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.
Fig.1
Resective bone surgery with fiber retention. Buccal probing.
Fig.2
Lingual probing.
Fig.3
Initial radiographs.
Fig.4
Design of the buccal flap with a double parabola on 46. Than Vertical incision distal to 43.
Fig.5
Lingual sub-marginal incision.
Fig.6
Buccal bone defects before bone re-contouring.
Fig.7
Buccal bone re-contouring with elimination of the defect between 46 and 47 and correction of the reverse bone morphology on premolars.
Fig.8
Lingual bone defects before bone re-contouring.
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.
Fig.10
Fig.11
Sutures with apical repositioning of flaps at the bone crest.
Fig.12
Fig.13
Radiographic comparison between before surgery (upper) and after 2 years.
Fig.14
Fig.15
Buccal comparison between before surgery (Img. 14) and after 2 years.
Fig.16
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.
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