Meaning of apically repositioned flap in mucogingival surgery medical term. Implant supported overdentures, keratinized tissue, modified palatal roll. The distance from the tooth, buccally or lingually, is dependent on the pocket depth, and the beveled incision should. The goal of this study was to evaluate the ability of the modified apically repositioned flap marf technique to increase keratinized tissue at the donor site and to analyze if this procedure would enhance the indication for and predictability of the laterally positioned. Define apically repositioned flap in mucogingival surgery.
Pdf modified apically repositioned flap in the treatment of. The aim may be to cover exposed root surfaces or merely to. Modified technique for the sliding flap operation grupe. Case report a 12yearold girl was referred by her general dental practitioner to the department of orthodontics at the. Pdf the modified apically repositioned flap to increase.
However, these techniques have distinct limitations, such as a limited quantity of. It also shows the final healing creating attached gingiva using a split thikness apically repositioned flap dr hl gluckman on vimeo. Associate professor of periodontology and oral pathology, school of dentistry, university of southern california, beverly hills, california. Flap surgical technique for pocket elimination apically displaced flap md.
Apically repositioned flap in mucogingival surgery. Conventional versus modified technique of the apically repositioned. Creating attached gingiva using a split thikness apically. Download pdf apically positioned flap, free gingival graft and apically positioned flap with collagen matrix around dental implants. Conventional flaps include the modified widman flap, the undisplaced flap, the apically displaced flap, and the flap for reconstructive procedures. Post crown lengthening image after temporization 2.
The pedicle flap technique is an approach similar to an apically repositioned flap and should be used when there is adequate keratinized tissue adjacent to the implant. Modified flap operation article about modified flap. Jan 15, 2015 the conventional flap is used 1 when the interdental spaces are too narrow, thereby precluding the possibility of preserving the papilla, and 2 when the flap is to be displaced. Split thickness apically repositioned flap osseonews dental. Clinical evaluation of increase in the width of attached gingiva. Looking for online definition of apically repositioned flap in mucogingival surgery in the medical dictionary. A surgical approach to enhance donor sites prior to employing a laterally positioned flap. Various techniques to increase keratinized tissue for. The modified apically repositioned flap marf technique is an effective procedure to increase the dimensions of attached gingiva in areas that. Modified apically repositioned ap guar d et al 25 3 v 3 1 w 3, 1 x v w z 1 j d o r case report modified apically repositioned flap. Double papilla repositioned flap for the treatment of. Myers, dds, and steve montgomery, dds, facd sixty extracted human teeth were divided into three groups of 20 each. Apically positioned flap with immediate implantation dentiumworld. This video shows you how to create attached gingiva in the upper jaw by creating a split thickness flap and apically repositioning it.
Aim the purpose of this study is to evaluate the increase in the width of attached gingiva ag in singlemultiple adjacent teeth using variation of modified apically repositioned flap marf. The goal of this study was to evaluate the ability of the modified apically repositioned flap marf technique to increase keratinized tissue at the donor site and to analyze if this procedure would enhance the indication for and predictability of the laterally positioned flap lpf without any consequences to the donor area. Split thickness apically repositioned flap osseonews. Various techniques to increase keratinized tissue for implant. Modified apically repositioned flap for increasing the width of attached gingiva along with plateletrich fibrin a case series with 6 months follow. Pdf apically positioned flap, free gingival graft and. Partial or split thickness flap is an elevated flap which includes only epithelium and the layer of underlying connective tissue. With regards to implants, many studies suggest that the presence of healthy periimplant softtissue plays an important role in longterm success of dental implants see studies below. Apically positioned flap with immediate implantation youtube. This conventional apically repositioned flap method has been modified by. The modified apically repositioned flap marf technique is an effective procedure to increase the dimensions of attached gingiva in areas that present with some existing keratinized tissue. The advantages of the marf technique includes its simplicity and ease of execution as it involves the use of a single horizontal incision in the recipient site, absence of palatal donor tissue, shorter operative time, and enhanced colour match between the.
