The document discusses various techniques for preserving interdental papilla during periodontal procedures. It begins by defining the papilla and classifying types of papilla loss. Factors contributing to loss are described. Non-surgical and surgical preservation techniques are then covered in detail, including the papilla preservation flap, modified papilla preservation flap, simplified papilla preservation flap, entire papilla preservation flap, semilunar coronally repositioned flap, and whale's tail technique. Healing and references are lastly summarized.
The future of dentistry and periodontics lies in regeneration. The goals of periodontal therapy lies in not only the arrest of periodontal disease progression but also regeneration of the lost periodontal structures. This presentation provides a review of the current understanding of the regeneration of the periodontium and the procedures involved to restore the periodontal tissues around the teeth.
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
The future of dentistry and periodontics lies in regeneration. The goals of periodontal therapy lies in not only the arrest of periodontal disease progression but also regeneration of the lost periodontal structures. This presentation provides a review of the current understanding of the regeneration of the periodontium and the procedures involved to restore the periodontal tissues around the teeth.
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
Pathogenesis is derived from the Greek work ‘pathos’ meaning suffering and ‘ genesis’ meaning generation or creation. Plaque is considered as the main etiologic factor in the pathogenesis of periodontal disease.
Modern Treatment for Congenitally Missing Teeth : A Multidisciplinary Appro...Abu-Hussein Muhamad
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics
This review covers the surgical and non-surgical management of
Gingival black triangles (GBTs).
This review also covers the aetiology and management of GBTs,
highlighting the importance of considering the options currently
available when treating a lost dental papilla.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
Pathogenesis is derived from the Greek work ‘pathos’ meaning suffering and ‘ genesis’ meaning generation or creation. Plaque is considered as the main etiologic factor in the pathogenesis of periodontal disease.
Modern Treatment for Congenitally Missing Teeth : A Multidisciplinary Appro...Abu-Hussein Muhamad
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics
This review covers the surgical and non-surgical management of
Gingival black triangles (GBTs).
This review also covers the aetiology and management of GBTs,
highlighting the importance of considering the options currently
available when treating a lost dental papilla.
Combined endodontic periodontic treatment of a palatal groove/ dental implant...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Dense Evaginatus: Management Using Novel Materials A Case ReportQUESTJOURNAL
ABSTRACT: Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by a projection of enamel and dentin that usually encloses pulp tissue. Most commonly found as the tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth.Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case reports about the presentation of dens evaginatus in mandibular premolar 35 which was associated with open apex and chronic apical periodontitis. Root canal treatment was performed with tooth 35. DFDBA apical barrier and Biodentine as an apical plug was placed showing successful management of the same.
The denture-wearing history should provide information on the age of existing dentures, the frequency of denture replacement, the patient's experiences and expectations. It is important to identify whether any previous dentures have been successful as it may be suitable to copy features from a previously successful set. It will be important to manage expectations for those patients with a history of denture intolerance, yet technically satisfactory prostheses.
Clinical examination
Clinical examination should fully evaluate both the patient's anatomy and previous dentures to anticipate challenges and the potential to improve upon retention, stability, support, appearance and/or other factors. This should be undertaken in a systematic manner and would typically involve assessment of anatomy followed by an assessment of any existing dentures. This should follow a diagnostic process to determine if the patient presents with:
Technically adequate dentures on a favourable tissue base
Technically adequate dentures on an unfavourable tissue base
Technically inadequate dentures on a favourable tissue base
Technically inadequate dentures on an unfavourable tissue base.
Endodontic Management of Unusual Case of Type II Dens Invaginatus – A Case Re...QUESTJOURNAL
ABSTRACT: A thorough knowledge of the normal anatomy of the root canal system as well as the possible aberrancies is imperative for success of endodontic therapy .The challenge lies in diagnosing these conditions properly, complete debridement of the root canal system, and 3-dimensional sealing of the same. Morphological dental anomalies of the maxillary lateral incisors are relatively common . Endodontic treatment for teeth that exhibit the dental anomaly, dens invaginatus, can be difficult due to the bizarre anatomy and relative inaccessibility of the diseased pulp tissue. Dens invaginatus is a developmental malformation of teeth. Affected teeth show a deep infolding of enamel and dentine starting from the foramen caecum or even the tip of the cusps and which may extend deep into the root. . The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Dens invaginatus is a critical condition for endodontic treatment once it frequently presents a complex internal anatomy and might be associated with incomplete root and apical development. Therefore every effort must be made to identify and diagnose the variation. This article presents an Unusual case of Endodontic Management of maxillary left lateral incisior with Type II Dens Invaginatus .
Surgical procedures in fixed partial denture prostheses/ General orthodonticsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Treatment of Endodontic –Periodontic lesion with combination therapy: PRF and...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The presence of furcation involvement is one clinical finding that can lead to a diagnosis of advanced periodontitis and potentially to a less favourable prognosis for the affected tooth or teeth. Furcation involvement therefore presents both diagnostic and therapeutic dilemmas. This review explains the vast aspects of furcation involvement in form of etiology, classification, diagnosis and different treatment modalities in detail.
