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. 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. The flap technique for pocket therapy free download as powerpoint presentation. First, the program demonstrates the teeth and emphasizes those factors which indicate the need for surgery. W i d m a n 1 i n t r o d u c e d t h e reverse bevel scalloping type of gingival incisions in 1916 as a modification of neumanns 2 periodontal flap surgery.
After 6 12 years, sustained attachment loss in shallow mm pockets was found after the modified widman flap. Patient preparation reevaluation after initial treatment. The procedure involved incisions made intracrevicularly through the bottom of the pocket and scaling and curettage after the elevation of flap. To obtain surgical anesthesia, 2% lignocaine in the required amount was used along with 1. I lie modified widman flap does not intend to remove the pocket wall, but it does eliminate the pocket lining. The program also provides the roentgenograms of the area. Lack of or very thin and narrow attached gingiva can render the technique. Choose from 3 different sets of modified widman flap flashcards on quizlet. The clinical efficacy of laser assisted modified widman. Comparative evaluation of analgesic and antiinflammatory. Even modified widman flap with excision of sulcular lining has been shown to heal by long junctional epithelium rather than connective tissue attachment. Sulcular or submarginal incisions are made initially, and fullthickness flaps are elevated beyond the mucogingival junction for debridement, scaling, and root planing.
Modified widman flap flashcards and study sets quizlet. Comparison of surgical and nonsurgical treatment of. In a free gingival graft, lots of keratinized tissue is gained but no height. Twenty patients requiring comparable bilateral flap procedures were selected. This article is from journal of indian society of periodontology, volume 14. Flap techniques and flaps in the treatment of pocket therapy. Professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. Periodontal surgery involving modified widman flap. The flap technique for pocket therapy pocket dentistry. The original widman flap was comprised of a mucoperiosteal flap. The main goals of the procedure include optimum mechanical sub gingival root planing with direct vision. The flap technique for pocket therapy mouth medical. This is distinct from a graft, which does not have an intact blood supply and therefore relies on growth of new blood vessels. Comparison of periodontal open flap debridement versus.
The patient was placed on a 2 to 3month maintenance protocol. It does not attempt to reduce the pocket depth, but it does eliminate the pocket. Modified widman flap and nonsurgical therapy using. 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 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. This website is a small attempt to create an easy approach to understand periodontology for the students who are facing difficulties during the graduation and the postgraduation courses in our field. Postoperative reevaluation revealed a reduction in probing depth and an improvement. A widman flap is also known as open or flap curettage. Periodontic surgery an overview sciencedirect topics. View the article pdf and any associated supplements and figures for a period of 48 hours. Flap techniques and flaps in the treatment of pocket therapy authorstream presentation. The other clinical parameters remained the same at the three time intervals. The three different categories of flap techniques used in periodontal flap surgery are as follows. 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.
The anesthetic technique was standardized for the study. Patients were given both verbal and written instructions. It differs from the modified widman flap in that the soft tissue pocket wall is removed with the initial incision. 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. A report of laserassisted modified widman flap for. Patient preparation reevaluation after initial treatment srp may eliminate some pocket depths.
Modified widman flap flap debridement surgery is defined. A modified widman flap procedure was then performed on. Change in clinical indices following laser or scalpel. Treatment of periodontitis is aimed at disease prevention, slowing. A modified widman flap procedure was then performed on sites with residual periodontal pockets. An ode to kirkland flap obituary to modified widman flap. 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. Open flap debridement, gingivectomy, gingival curettage.
Twentyfive patients between the ages of 20 and 50 years with generalized chronic periodontitis were selected for the study. Shallow sites lose attachment, while moderate and deep sites gain attachment. Mucoperiosteal flaps with and without removal of the. 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.
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. 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 original widman flap widman, 1918 was a mucoperiosteal flap that followed a scalloped gingival incision that separated the pocket. The modified widman flap facilitates instrumentation for root therapy. The mwf is a standard three incision approach with fullthickness flap reflection to gain access to the root surfaces and crestal bone.
Control sites group a were randomly selected to receive an. Periodontal regenerative emdogain surgery with papilla preservation flap design and suturing duration. 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. 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. Once treated, these patients were placed on a 3month recall interval for maintenance prophylaxis and received yearly examinations for a period of 8 years. Laser, laser bacterial reduction, modified widman flap, surgical therapy. F, interdental incision sectioning the base of the papilla g, removal ol tissue. Flap surgery free download as powerpoint presentation. Suturing for optimal softtissue management journal of. The same clinician performed all surgeries modified widman flap surgery. Antibiotics were prescribed to all patients after open flap debridement.
Present status of the modified widman flap procedure. When esthetic considerations are paramount, intracrevicular incisions starting at the free gingival margins are used to minimize. Reset share links resets both viewing and editing links coeditors shown cirugia preprotesica are not affected. Perio exam 4 lec 2 the periodontal flap flashcards quizlet. In contrast to these conventional treatments, ablating the inflamed lesions and epithelial lining of the soft tissue wall within periodontal pockets with a laser retards epithelial migration. Posteriorly, conventional modified widman flap surgery was performed. 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. This is done to fill a defect such as a wound resulting from injury or surgery when the. Periodontal indices were recorded at entry, at 1 year after treatment, and at the conclusion of the study.
Modified widman flap is one of them 5 which by a re. Ramfjord professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. C, internal bevel incision d, elevation of the flap, leaving a wedge of tissue still attached by its base. The modified widman flap periodontal disease click to. Article pdf available in open journal of stomatology 0203. The most commonly practiced technique is based upon the modified widman flap. Pdf periodontal surgery involving modified widman flap. Papillary retention flap design for pocket reduction. 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. Sites free of pathogens on the membrane surface toward the tooth gained the most. Flaps are then apically positioned and closed with sutures. 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. Abstractintroduction it is a well established fact that periodontitis is caused. It has been shown experimentally in animals11 and humans that with a close adaptation of gingival tissues to the tooth surface.
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