Dentaltown August 2021 - 41
Surgical approach:
Papilla preservation
techniques
Papilla preservation techniques were
developed to achieve and maintain primary
closure of the fl ap and to increase the ability to
create space for regeneration in the interdental
area. This approach is based on the elevation
of full-thickness buccal and lingual fl aps,
followed by a buccal periosteal incision
to increase buccal fl ap mobility. Vertical
releasing incisions are traced when needed.
Flaps are generally coronally positioned
on top of barriers, grafts or combinations
and are sutured with a double-layer suturing
technique to provide stable interdental
closure.
The modified papilla preservation
technique (MPPT) can be successfully
applied in the anterior and premolar region
when the interdental space width is ≥2 mm
at the most coronal portion of the papilla.3
When interdental sites are narrower
(<2 mm) or when we are in molar region,
a different papilla preservation procedure
has been proposed: the simplifi ed papilla
preservation fl ap (SPPF).4
Materials for
regenerative surgery
Regarding materials and products,
three different regenerative concepts have
been explored: barrier membranes, grafts
and wound-healing modifi ers, along with
many combinations of those.
Early studies involved nonresorbable
membranes-especially expanded polytetrafl
uoroethylene (ePTFE) barrier membranes-
but the need for a second surgical procedure
to remove them, the consequent increase
in morbidity and the recognized problems
associated with protection of the regenerated
tissue following membrane removal have
directed most clinicians toward the use
of bioabsorbable membranes derived from
native or linked collagen fi bers, pericardium
or poly(D,L-lactide-coglycolide) (PLGA).
Because a considerable number of controlled,
randomized clinical trials comparing
outcomes after application of bioabsorbable
Fig. 9: Resorbable barrier membrane and bone
substitute positioned over the bone defect.
Fig. 8: Intrabony component of the defect,
measured with a 15 mm periodontal probe.
Fig. 7: Clinical aspect of the intrabony defect.
Fig. 10: Resorbable barrier membrane
secured with a titanium pin.
dentaltown.com \\ AUGUST 2021 41
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Dentaltown August 2021
Table of Contents for the Digital Edition of Dentaltown August 2021
Dentaltown August 2021 - Intro
Dentaltown August 2021 - Cover1
Dentaltown August 2021 - Cover2
Dentaltown August 2021 - 1
Dentaltown August 2021 - 2
Dentaltown August 2021 - 3
Dentaltown August 2021 - 4
Dentaltown August 2021 - 5
Dentaltown August 2021 - 6
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Dentaltown August 2021 - Cover3
Dentaltown August 2021 - Cover4
Dentaltown August 2021 - SI_1
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