Key Words: Furcation, periodontitis, plaque.
M.M Devan Dictum “Aim of a prosthodontist is not only the meticulous replacement of what is missing, but also perpetual preservation of what is present”
Complete denture must function in harmony with the remaining natural tissues so for the success, a through knowledge of the anatomy is a must.
Similar to Papilla Preservation Techniques.pptx (20)
Being a Periodontist, what necessary is to know what actually periodontal flaps are. So this presentation might provide you an insight into the field of periodontics as well as periodontal flaps.
Local anesthesia, all in one place with all the references and all the important points.
It contains some videos and animations, for which feel free to contact. As such animations are not compatible with Slideshare. Enjoy and please hit the like button if you liked the presentation.
A complete presentation made on the topic of blood with everything needed together in one place.
This presentation contains some animations and videos that might not be that compatible with Slideshare, so feel free to contact me and I shall share it.
Everything a dentist needs to know about a periodontal abscess is here.
Along with all the relevant facts, references, definitions, classifications, and each and every statement is given with proper detail
Here's all that you need to know about dental calculus.
With proper references and all the recent advances, along with the detailed facts and description.
Each and every statement is provided with an accurate reference and all the things to know are very well summarised in one place.
Aberrant Frenum !!
No worries... When Frenectomy is here.
Hello Periodontists,
Here's the entire process of Frenectomy in a nutshell and various ways to encounter the same.
Lets Shoot ...
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
3.
A valleylike
depression that
connects a facial
and lingual
papilla and
conforms to the
shape of the
interproximal
contact
The tip of the
papilla is located
immediately
beneath the
contact point
4.
Reference : Park JH. Esthetic consideration in
interdental papilla: remediation and regeneration. J
Esthet Restor Dent; 2010
Reference : Cohen B. pathology of the interdental
tissues. Dent Pract; 1959
Gingival black triangle is a cosmetic deformity
which refers to an absence of papilla resulting in
black spaces or open embrasures which impairs
esthetic features, phonetics problems and food
accumulation.
Reference : P.
Ziahosseini, B. J. Millar,
Management Of Gingival
Black Triangles; 2014
6. The Interdental Contact
Point
The Apical extent of the
Facial Cementoenamel
Junction (CEJ)
The Coronal extent of the
Proximal Cementoenamel
Junction (CEJ)
Reference : W. P. Nordland And D. P.
Tarnow, A Classification System For
Loss Of Papillary Height, J. Periodontol;
Oct. 1998
7. PPI score 1 • Papilla completely present
PPI score 2 • Apical to contact point
PPI score 3 • Apical and CEJ visible
PPI score 4 • Apical to both CEJ.
Reference : C Nemcovsky. Interproximal Papilla Augmentation Procedure: A Novel
Surgical Approach And Clinical Evaluation Of 10 Consecutive Procedures. Int J
Periodontics Restorative Dent; 2001
8. PIS 0
• Papilla not present and no curvature of the
soft tissue contour.
PIS 1
• Present papillae height less than half the
height of the papilla in the proximal teeth
and a convex curvature of the soft tissue
contour.
PIS 2
• Presence of at least half the height of the
papilla in the proximal teeth, but not in
complete harmony with the interdental
papilla of the proximal teeth.
PIS 3
• Papillae able to fill the interproximal
embrasure to the same level as in the
proximal teeth and in complete harmony
with the adjacent papillae.
Reference : C Nemcovsky. Interproximal Papilla
Augmentation Procedure: A Novel Surgical Approach And
Clinical Evaluation Of 10 Consecutive Procedures. Int J
Periodontics Restorative Dent; 2001
9.
10. Alveolar Bone
Interproximal Contact
Distance / Periodontal
Bone Loss / Age
Root Divergence
Triangular Crown Morphology
Embrasure Morphology
Initial position of teeth (Diastema, Crowding, Imbrication )
Reference : Tornow DP, Magner AW, Fletcher P. the effect of the
distance from contact point to the crest of bone on the presence
or absence of interdental papilla. J Periodontol; 1992
Reference : Tal H. relationship between the
interproximal distance of roots and the prevalence of
infrabony pockets. J periodontal; 1984
Reference : Ahmad I. anterior dental
esthetics: gingival perspective. Br Dent
J; 2005
Reference : Kois JC.
Predictable single tooth peri-
implant esthetic; five
diagnostic keys. Compend
Contin Educ Dent; 2001
12. Abnormal form and size of the tooth
Irregular restorations and prosthetic crowns
Traumatic oral hygiene measures like improper tooth brushing technique
and flossing in the interdental space
Periodontal disease.
Acute necrotizing ulcerative gingivitis which results in punched out crater
like depression of the interdental papilla.
After periodontal therapy during healing.
Missing of teeth or spacing between the teeth
Reference : Jenabian N, Rahimi Rad M, Bijani A, Ghahari P. The comparison of papilla preservation technique and
semilunar incision with sub- epithelial connective tissue graft in dark triangle treatment. Caspian J Dent Res; 2018
14. Non-Surgical
• Scaling and root planing is to be
done prior to any treatment procedures.
