It does not attempt to reduce the pocket depth, but it does eliminate the pocket. Therefore the internal bevel incision starts close no more than 1 to 2 mm apically to the gingival margin and follows the normal scalloping of the gingival margin figs. Antibiotics were prescribed to all patients after open flap debridement. Suturing for optimal softtissue management journal of. Pdf we report a case of generalized aggressive periodontitis agp requiring periodontal treatment. Papillary retention flap design for pocket reduction. The purpose of this study was to evaluate the postoperative pain experience and gingival indexes with and without the use of periodontal dressing after modified widman flap procedure. Even modified widman flap with excision of sulcular lining has been shown to heal by long junctional epithelium rather than connective tissue attachment. Control sites group a were randomly selected to receive an. The anesthetic technique was standardized for the study.
The original widman flap widman, 1918 was a mucoperiosteal flap that followed a scalloped gingival incision that separated the pocket. Microsurgery, open flap debridement, modified widman flap introduction periodontitis is a chronic inflammatory disease of multifactorial origin which results in pocket formation, loss of attachment, gingival recession, bone loss, mobility and eventually loss of tooth 1. C, internal bevel incision d, elevation of the flap, leaving a wedge of tissue still attached by its base. Reset share links resets both viewing and editing links coeditors shown cirugia preprotesica are not affected. The most commonly practiced technique is based upon the modified widman flap. Perio exam 4 lec 2 the periodontal flap flashcards quizlet. A report of laserassisted modified widman flap for. When esthetic considerations are paramount, intracrevicular incisions starting at the free gingival margins are used to minimize.
Comparison of surgical and nonsurgical treatment of. The modified widman flap facilitates instrumentation for root therapy. The objective of the study was to compare the clinical efficacy of use of a diode laser dl 810 nm as an adjunct to modified widman flap mwf surgery to that of mwf alone. Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with an intact blood supply. Pdf periodontal surgery involving modified widman flap. Modified widman flap the main advantage of the modified widman flap sur gery over any other periodontal surgical procedure is the intimate postoperative adaptation of healthy colla genous tissues to all tooth surfaces.
Patients were given both verbal and written instructions. However, as compared to baseline, pocket reduction was sustained to 6 12 years with the flap and only 3 years with scaling and root planing alone. F, interdental incision sectioning the base of the papilla g, removal ol tissue. Periodontal indices were recorded at entry, at 1 year after treatment, and at the conclusion of the study. This article is from journal of indian society of periodontology, volume 14. Sites free of pathogens on the membrane surface toward the tooth gained the most. The mwf is a standard three incision approach with fullthickness flap reflection to gain access to the root surfaces and crestal bone. Postoperative reevaluation revealed a reduction in probing depth and an improvement. Flaps are then apically positioned and closed with sutures. View the article pdf and any associated supplements and figures for a period of 48 hours.
First, the program demonstrates the teeth and emphasizes those factors which indicate the need for surgery. The term modified widman flap exposure of the interproximal bone and elimination of infrabony defects by osseous recontouring is not carried out no surgical pocket elimination and apical displacement of the flap incase of esthetic considerations,intracrevicular incisions starting at the free gingival margins are used to minimize postsurgical. Flap techniques and flaps in the treatment of pocket therapy authorstream presentation. Mucoperiosteal flaps with and without removal of the. I lie modified widman flap does not intend to remove the pocket wall, but it does eliminate the pocket lining. Treatment of periodontitis is aimed at disease prevention, slowing. Comparative evaluation of analgesic and antiinflammatory. The flap technique for pocket therapy free download as powerpoint presentation.
Patient preparation reevaluation after initial treatment. Modified widman flap is one of them 5 which by a re. Posteriorly, conventional modified widman flap surgery was performed. The other clinical parameters remained the same at the three time intervals. A modified widman flap procedure was then performed on sites with residual periodontal pockets.
