Periodontal surgery involving modified widman flap. Flaps are then apically positioned and closed with sutures. 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. Microsurgery, open flap debridement, modified widman flap introduction periodontitis is a chronic inflammatory disease of multifactorial origin which results in pocket formation, loss of attachment, gingival recession, bone loss, mobility and eventually loss of tooth 1.
The original widman flap was comprised of a mucoperiosteal flap. Dept of periodontics periodontal flaps presented by, shiji margaret d. The main goals of the procedure include optimum mechanical sub gingival root planing with direct vision. C, internal bevel incision d, elevation of the flap, leaving a wedge of tissue still attached by its base. Change in clinical indices following laser or scalpel.
Open flap debridement, gingivectomy, gingival curettage. Graziani f, gennai s, cei s, cairo f, baggiani a, miccoli m, et al. Open flap debridement includes conventional surgical procedures such as the modified widman flap procedure. Professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. A modified widmans flap in therapy of periodontal pockets. Pdf periodontal surgery involving modified widman flap. A modified cross leg flap for large triangular defects of the foot and ankle by b.
Ramfjord professor and chairman, department of periodontics, the university of michigan school of dentistry, ann arbor, michigan 48104. The most commonly practiced technique is based upon the modified widman flap. Open flap debridement, gingivectomy, gingival curettage, enap. A modified widman flap procedure was then performed on sites with residual periodontal pockets. Present status of the modified widman flap procedure. Simple flap procedures include the simple apically repositioned flap and the modified widman reverse bevel flap. Surgical procedures, however, have a number of disadvantages and hence efforts have been on at improving various nonsurgical approaches, which are directed more specifically at the microbial nature of periodontal disease. Flap techniques and flaps in the treatment of pocket therapy authorstream presentation. The gingival margin is removed, and the flap is reflected to gain access for root therapy. Plaque prevalence decreased with all therapy groups, however the fo group had more plaque accumulation after surgical therapy. A widman flap is also known as open or flap curettage. Repositioned flap replacing the flap back to where it was before modified widman surgeries apically positioned flap used after 46week postop probing after srp assuming pocket depths dont improve crown lengthening restorative margin cannot be closer than 2mm to crestal bone, or will disrupt osseous structure. F, interdental incision sectioning the base of the papilla g, removal ol tissue. The internal beveled incision for the modified widman flap closely follows the scalloped outline of the dentition to minimize the loss of the attached keratinized gingiva.
Modified apically repositioned flap in the treatment of. The procedure involved incisions made intracrevicularly through the bottom of the pocket and scaling and curettage after the elevation of flap. Case report a 12yearold girl was referred by her general dental practitioner to the department of orthodontics at the eastman dental hospital. Gingival flaps may include open flap curettage, and may utilize modified kirkland or modified widman flap procedures3,5. The three different categories of flap techniques used in periodontal flap surgery are as follows. Modified widman flap is one of them 5 which by a re verse bevel incision into alveolar crest makes a full access to root surface of pocket while the bone exposure is mini. A 810 nm diode laser following modified widman flap surgery. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Initial reflection of a gingival flap usually follows inverse or reverse bevel incisions as a means to maintain gingival esthetics by retaining maximum amounts of keratinized gingiva. One quadrant of each jaw randomly received periodontal dressing after the surgery. To gain access to the deeper periodontal structures using a flap reflected from the root and alveolar surfaces. Modified widman flap is classified with the access flap operations as the goal is to provide access to periodontally involved tissues. Choose from 3 different sets of modified widman flap flashcards on quizlet. The original widman flap the main advantages of this technique as compared to gingivectomy were claimed to be less discomfort, since healing.
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. 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. Treatment of intrabony defects with access flap surgery. Learn modified widman flap with free interactive flashcards.
