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One of the biggest failure of surgical treatment is Wound dehiscence. In particular, the interproximal papilla area is a region susceptible to Wound dehiscence. The reason of such failure is the gingival capillary plexus not extending to the interproximal area resulting in small volume of blood supply. Therefore, once we cut through the papilla, to achieve healing by primary intention is very complicated. Therefore, in order to achieve Primary closure at the interproximal papilla, it is quite important to have a flap design taking into consideration the blood supply.
Currently, Flap design has been progressing due to introduction of microscope magnified visual field technology and usage of specialized micro instruments. As a result, the tissue management performance in periodontal tissues and surrounding implants has dramatically improved. Also, at the present time, due to the usage of a microscope it is changing into a small surgical range limited to bone defect. With this minimal approach, the influence of postoperative pain and postoperative discomfort to the patient is reduced, and it is turning into patient friendly and patient oriented treatment. However, minimally invasive surgery cannot be applied to everything. By forcibly reducing the surgical field, in some cases access becomes difficult and treatment may become insufficient. Therefore, when the operation field is narrow and treatment becomes difficult, it is necessary to gradually expand the treatment range. In addition, preoperative CT examination is considered effective in order to select the operation type and to determine the position and range of the incision line. In this presentation, I would like to give the new flap design, which is primarily considering Blood supply in Microsurgery of periodontal tissue while presenting the relevant sources and clinical examples.
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Fumiyo Yamaguchi, DDS has no relevant commercial relationships.
Release Date: October 21, 2017
*Expiration Date: October 21, 2020
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Fumiyo Yamaguchi, DDS
Dr. Fumiyo Yamaguchi D.D.S
1998: Graduated Showa University, School of Dentistry
2003: Japanese Society of Periodontology: Certified Dentist, specialist
2006: Opened Yamaguchi Dental Clinic in Yokohama, Japan
Japanese Society of Periodontology
The Japanese Academy of Clinical Periodontology
Japan Association of Microscopic Dentistry
Japanese Society of Oral implantology
Osseointegration Study Club of Japan