Skip to main content

Microscope-Assisted Preprosthetic Surgery

  • Chapter
  • First Online:
Microsurgery in Periodontal and Implant Dentistry
  • 619 Accesses

Abstract

In recent years, esthetic dentistry has continued to evolve with our patients’ demands. In addition to the harmony of facial features and smiles, it has become possible to achieve extremely advanced esthetic results including improving soft tissue quality and quantity. For that reason, we need to have the option of surgical management of soft tissues applying periodontal plastic surgery (PPS) when performing prosthetic restoration. As a pretreatment for prosthetic restoration, a soft tissue with the required amount and morphology around the implant and natural teeth is constructed in harmony with the surrounding tissue. Diagnosis and preoperative examinations are very important before the treatments. Clinical parameters include the periodontal phenotype, the amount of keratinized gingiva, position of gingival margin, the height of interdental papilla, etc. Applying PPS options to gain esthetics and long-term function after prosthetic restoration are often needed. The application of microsurgery is an effective method because these PPS procedures requires extremely delicate and precise surgical procedures. This chapter presents practical clinical examples and verifies the advantages of microsurgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schallhorn RG. Specialty perspective: periodontal therapy overview. Int J Prosthodont. 1988;1(1):107–15.

    PubMed  Google Scholar 

  2. Padbury A Jr, Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003;30(5):379–85.

    Article  Google Scholar 

  3. Burkhardt R, Lang NP. Coverage of localized gingival recessions: comparison of micro- and macrosurgical techniques. J Clin Periodontol. 2005;32(3):287–93.

    Article  Google Scholar 

  4. Studer SP, Allen EP, Rees TC, et al. The thickness of masticatory mucosa in the human hard palate and tuberosity as potential donor sites for ridge augmentation procedures. J Periodontol. 1997;68:145–51.

    Article  Google Scholar 

  5. Tavelli L, Barootchi S, Greenwell H, Wang HL. Is a soft tissue graft harvested from the maxillary tuberosity the approach of choice in an isolated site? J Periodontol. 2019;90(8):821–5.

    Article  Google Scholar 

  6. Zuhr O, Bäumer D, Hürzeler MB. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014;41(Suppl 15):S123–42.

    Article  Google Scholar 

  7. Zucchelli G, 沼部幸博, 中田光太郎,他:イラストで見る天 然歯のための審美形成外科.第1版.東京:クインテッセンス出版, 425–35, 2014.

    Google Scholar 

  8. Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol. 1974;1(4):185–96.

    Article  Google Scholar 

  9. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985;56(12):715–20.

    Article  Google Scholar 

  10. Hürzeler MB, Weng D. A single-incision technique to harvest subepithelial connective tissue grafts from the palate. Int J Periodontics Restorative Dent. 1999;19:279–87.

    PubMed  Google Scholar 

  11. Sclar AG. Soft tissue and esthetic considerations in implant therapy. Batavia, IL: Quintessence Publishing Co, Inc; 2003. p. 114–5.

    Google Scholar 

  12. Pini-Prato G, Baldi C, Pagliaro U, Nieri M, Saletta D, Rotundo R, Cortellini P. Coronally advanced flap procedure for root coverage. Treatment of root surface: root planning versus polishing. J Periodontol. 1999;70(9):1064–76.

    Article  Google Scholar 

  13. Langer L, Langer B. The subepithelial connective tissue graft for treatment of gingival recession. Dent Clin North Am. 1993;37(2):243–64. Review.

    Article  Google Scholar 

  14. Huang LH, Wang HL. Sling and tag suturing technique for coronally advanced flap. Int J Periodontics Restorative Dent. 2007;27(4):379–85.

    PubMed  Google Scholar 

  15. Azzi R, Takei HH, Etienne D, Carranza FA. Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts. Int J Periodontics Restorative Dent. 2001;21(2):141–7.

    PubMed  Google Scholar 

  16. Azzi R, Etienne D, Takei H, Fenech P. Surgical thickening of the existing gingiva and reconstruction of interdental papillae around implant-supported restorations. Int J Periodontics Restorative Dent. 2002;22(1):71–7.

    PubMed  Google Scholar 

  17. Azzi R, Etienne D, Takei H, Carranza F. Bone regeneration using the pouch-and-tunnel technique. Int J Periodontics Restorative Dent. 2009;29(5):515–21.

    PubMed  Google Scholar 

  18. Zuhr O, Hurzeler M. ペリオとインプラントのための審美形成外科. クインテッセンス出版.

    Google Scholar 

  19. Valderhaug J. Periodontal conditions and carious lesions following the insertion of fixed prostheses: a 10-year follow-up study. Int Dent J. 1980;30(4):296–304.

    PubMed  Google Scholar 

  20. Tao J, Wu Y, Chen J, Su J. A follow-up study of up to 5 years of metal-ceramic crowns in maxillary central incisors for different gingival biotypes. Int J Periodontics Restorative Dent. 2014;34(5):e85–92. https://doi.org/10.11607/prd.2024.

    Article  PubMed  Google Scholar 

  21. Dolt AH, Robbins J. Altered passive eruption: an etiology of short clinical crowns. Quintessence Int. 1997;28:363–72.

    PubMed  Google Scholar 

  22. Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000. 1996;11:18–28.

    Article  Google Scholar 

  23. Coslet J, Vanarsdall R, Weisgold A. Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan. 1977;70:24–8.

    PubMed  Google Scholar 

  24. Beagle JR. Surgical reconstruction of the interdental papilla: case report. Int J Periodontics Restorative Dent. 1992;12(2):145–51.

    PubMed  Google Scholar 

  25. Azzi R, Etienne D, Sauvan JL, Miller PD. Root coverage and papilla reconstruction in Class IV recession: a case report. Int J Periodontics Restorative Dent. 1999;19(5):449–55.

    PubMed  Google Scholar 

  26. Evian CI, Corn H, Rosenberg ES. Retained interdental papilla procedure for maintaining anterior esthetics. Compend Contin Educ Dent. 1985;6(1):58–64.

    PubMed  Google Scholar 

  27. Han TJ, Takei HH. Progress in gingival papilla reconstruction. Periodontol 2000. 1996;11:65–8.

    Article  Google Scholar 

  28. Nemcovsky CE. Interproximal papilla augmentation procedure: a novel surgical approach and clinical evaluation of 10 consecutive procedures. Int J Periodontics Restorative Dent. 2001;21(6):553–9.

    PubMed  Google Scholar 

  29. Azzi R, Etienne D, Carranza F. Surgical reconstruction of the interdental papilla. Int J Periodontics Restorative Dent. 1998;18(5):466–73.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kotaro Nakata .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nakata, K. (2022). Microscope-Assisted Preprosthetic Surgery. In: Chan, HL.(., Velasquez-Plata, D. (eds) Microsurgery in Periodontal and Implant Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-030-96874-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-96874-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-96873-1

  • Online ISBN: 978-3-030-96874-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics