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Giano Ricci

Resective bone surgery with fibers retention

5028 Views - Jul 2017

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The updated approach to resective bone surgery is the fibers retention technique, proposed many years ago and widely used today in the everyday practice to treat bone irregularities and intrabony defects up to 2-3 mm. It is also essential to perform crown lenghtening procedures.

A young 35 years old, healthy, female with no history of diabetes, or smoking presented with deep probing depth, bleeding on probing and sligth mobility of the molars. It was decided to approach the case with osseous surgery with fiber retention.



Img. 1 - RBS with fiber retention. Buccal probing.

Img. 2 - Lingual probing

Img. 3 - Initial radiographs

Img. 4 - Design of the buccal flap with a double parabola on 46. Than Vertical incision distal to 43

Img. 5 - Lingual sub-marginal incision

Img. 6 - Buccal bone defects before bone recontouring

Img. 7 - Buccal bone recontouring with elimination of the defect between 46 and 47 and correction of the reverse bone morphology on premolars

Img. 8 - Lingual bone defects before bone recontouring

Img. 9 - Lingual recontouring with osteoplasty of lingual tori, creation of lingual buccal ramps, and retention of fibers at the interproximal level and in the furcation area

Img. 10

Img. 11 - Sutures with apical repositioning of flaps at the bone crest

Img. 12

Img. 13 - Radiographic comparison between before surgery (upper) and after 2 years

Img. 14

Img. 15 - Buccal comparison between before surgery (Img. 14) and after 2 years

Img. 16

Img. 17 - Lingual comparison between before surgery (Img. 16) and after 2 years

Conclusions

The resective bone surgery approach allowed elimination of probing depths, of minor intrabony defects, obtainement of adequate soft tissue architecture and better possibility for the patient to maintain proper oral hygiene.
 

Bibliography

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  2. Olsen CT, Ammons WF, Van Belle G. A longitudinal study comparing apically repositioned ?aps, with and without osseous surgery. Int J Periodontics Restorative Dent. 1985;5(4):10-33.
  3. Ochsenbein C. Osseous resection in periodontal surgery. J Periodontol. 1958;29:15-26.
  4. Ochsenbein C. Current status of osseous surgery. J Periodontol. 1977;48(9):577-86.
  5. Rosling B, Nyman S, Lindhe J, Jern B. The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque-free dentitions. A 2-year clinical study. J Clin Periodontol. 1976;3(4):233-50.
  6. Carnevale G, Kaldahl WB. Osseous resective surgery. Periodontol 2000. 2000;22:59-87.
  7. Levine HL. Periodontal ?ap surgery with gingival ?ber retention. J Periodontol. 1972 Feb; 43(2): 91-8.
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  9. Carnevale G. Fibre retention osseous resective surgery: a novel conservative approach for pocket elimination. J Clin Periodontol. 2007;34(2):182-7.

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