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Periodontal Flap Designs for Access and Osseous Surgery

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Abstract

In the sequence of treatment of the periodontal patient, surgical intervention may become necessary after completion of the nonsurgical phase. Periodontal surgical techniques aim to gain access to root surfaces for debridement and root planing and/or to remove soft and hard tissue structures to reestablish physiologic contours. Surgical techniques can be divided into resective, minimally resective, and non-resective techniques. Periodontal resective surgery includes removal of soft tissue, hard tissue, or a combination of both. Soft tissue resection includes gingivectomy, gingivoplasty, and distal wedge procedures. Moreover, combined soft and hard tissue resection procedures also aim to provide the restorative dentist to deliver biologically stable restorations that are compatible with a healthy periodontium. Periodontal minimally resective surgery includes two main flap designs that have been modified over the years to reflect changing perspectives and updated technology. Periodontal non-resective surgery includes flap designs to gain access to the roots and bony defects while maintaining the soft tissue. While periodontal surgical therapy allows for improved outcomes following nonsurgical therapy, cigarette smoking, inadequate oral hygiene, and poor maintenance compliance can all negatively influence outcomes. Decisions for flap design and concomitant bacterial biofilm control are individualized based on the patient’s needs and commitment to treatment for periodontal disease.

Keywords

Periodontal disease Flap surgery Resective surgery Osseous surgery 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of PeriodontologyUniversity of North Carolina at Chapel HillChapel HillUSA

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