Interdental multiple papilla amplification flap with the lateral position for enlargement of the attached gingival tissue on a tooth with an abnormal surface of the root
The main subject of this article is the use of interdental multiple papilla amplification flap with the lateral position for the enlargement of the attached gingival tissue on a tooth with an abnormal surface of the root.
A man, 35 y.o., nonsmoker and non-diabetic was presented with relapsing inflammation of gingiva on a lower cuspid tooth. A surgical treatment was ordered after several recall visits and after the detection of an enamel pearl on the root surface.
Image 2. Diagram with the submarginal section in the donor area and oblique sections towards the parallel sections. The muscles running in the mesiodistical direction pull the flap until its position is in the area of host teeth. The interproximal papillae are replaced over the surface of adjacent teeth. Sling sutures are performed around the individual teeth and horizontal sutures and anchored to the periosteum.
Image 3. On the left, relapsing gingival inflammation of tooth 33, caused by the presence of an enamel pearl on the surface of the root. After that, a the dentist performs a partial-thickness flap in the area of tooth 32 with the submarginal internal beveled section.
Image 4. Preparations of a host bed with periosteum firmly attached to the indicated bone in the area of teeth 33, 34, 35. After that, the enamel pearl on the tooth 33 is removed with the means of carbide bur.
Image 5. The flap is removed laterally from the tooth 32 and sutured on the tooth 33 with a horizontal sling suture for the adaptation of the flap to the periosteum. The papillae between the teeth 33-34 and 34-35 are removed distally and sutured similarly. 2-years follow-up.
Image 6. Comparison of the initial case and the 25-years follow-up.
After an appropriate diagnosis and the suitable surgical treatment, cure of gingival inflammation, the enlargement of the attached gingiva and root coverage can be obtained for a long term.