• Reinforcement of oral hygiene
procedures and oral health
education should be given to the
patients.
• Correction and relocation of the
contact point should be established.
• Orthodontic treatment should be
carried out to create a contact point.
Surgical
• Conventional Papilla Preservation Flap
• Modified Papilla Preservation Flap
• Simplified Papilla Preservation Flap
• Entire Papilla Preservation Flap
• Semilunar Coronally Repositioned Flap
• The “Whale’s Tail” Technique
If the primary cause of
periodontal disease is
interdental papilla loss
If traumatic tooth
brushing
If mal-positioning of the
teeth
If no contact point
between the teeth like in
the case of midline
diastema Every 15 days for 3 months curettage of
interdental papilla should be performed
repeatedly
16. Reference : Cohen; 3rd edition
ADVANTAGES
• Esthetically pleasing.
• Primary coverage of
implant material.
• Prevention of
postoperative tissue
craters.
DIS-ADVANTAGES
• Technically difficult.
• Time consuming.
17. Takei et al; 1985
The first modification of PPF
The horizontal incision beneath the
interproximal area, on opposite side of
bone defect was deemed best because it
allowed protection of the regenerated
area from the oral environment.
Checchi et al; 1988
Reference : Chacko LN, Abraham S, Landge N, Ali FM. Papilla Preservation
Flap: Revisited; 2013
Reference : Cortellini P, Prato GP, Tonetti MS. The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures. Int J
Periodontics Restorative Dent 1999
19. Cortellini et al; 1995
Step 1
• In the
interdental
space at the
base of the
papilla, a
horizontal
incision is
made at
buccally and it
is extended
towards
palataly.
Step 2
• After placing a
horizontal
incision,
oblique
releasing
incision is
placed in the
alveolar
mucosa and it
is extended to
the interdental
papilla in
corono-apical
direction.
20. Reference : Aslan S, Buduneli N, Cortellini P. Entire papilla preservation
technique in the regenerative treatment of deep intrabony defects: 1-Year
results. J Clin Periodontol; 2017
Pre-surgical site showing defect
on the mesial aspect of the
maxillary right lateral incisor
Oblique Incision beginning at
gingival margin of mesiobuccal
line angle of lateral incisor.
Blade parallel to the long axis of
the tooth and reaches the mid-
point of the distal surface of the
central incisor below the
contact point
Oblique Incision continues
intrasulcularly in the buccal
aspect of the lateral and central
incisor.
Full thickness buccal flap
elevated.
21. Wide interproximal
space
Horizontal incision
Anterior and
pre-molar region
Narrow interproximal
space
Oblique incision
Anterior and
posterior regions
Healing of gingival blood flow postoperatively is faster in SPPT than MPPT.
Reference : (Retzepi et al, 2007)
SPPT MPP
T
22. Reference : Aslan S, Cortellini P. Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results. J Clin Periodontol; 2017
Cortellini, Aslan; 2017
Aim : to preserve to affected papilla providing a
tunnel like undercut incision
Advantage : The entirely conserved inter-dental
papilla provides an intact gingival chamber to
stabilize the blood clot and also improves the wound
healing process
EPP : requires a short buccal vertical releasing
incision on the buccal side of the adjacent tooth
extending just beyond the Mucogingival line
24. Bianchi and Basseti; 2009
Indications
• for the treatment of wide intrabony defects
in the esthetic zone that involves the
elevation of a large flap from the buccal to
the palatal side allowing accessibility and
visibility of the intrabony defect
• to perform GTR while maintaining
interdental tissue over grafting material
The reflected flap looks like a tail of a whale,
hence the name Whales Tail technique
Reference : Bianchi AE, Bassetti A. Flap design for guided tissue regeneration surgery in the
esthetic zone: The “Whale’s tail” technique. Int J Periodontics Restorative Dent 2009
26. Carranza’s Clinical
Periodontology :
10th Edition
Cohen B.
pathology of the
interdental
tissues
International
Journal of Applied
Dental Sciences
Interdental papilla and
various preservation
techniques: A review - S.
Uma et al; 2020
Treatment of Interdental
Papilla: A Review – Jamwal
D. et al; 2019
Cortellini, Prato, and M.
Tonetti, “The simplified
papilla preservation flap. A
novel surgical approach for
the management of soft
tissues in regenerative
procedures”
Journal of
Dentofacial
Sciences
Chacko, Neelathil &
Abraham, Sathish &
Landge, Nilima & Ali,
Fareedi. Papilla
Preservation Flap :
Revisited; 2013
Miscellaneous
• W. P. Nordland and
D. P. Tarnow, “A
classification
system for loss of
papillary
height,” Journal of
Periodontology
• H. H. Takei, T. J.
Han, F. A. Carranza
Jr., E. B. Kenney,
“Flap technique for
periodontal bone
implants. Papilla
preservation
technique,” Journal
of Periodontology;
1985