Resective bone surgery with fibers retention

Perio
26 Jul 2017

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.

Fig. 1

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

Fig. 2

Img. 2 – Lingual probing

Fig. 3

Img. 3 – Initial radiographs

Fig. 4

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

Fig. 5

Img. 5 – Lingual sub-marginal incision

Fig. 6

Img. 6 – Buccal bone defects before bone recontouring

Fig. 7

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

Fig. 8

Img. 8 – Lingual bone defects before bone recontouring

Fig. 9

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

Fig. 10

Img. 10

Fig. 11

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

Fig. 12

Img. 12

Fig. 13

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

Fig. 14

Img. 14

Fig. 15

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

Fig. 16

Img. 16

Fig. 17

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.

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