Resective bone surgery with fibers retention
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. 11 – Sutures with apical repositioning of flaps at the bone crest
Img. 13 – Radiographic comparison between before surgery (upper) and after 2 years
Img. 15 – Buccal comparison between before surgery (Img. 14) and after 2 years
Img. 17 – Lingual comparison between before surgery (Img. 16) and after 2 years
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.