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 intra-bony defects up to 2-3 mm. It is also essential to perform crown lengthening 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.

styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.1

Resective bone surgery with fiber retention. Buccal probing.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.2

Lingual probing.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.3

Initial radiographs.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.4

Design of the buccal flap with a double parabola on 46. Than Vertical incision distal to 43.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.5

Lingual sub-marginal incision.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.6

Buccal bone defects before bone re-contouring.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.7

Buccal bone re-contouring with elimination of the defect between 46 and 47 and correction of the reverse bone morphology on premolars.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.8

Lingual bone defects before bone re-contouring.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.9

Lingual re-contouring with osteoplasty of lingual tori, creation of lingual buccal ramps, and retention of fibers at the inter-proximal level and in the furcation area.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.10

styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.11

Sutures with apical repositioning of flaps at the bone crest.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.12

styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.13

Radiographic comparison between before surgery (upper) and after 2 years.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.14

styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.15

Buccal comparison between before surgery (Img. 14) and after 2 years.
styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.16

styleitaliano style italiano perio periodontics probing resective bone surgery flap widman pocket depth

Fig.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, and obtaining of adequate soft tissue architecture and better possibility for the patient to maintain proper oral hygiene.

Bibliography

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