A modified widman flap procedure was then performed on. An ode to kirkland flap obituary to modified widman flap ashish kumar editor, journal of indian society of periodontology, professor, department of periodontology, institute of dental studies and technologies, kadrabad, modinagar 201 201, ghaziabad, uttar pradesh, india. Laser, laser bacterial reduction, modified widman flap, surgical therapy. Ultrasonic and hand curette debridement, scaling, and root planing was performed to the point of visual cleanliness of the roots and any associated bony defects.
The program also provides the roentgenograms of the area. The modified widman flap periodontal disease click to. After 6 12 years, sustained attachment loss in shallow mm pockets was found after the modified widman flap. Periodontic surgery an overview sciencedirect topics.
Shallow sites lose attachment, while moderate and deep sites gain attachment. This is done to fill a defect such as a wound resulting from injury or surgery when the. Modified widman flap flashcards and study sets quizlet. The flap technique for pocket therapy pocket dentistry. Once treated, these patients were placed on a 3month recall interval for maintenance prophylaxis and received yearly examinations for a period of 8 years. It has been shown experimentally in animals11 and humans that with a close adaptation of gingival tissues to the tooth surface. Periodontal surgery involving modified widman flap. An ode to kirkland flap obituary to modified widman flap. Flap surgery free download as powerpoint presentation.
It differs from the modified widman flap in that the soft tissue pocket wall is removed with the initial incision. Article pdf available in open journal of stomatology 0203. The main goals of the procedure include optimum mechanical sub gingival root planing with direct vision. Sulcular or submarginal incisions are made initially, and fullthickness flaps are elevated beyond the mucogingival junction for debridement, scaling, and root planing. The original widman flap was comprised of a mucoperiosteal flap. The most commonly practiced technique is based on the modified widman flap, although not always performed as originally described by ramfjord and nissle 1974. The patient was placed on a 2 to 3month maintenance protocol. Professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. This is distinct from a graft, which does not have an intact blood supply and therefore relies on growth of new blood vessels. Open flap debridement, gingivectomy, gingival curettage. Learn modified widman flap with free interactive flashcards. Patient preparation reevaluation after initial treatment srp may eliminate some pocket depths.
In a free gingival graft, lots of keratinized tissue is gained but no height. Present status of the modified widman flap procedure. The term modified widman flap was adopted to designate a flap procedure which has been modified by several persons and came to designate an open subgin gival curettage for reattachment, although the original purpose of the widman flap was surgical pocket elimi nation. The simple loop figures 5 and 6 is the most commonly used technique in dentistry and is routinely used to coapt tension free, mobile surgical flaps. Choose from 3 different sets of modified widman flap flashcards on quizlet. A periodontal flap is a section of gingiva andor mucosa surgically separated from the underlying tissues to provide visibility and access to the bone and root surface. A widman flap is also known as open or flap curettage. Lack of or very thin and narrow attached gingiva can render the technique.
Modified widman flap and nonsurgical therapy using. Twenty patients requiring comparable bilateral flap procedures were selected. Ramfjord professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. The clinical efficacy of laser assisted modified widman. Modified widman flap flap debridement surgery is defined. Abstractintroduction it is a well established fact that periodontitis is caused.
Flap techniques and flaps in the treatment of pocket therapy. Comparison of periodontal open flap debridement versus. Periodontal regenerative emdogain surgery with papilla preservation flap design and suturing duration. The flap technique for pocket therapy mouth medical.
The purpose of this program is to demonstrate the technique for using a modified widman or reversed double flap procedure to remove gingival pockets on six anterior maxillary teeth. The same clinician performed all surgeries modified widman flap surgery. Twentyfive patients between the ages of 20 and 50 years with generalized chronic periodontitis were selected for the study. Change in clinical indices following laser or scalpel. This study compares the clinical, as well as, microbiological results of a splitmouth trial using modified widman flap and nonsurgical therapy of srp and the use of a controlled release drugdelivery device chlorhexidine chip.
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