The described technique is a variation of the apically repositioned flap technique previously proposed by freidman in 1962. Pdf use of the modified apically repositioned flap. Increasing the width of attached gingiva by using modified apically. Apically repositioned flap in the lower jaw splitthickness. In this study, we describe a modification of the cv flap, and present results of our first 50 patients who have had nipple reconstruction using this modified technique. 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. Apically repositioned flap periodontal gum surgery nyc dentist. Impacted teeth, surgical exposure, apically positioned flap, periodontal health, periodontal esthetic. Miller, increasing the amount of attached gingiva using a modified apically repositioned flap, journal of periodontology, 70, 9, 11101117, 1999. Surgery any manipulation of the body or one of its organs or parts to repair damage, arrest the progress of a disease, remove foreign matter, etc. Jul 23, 2017 flap surgical technique for pocket elimination apically displaced flap md. Modified palatal roll technique with and without apical positioning and ctg are simpler surgical techniques, which can be successfully and predictably used for increasing the zone of keratinized tissue around implants. Enhancing the zone of keratinized tissue around implants. Flap repositioning versus conventional suturing in third.
The modified apically repositioned flap marf technique uses a single horizontal incision within the keratinized tissue. Increasing the apicocoronal dimension of attached gingiva. Simple flap procedures include the simple apically repositioned flap and the modified widman reverse bevel flap. If there is a sufficient amount of keratinized tissue near the implants, apically or laterally positioned flaps can be applied using the preexisting keratinized mucosa 8, 9, or the combination of an apically positioned flap apf and fgg can be used 10, 11. To achieve this goal, many non surgical and surgical techniques have been proposed to treat a variety of period. Attached gingiva is desirable for the maintenance of gingival health. Stagetwo surgery was performed using wither the apically repositioned flap, the roll flap, or an apically repositioned flap combined with a connective tissue graft. In three patients, an apically repositioned flap was used as described in case 1, which resulted in a mean increase in the width of keratinized tissue of 3. The apically repositioned flap in tooth exposure helen lawton and p. Use of the modified apically repositioned flap technique to create attached gingiva in areas of no keratinized tissue. A novel technique for increasing the width of attached gingiva.
A wide variety of file folder with flap options are available to you, such as folder, bag, and wallet. Position the flap back to its original site, therefore have attachment between tissue and root surface. Bed preparation has been done simulationally for apically positioned flap. Periodontal health and esthetic results in impacted teeth. In this surgery, in the vestibular and lingual area of tooth 36 and 37 the gingiva is apically repositioned to facilitate the prosthetic procedures planned. Definition 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. Sanchis bielsa 1, sergio hernandez bazan 2, miguel penarrocha diago 3 1 staff physician, service of stomatology, valencia university general hospital. Gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of periodontal surgical procedures in which the gum tissue is grafted. Aug 15, 2016 in 1979, carranza classified flap as full thickness flap and partial thickness flap. A beveled horizontal incision of approximately 6 mm was made distal to the implant, with a small vertical incision at the distal end part of the first incision. Apically repositioned flap periodontal gum surgery nyc. The apically positioned flap is a commonly used surgical approach, and is important for maintaining an adequate zone of keratinized tissue. Flap repositioning versus conventional suturing in third molar surgery jose m. A simple technique for stabilization of apically repositioned.
What is apically repositioned flap in mucogingival surgery. Pdf access policy full text access is free in html pages. It is at this stage in the procedure that extractions are performed if necessary. Check the angulation of implants to see whether it needs any modification of surgical procedure. Pdf modified apically repositioned flap in the treatment. The modified apically repositioned flap marf technique has been previously published as a successful method to increase the zone of attached gingiva with. Dept of periodontics periodontal flaps presented by, shiji margaret d. You can also choose from elastic closure folder, presentation folder, and clip file flap file, as well as from pp, paper, and leather flap file there are 1,012 suppliers who sells flap file on, mainly located in asia. Patient preparation reevaluation after initial treatment.
Root planing and modified widman flap to apically positioned flap during 5 year of follow up obtained similar results for both the treatment. After removal ol all granulation tissue, scaling and root planing, and osseous surgery il needed, the flap is displaced apicallv. Bed preparation has been done simulationally for apically positioned flap at the 1st stage surgery. 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. To gain access to the deeper periodontal structures using a flap reflected from the root and alveolar surfaces. A partialthickness flap about 3 mm was reflected from the crest of the osseous dehiscence area till the alveolar mucosa in the apical for easy flap migration. Apically repositioned flap during second stage implant surgery is. Modified apically repositioned flap in the treatment of. Find out information about modified flap operation. Various techniques have been advocated for nipple reconstruction following mastectomy, including the cv flap.