Modified widman flap and nonsurgical therapy using chlorhexidine. Periodontal therapy for severe chronic periodontitis with. Lack of or very thin and narrow attached gingiva can render the technique. A soft tissue flap is reflected or resected to allow debridement of the root surface and the removal of granulation tissue. Sulcular or submarginal incisions are made initially, and fullthickness flaps are elevated beyond the mucogingival junction for debridement, scaling, and root planing. International journal of current medical and pharmaceutical research. Lec 1 oral hygiene methods toothbrushing and flossing. Sites with suppuration that began between exams or at 2 exams had a less favorable response with respect to probing depth and attachment gain. Your code number and identity will be kept in a locked file of the principal investigator. Undisplaced flap differs from modified widman flap in that the pocket wall is removed with the initial incision considered as. Treatment of periodontitis is aimed at disease prevention, slowing.
This technique is designed to maximize healing in areas of previous periodontal. Postoperative complications bleeding ibuprofen increased bleeding during oral surgery two fold braganza, bissada et al. Papillary retention flap design for pocket reduction. Osseous recontouring is not accomplished in conjunction with this procedure. View the article pdf and any associated supplements and figures for a period of 48 hours. Periodontic surgery an overview sciencedirect topics. It does not attempt to reduce the pocket depth, but it does eliminate the pocket.
Flap surgery free download as powerpoint presentation. A comparative study on the bite force after modified widman s flap. Pdf on jan 1, 2012, kazuhiro murakami and others published modified widman flap procedure. The modified widman flap periodontal disease click to. Modified widman flap flap debridement surgery is defined.
Posteriorly, conventional modified widman flap surgery was performed. The modified widman flap facilitates instrumentation for root therapy. Pdf we report a case of generalized aggressive periodontitis agp requiring periodontal treatment including flap surgery and ridge. The control site was then covered with periodontal dressing. The patient was placed on a 2 to 3month maintenance protocol. Effect of modified widman flap surgery and systemic. Twenty patients requiring comparable bilateral flap. A modified widman s flap in therapy of periodontal pockets. I lie modified widman flap does not intend to remove the pocket wall, but it does eliminate the pocket lining. The mwf is a standard three incision approach with fullthickness flap reflection to gain access to the root surfaces and crestal bone. For 4 6 mm pockets, scaling and rool planing and curettage had better attachment results than pocket elimination surgery. She was diagnosed as a skeletal class iii with an incisor class iii relationship. Pdf a comparative study on the bite force after modified. Patient preparation reevaluation after initial treatment.
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, in the management of moderate to deep pockets. This study is an attempt to compare the timetested surgical approach, the modified widman flap, with the new technique of combined therapy consisting of srp. Therefore the internal bevel incision starts close no more than 1 to 2 mm apically to the gingival margin and follows the. Abstract 33 subjects with evidence of active destructive periodontal disease were treated by modified widman flap surgery and systemic tetracycline 1 gday for 21 days. 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. Ortho1, thangam varghese, mch plastic surgery, 2 praveen bhardwaj, m. Gingival closed curettage by definition a gingival curettage is the use of an instrument curett against the gingival side of a pocket in order to scrape and debride the soft tissue wall. Twenty patients requiring comparable bilateral flap procedures were selected. Postoperative reevaluation revealed a reduction in probing depth and an improvement.
May include open flap curettage, reverse bevel flap surgery, modified kirkland flap procedure, widman surgery, and modified widman surgery. Subgingival plaque samples were taken from 41 sites in 12 of these subjects before and 6 months after therapy for predominant cultivable microbiota studies. 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. The final incision is horizontal, and serves, especially in the interdental area, to release the pocket tissues sharply and atraumatically. Flap techniques and flaps in the treatment of pocket therapy. Presentation is made of the results obtained in the treatment of patients with advanced forms of progressive periodontal disease employing. Clinical performance of access flap surgery in the treatment of the intrabony defect. Principles of the modified widman procedureramfjord technique 311. Start studying open flap debridement, gingivectomy, gingival curettage, enap. Shows the modified widman flap periodontic surgery. Article pdf available in open journal of stomatology 0203. The flap technique for pocket therapy pocket dentistry.
For the control site, open flap debridement was performed and the soft tissue flap was repositioned at the original level and closed with simple interrupted sutures using 30 silk to obtain primary soft tissue closure. Modified widman flap and nonsurgical therapy using. Modified widman flap flashcards and study sets quizlet. It has been shown experimentally in animals11 and humans that with a close adaptation of gingival tissues to the tooth surface. Comparison of periodontal open flap debridement versus.
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