Mucogingival Surgery Short And Long Essay Question And Answers

Mucogingival Surgery Definition

Mucogingival surgery

• Surgical procedures are performed to correct/eliminate anatomic, developmental, or traumatic deformities of the gingiva or alveolar mucosa.

Mucogingival Surgery Important Notes

1. Mucogingival surgeries

• Techniques of increasing the width of attached gingiva
  • Free gingival graft
  • Apically displaced flap
• Techniques for coverage of denuded roots
  • Laterally displaced pedicle graft
  • Coronally displaced flap
  • Free gingival graft
• Techniques to deepen the vestibule
  • Free autogenous grafts
• Techniques for removal of a frenum

2. Undisplaced flap

• It surgically removes the pocket
• It does not increase the width of the attached gingiva, instead, it decreases the width
• It is essentially an excisional procedure of the gingiva

3. Disadvantages of full-thickness flap

• Loss of facial bone height
• Not preferred in cases of fenestrations and dehiscence

Mucogingival Surgery Long Essays

Question 1. Define periodontal plastic surgery. Describe procedures available to cover denuded root surfaces.
Answer:

Periodontal plastic surgery Definition:

• Surgical procedures are performed to correct/eliminate anatomic, developmental, or traumatic deformities of the gingiva or alveolar mucosa.

Periodontal plastic surgery Procedures For Root Coverage:

Periodontal plastic surgery Conventional Procedures

1. Laterally displaced flap:

Recipient site:

Periodontal plastic surgery  Donor site:

• Transfer the flap to the recipient site
• Suturing of flap
• Placement of periodontal pack

2. Double papilla flap:

By Wainberg:

• Dissecting both facial and lingual papilla

3. Coronally-repositioned flap:

Regenerative Procedures:

Mucogingival Surgery Short Essays

Question 1. Free gingival graft
Answer:

• A free gingival graft is used to create a widened zone of attached gingiva

2. Variant techniques:

1. Accordion technique
   • Achieved by giving alternate incisions on opposite sides of the graft
2. Strip technique
   • Consists of 2 or 3 strips of tissue to cover the entire length of the recipient site
3. Connective tissue technique

Question 2. GTR.
Answer:

• After the flap surgery, epithelium from the excised margin. No need for donor site may proliferate apically

1. Classical technique of GTR:

Read And Learn More: Periodontics Question and Answers

• This results in the formation of long junctional epithelium
• Thus this should be prevented
• To prevent this, a membrane is placed between healing connective tissue and cementum
• Such a membrane is GTR (Guided Tissue Regeneration)

Types of GTR:

• Degradable- Collagen, Guidor membrane
• Non-degradable- Millipore, Teflon membrane

GTR Indications:

• Esthetic demand
• In single tooth with wide deep localized recession
• In the presence of root sensitivity
• In recession associated with class V restorations

GTR Advantages:

• No need for a donor site
• Highly esthetic
• Disadvantages:
• Technique sensitive
• Expensive

GTR Technique:

• The incision along with releasing incisions extending

Question 3. Coronally displaced flap
Answer:

Coronally displaced flap Indications:

• Esthetic coverage of exposed roots
• Gingival recession

Coronally displaced flap Advantages:

• Treatment of multiple areas
• Adjacent teeth are safe
• The high degree of success
• It does not increase the existing problem

Coronally displaced flap Disadvantages:

• No need for two surgical procedures

Coronally displaced flap Technique:

Mucogingival Surgery Short Question And Answers

Question 1. Frenectomy.
Answer:

• It is the complete removal of the frenum including its at-attachment to the underlying bone

Frenectomy Technique:

Question 2. Mucogingival Problems.
Answer:

• Deep pockets
• Recession
• High frenal attachment
• Inadequate width of attached gingiva

Question 3. Indications of Mucogingival surgery.
Answer:

• Augmentation of the edentulous ridge
• Prevention of Residual Ridge Resorption (R)
• Crown – lengthening
• Esthetic purpose

Question 4. Frenectomy and frenotomy
Answer:

Frenectomy:

• It is the complete removal of the frenum including attachment to the underlying bone

Frenotomy:

• It is the relocation of the frenum usually in a more apical position

Frenectomy Indications:

• Esthetic purposes
• Deepening of vestibule in mandibular anterior area

Frenectomy Technique:

Question 5. High frenal attachment
Answer:

• High frenal attachment is a condition where the frenum is. attached too close to marginal gingiva.

High frenal attachment Etiology:

• Genetic
• Gingival recession

High frenal attachment Effects:

• Tension on frenum
• Plaque accumulation
• Inhibit proper placement of toothbrush
• Poor oral hygiene
• Deep maxillary anterior vestibule
• Esthetic problems

Question 6. Vestibuloplasty.
Answer:

• It is a procedure for vestibule extension
• As described by Edlan and Mejchar

High frenal attachment Technique:

Two vertical incisions are given from the junction of marginal and attached gingiva to approx 12 mm from the alveolar margin into the vestibule

High frenal attachment Types:

1. Labial vestibuloplasty
2. Lingual vestibuloplasty

Question 7. Objectives of mucogingival surgery
Answer:

• Widening of attached gingiva
• Coverage of denuded roots
• Removal of an aberrant frenum
• Creation of some vestibular depth
• As an adjunct to routine pocket elimination procedure

Mucogingival Surgery Viva Voce

1. Surgical removal of the frenum is indicated when tension on the frenum may tend to open the sulcus
2. The ideal thickness of a free gingival autograft is 1-1.5 mm
3. Revascularization of a free gingival autograft starts from 2nd or 3rd day
4. The central portion of the free gingival margin is last to vascularize
5. Healing of free gingival autograft of intermediate thickness of 0.75 mm is completed by 10.5 weeks
6. After 24 weeks free gingival autograft placed on de- nude bone shrink by 25%