evolution of perio

8/12/2019 Evolution of Perio

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Congrs IAHD 2000

Evolution of Periodontal Surgery

Techniques in this Century

SILVIO ANTONIO DOS SANTOS PEEIA, D.D.S., MSc.D.Assistant Professor, Periodontology Department, Faclty of Dentistry, !ni"ersity Camilo Castelo #ranco,ED!ADO SA"A#C$!%&I, D.D.S., MSc.D., PH.D.Professor and C%airman, Periodontology Department, Faclty of Dentistry, !ni"ersity Camilo Castelo #ra

In t%e 'eginning of t%e centry, t%e srgical treatment (as not attracti"e to clinicians, not (enpredicta'ility of good reslts.

In t%e 'eginning of t%e centry, (e also didn*t +no( mc% a'ot t%e etiologic agent of al"eolar pyorr%e

In -/, t%e researc%er and clinician o'icse+, (as t%e first to descri'e t%e radical tec%ni1e of gin

measred t%e poc+et dept% to determinate t%e line (%ere t%e gingi"al tisse (old 'e ecised. Afteincision on eac% toot%, %e incised t%e tisse to 'e remo"ed on t%e la'ial and lingal srfaces of t%e sinterdental gingi"a (as ecised and t%e remaining tisse (as remo"ed (it% crettes. 3%e remo"al of t%of t%e srgery. 3%e follo(ing srgical p%ase consisted on remo"ing t%e 'one tisse (it% srgical drillsiodine dye and t%e patient instrcted to mot%(as% (it% an antiseptic soltion 4Stern I#5 6"erett F75srgical treatment of periodontal disease. 9 Periodontol -:;2;


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Historically, osseos srgery (as performed for t%e primary prpose of eliminating necrotic or infereconstrcti"e periodontal srgery. 2ed Mal"ern> ea Fe'iger, -::/, p.2 to o'tain access to t%e 'one tisse,periodontal poc+ets, to redce t%e %ealing period and to minimi&e t%e postoperati"e pain 4o'inson/>2


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In -:/:, SCH!76 (as one of t%e first researc%ers t%at descri'ed t%e principles of resecti"e osseo'one (%ere it cold 'e esta'lis%ed t%e p%ysiologic contors (it%ot attac%ment loss, elimination of intt%e o'ecti"e of eliminating periodontal poc+ets and reac%ing a p%ysiologic gingi"al and osseos arc%iteA 'asic principle in periodontal srgery. @ral Srg@ral Med @ral Pat%ol -:/:5 2>=-;)=2


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@!B76 4-:02? (as one of t%e first clinical researc%ers to descri'e a srgical tec%ni1e to restorprocedre consisted in scaling t%e root srfaces to remo"e dental calcls, treat it (it% lactic acid, dralco%olic soltion, place on t%e root and 'one defect a piece of 9apanese paper soa+ed in cellloid pre"enting all possi'ilities of t%e paper getting ot of position and, finally, stre t%e flaps of t%e srgiccl' t%e Paris. Dental Cosmos -:0/5 /;>=:?.

In -:2, BMAB et al., tested t%e %ypot%esis t%at ne( connecti"e tisse attac%ment cold 'e o'tainedsrface t%rog% cells originating from t%e periodontal ligament. 3%ey demonstrated 'y %istological sinserting principal fi'ers formed on t%e pre"iosly diseased root srface (%en a periodontal srgery tec4(%ic% dring t%e (ond %ealing did not allo( t%e dentogingi"al epit%elim and t%e gingi"al connec

prepared root srface?4Byman S5 ind%e 95 8arring 35 ylander H Be( attac%ment follo(ing srgicalClin Periodontol -:25 :>2:0)2:


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C@B 4-:;/'? and 7!P6 4-:;;?, proposed different modifications in t%e tec%ni1e of lateral sliding of

) ct'ac+ incision 4Corn H Periodontics -:;/'5 2>22:?.

) s'marginal incision 47rpe H6, Modified tec%ni1e for t%e sliding flap operation. 9 Periodontol -:;;5

For C@H6B5 @SS 4-:;?, t%e lateral sliding of t%e flap and t%e flap mo"ed laterally from edentlos adonor area. 3%ese displacement tec%ni1es re1ire a 'and of attac%ed gingi"a e1al or lig%tly larger t%aFre1ently, an insfficient or a'sent 'and of attac%ed gingi"a in t%e adacent toot% redces t%e pred

aspects, t%ey de"eloped t%e tec%ni1e of do'le papilla laterally positioned flaps. 3%e flap is formed 'yto 'e co"ered 4Co%en DE5 oss S6 3%e do'le papillae repositioned)flap in periodontal t%erapy. 9 Period

B@#67 in -:2; (as t%e first to report t%e coronally repositioned flap in order to co"er root srfacestec%ni1e (it% t%e same goal 't com'ining t%e se of a free gingi"al graft 2 mont%s prior to t%e coroperformed t%rog% t(o "ertical parallel incisions lea"ing reac%ing t%e al"eolar mcosa, o'taining a enla9P5 Ksc%er #5 MK%lemann H Coronally repositioned periodontal flap> clinical e"alation after one year.

In -:;=, #9LB, descri'ed a free transplantation of gingi"a. In -:;;, BA#6S de"eloped a tec%ni1mcosa mem'rane in periodontal srgical procedres t%at aimed to create 'ands of attac%ed gingi"a,"esti'lar forni 4Ba'ers 9M 6tension of t%e "esti'lar forni tili&ing a gingi"al graft. Periodontics -:;

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root, 't its maor part is placed in an en"elope pre"iosly created 'y an ndermining partial t%ic+ndefect 4aet&+e P# Co"ering locali&ed areas of root eposre employing t%e en"elope tec%ni1e. 9 Per

AB765 AB76 4-:

evolution of perio

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