Periodontal pocket elimination techniques
- 4. Non surgical procedures Oral hygiene instructions and follow up. Scaling and root planing(SRP). Periodontal medication: Tetracycline. Metronidazole.
- 5. Surgical procedures Pocket depth reduction through different surgical procedures : Gingival currettage. Gingivectomy. Periodontal flap procedures . Osseous surgery .
- 6. Gingival currettage Def: it consists of removal of the inflamed soft tissue lateral to the pocket wall. Methods of gingival currettage: Basic technique by curettes. Excisional new attachment procedure (ENAP). Ultrasonic currettage. Chemical currettage.(sodium sulphide,alkaline sodium hypochlorite,phenol,silver nitrate ,etc)
- 8. GingivectomyMeans excision of gingiva. Gingivectomy derives it's effectiveness by removing pocket wall which obscures the tooth surfaces and by doing so provides the visibility and accessibility that are essential for complete removal of irritating deposits. Methods of gingivectomy: Surgical gingivectomy. Gingivectomy by electrosurgery. Laser gingivectomy. Gingivectomy by chemosurgery(paraformaldehyde,potassium
- 10. Periodontal flap surgery Rationale for flap surgery: Flaps are used for pocket therapy to accomplish following: Increase accessibility to edit deposits . Eliminate or reduce pocket depth by resection of pocket wall. Expose the area to perform regenerative methods.
- 11. Flap techniques Several flap techniques are currently available and in use: Modified widman flap :does not reduce pocket depth.It exposes the root surfaces for meticulous instrumentation and removes the pocket lining only not the pocket wall. Two flaps have their main purpose the reduction or elimination of pocket depth : The undisplaced flap and apically displaced flap.
- 14. Contd... The undisplaced flap(unrepostionaed),in addition to improving accessibility for instrumentation ,removes the pocket wall ,thereby reducing or eliminating the pocket . Apically displaced flap also improves accessibility and eliminates the pocket does the latter by apically positioning the soft tissue wall of the pocket .
- 15. Thank you.