the. The following three case reports involve the careful management of the gingival tissues for optimal esthetic results.
Laserassisted gingival tissue procedures in esthetic. The ability of soft tissue lasers to control moisture and facilitate hemostasis appears. Despite an increased emphasis on the periorestorative interface in restorative dentistry, many clinicians have been unable to utilize the concept of biologic width in a practical manner. The form and function must be in harmony with the periodontium for a restoration to become an integral component of total oral complex. Bds, fcpsoperative dentistry, assistant professor department of. Further, in depth studies are needed to establish the link between drugs and gingival enlargement for prevention and improved treatment. What is gingival retraction, different materials and methods used. Lowe discusses ways to properly manage the gingival tissues prior to taking master physical or digital impressions.
Gingival tissue management by indiandentalacademy issuu. Gingival tissue retraction is an important step in the fabrication of a crown and or bridge. The gingiva is composed of an outer epithelium and an inner network of connective tissue. Scaling refers to the removal of deposits from the root surface, whereas planing means smoothing the root to remove infected and necrotic tooth substance. A copper band or tube also known as matrix method6. Gingival recession around natural teeth is commonly found in adult patients, with a prevalence of 60% to 90% in western societies. International journal dental and medical sciences research ijdmsr. The initial part of the management of the patient with gingival recession should be directed towards correcting the etiological factors. Gingival recession is defined as the displacement of the gingival margin apical to the cementoenamel junction cej with the loss of periodontal connective tissue. Maxillary teeth with millers class i gingival recession were included in the study. Lee, dmd, dcd soft tissue lasers are increasing in popularity among clinicians in part due to their potential value in preprosthetic gingival procedures.
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