Marf is an effective technique in increasing the width of the keratinized tissue. Implant supported overdentures, keratinized tissue, modified palatal roll technique. Apically repositioned flaps may be preferred due to its advantages. This is the 2010 version of hcpcs d4245 please refer to the 2016 hcpcs code set for the latest version added on.
Clinical image prior to crown lengthening for preparation for restoration fig. A case series lecturer, department of periodontics and oral implantology, dr. Flap techniques and flaps in the treatment of pocket therapy. Pdf use of the modified apically repositioned flap technique to. The distance from the tooth, buccally or lingually, is dependent on. This case series describes a modified technique for increasing the width of the attached gingiva ag. Coronally and apically positioned flaps, although technically not grafting procedures, are other forms of a pedicle grafts in that gingival tissue is freed up and moved either coronally or apically. These cases show the modified apically repositioned flap marf technique and its potential to increase the likelihood of repigmentation of the surgical site with better matching esthetic results. The modified apically repositioned flap technique and its. Studies have shown that free gingival graft, apically positioned flap and collagen matrix graft can be. Open curettage involves the raising of a gingival flap, hand or mechanical scaling, and then replacing the flap in its original position or more apically, so as to reduce the pocket apically repositioned flap. Full thickness flap is surgical procedure of which all soft tissue and the periosteum are reflected. The advantages of the marf technique includes its simplicity and ease of execution as it involves the use of a single horizontal incision in the recipient site, absence of palatal donor tissue, shorter operative time.
The ultimate goal of periodontal therapy has been aimed to restore the health and function of the periodontium. An external file that holds a picture, illustration, etc. If a split thickness flap is required, it is elevated using sharp dissection with 1 hardparker knife to split it, leaving a layer ol connective tissue, including the periosteum, 011 the bone. The modified apically repositioned flap technique and its potential. While in the buccal area a split thickness flap is needed for the apical positioning, in the lingual area a full thickness flap is appropriate. Wennstrom, mucogingival therapy, annals of periodontology, 1, 1, 671701, 2017.
These procedures aim to facilitate the eruption of the. Jun 22, 2016 apically positioned flap with immediate implantation dentiumworld. Increasing the apicocoronal dimension of attached gingiva using the modified apically repositioned flap technique. Apically definition of apically by medical dictionary. Patients were divided into three groups based on preoperative anatomical considerations. This requires adequate thickness and width of gingival tissue at the base of the recession defect. A wide variety of flap file options are available to you, such as folder, bag, and wallet. Apically repositioned flap technique around implants. Case 5 was also treated as part of the second stage surgery utilizing pedicle flap with a. After removal of the marginal tissue, tetracycline was applied to the exposed root surface for about 5 min for root biomodification. Before and after photos on apically repositioned flap periodontal gum surgery performed in our gum disease treatment office. A comparison of weights of debris extruded apically by conventional filing and canal master techniques garry l.
It differs from the modified widman llap in that the soft tissue pocket wall is removed with the initial incision. Methods of exposing impacted teeth in order to bring them into the line of the arch include gingivectomy, the apically repositioned flap and closed eruption techniques. The conventional flap is used 1 when the interdental spaces are too narrow, thereby precluding the possibility of preserving the papilla, and 2 when the flap is to be displaced. Periodontal gum surgery for a patient whose gums had 57mm periodontal pocketing and bleeding upon probing. In the present case series we describe three different techniques for uncovering the impacted teeth, which are closed eruption technique, apically positioned flap, and a modified apically. Pdf on feb 14, 2017, joao carnio and others published the use of the modified apically repositioned flap technique in creating. The undisplaced flap periodontal disease click to cure cancer. Flap techniques and flaps in the treatment of pocket therapy authorstream presentation. A comparison of weights of debris extruded apically by. The undisplaced flap periodontal disease click to cure. Patient preparation reevaluation after initial treatment srp. Nov 16, 2017 the apically positioned flap is a commonly used surgical approach, and is important for maintaining an adequate zone of keratinized tissue. International poster journal of dentistry and oral medicine. In 1979, carranza classified flap as full thickness flap and partial thickness flap.
187 225 290 1467 1493 234 926 1029 1511 370 1191 1220 1233 382 181 306 260 740 1324 576 675 891 341 466 504 856 519 1297 343 264