Use of the fiber retention procedure in treating the maxillary anterior region

Evaluation of gingival fiber retention technique on the treatment of patients with chronic periodontitis: A comparative study

The destructive action of the chronic periodontitis on the periodontal tissues has provided a continuous challenge to the dental profession to develop better methods to achieve repair of the recession regions and even regeneration of post periodontal tissues.

AIMS

To assess the effect of periodontal muco-periostal flap surgery with gingival fiber retention technique on minimizing the post surgical recession.

MATERIALS AND METHODS

The sample for the study comprised of 20 patients. The criteria for selection included patients with moderate periodontitis, with minimum recession in the anterior teeth, with adequate width of the attached gingiva, and with no traumatic occlusion. Periodontal muco-periosteal flap surgery with gingival fiber retention technique was done in the experimental site with internal bevel incision, and in control site, muco periosteal flap surgery with crevicular incision was done. Thereafter, observation period was of one week, four weeks, and eight weeks were done for both the sites.

STATISTICAL ANALYSIS USED

The results were subjected to statistical analysis using student's t'-test.

RESULTS

The result of this study suggests that the periodontal flap surgery with gingival fiber retention technique has a beneficial effect on the anterior teeth, as it maintains the esthetics, recontours the gingiva with minimal recession. The area of recession was more on the control site as compared to experimental site at 4 weeks, 8 weeks and 12 weeks.

CONCLUSIONS

Gingival fiber retention technique showed less post-surgical recession and also there was fall in values of plaque index, gingival index, and periodontal index scores, throughout the study.

The apical location of calculus within the intrabony defect

Although several studies have concluded that calculus removal becomes more difficult as pocket depth increases, few have examined the clinical location of calculus within the intrabony defect. This study evaluated the relationship between apical calculus position and the depth and morphology of the intrabony defect. As part of an on-going study of new attachment procedures in humans, 260 intrabony defects were surgically entered in 39 patients. Using magnifying loops and fiber optics in all defects, the most apical level of calculus was grooved to serve as both a clinical and histologic reference point. Clinical measurements made prior to root debridement included the alveolar crest to base of calculus, and the base of calculus to base of defect. The type of defect was classified by the number of remaining osseous walls. Calculus has not been found apical to the groove in any histologic section. The mean distance measured clinically between the base of the calculus and the base of the defect was found to increase with the depth of the defect. This relationship did not vary with either tooth type or number of remaining osseous walls in the defect. Data analysis of this group of patients (N = 39) showed a positive correlation (r = .83) between increasing depth of intrabony defect and the distance of the most apical calculus from the defect base.

A modification of the "curtain technique" incorporating an internal mattress suture

An internal mattress suture is described for suturing labial papillae to palatal flaps when using the "curtain technique." The suture is simple to perform and does not violate the intact labial sulci. It gives stability to both the labial papillae and palatal flap while maintaining maximum esthetic results.