Periodontal surgery for the orthodontic patient mohamad aboualnaser - oussama sandid 2009
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Transcript of Periodontal surgery for the orthodontic patient mohamad aboualnaser - oussama sandid 2009
Periodontics- Orthodontic interrelationships
interdisciplinary approach
Periodontal Surgery for theOrthodontic Patient
DR MOHAMAD ABOUALNASER- Orthodontiste- BUA- USA DR OUSSAMA SANDID – Orthodontist- France
2009
Periodontal Surgery for theOrthodontic Patient
• 1. Pericision-Circumferential Supracrestal Fiberotomy
• 2. Frenectomy
• 3. Mucogingival considerations
• 4. Gingival Grafting
• 5-Surgical Exposure of Impacted Tooth For Orthodontics
• 6- Extraction supernumerary teeth mesiodens
• 7- Mini-implant pose
• 8- Gummy smile
• 9- Wisdom tooth
MOHAMAD ABOUALNASER-OUSSAMA SANDID
1-Periodontics- Pericision-Circumferential Supracrestal Fiberotomy
Relapse of severely rotated teeth due to rebound of elastic fibres in the supracrestal tissues can be reduced by pericision. Fiberotomy (CSF) Preventing Orthodontic Relapse
http://www.aso.org.au/members/NSW%20Brighter%20Futures/Brighter_Futures_002.pdf
www.orthofree.com
MOHAMAD ABOUALNASER-OUSSAMA SANDID
2-Periodontics- Frenectomy
http://www.omahaperio.com/services/frenectomy.aspx
MOHAMAD ABOUALNASER-OUSSAMA SANDID
2-Periodontal Surgery for the Orthodontic Patient
http://www.mrzperio.com/
Frenectomy
Frenectomy: is the complete removal of the frenum, including its attachment to the underlying bone. Frenectomies was a commonly performed procedure which was an excisional surgery carried over to the palatal aspect. Since this procedure includes the complete removal of the frenum, a common complication encountered with this technique is the undesireable loss of interdental papilla. The frenotomy which is a more superficial procedure, with only partial removal of the frenum and just a relocation of the
attachment, is an esthetically preferable procedure lately . In frenotomy, the attachment to the gingiva and periosteum is severed and the insertion of the frenum is relocated upto the alveolar mucosa Frenotomy may be indicated in the mandible when a marked frenum attaches within thin gingiva and there is risk of development of labial recession.Another procedure to eliminate the alleged relapse is the Z plasty technique, which does not remove the frenum but instead is intended to relax the pull of the frenum of the interdental soft tissue.
MOHAMAD ABOUALNASER-OUSSAMA SANDID
3-Periodontics- Mucogingival considerations
Gingivae a. before and b. after crossbite correction.
http://www.aso.org.au/members/NSW%20Brighter%20Futures/Brighter_Futures_002.pdf
MOHAMAD ABOUALNASER-OUSSAMA SANDID
4-Periodontics-Gingival recesion -Gingival Grafting
http://www.aso.org.au/members/NSW%20Brighter%20Futures/Brighter_Futures_002.pdf
MOHAMAD ABOUALNASER-OUSSAMA SANDID
4-Periodontal Surgery for the Orthodontic Patient
http://www.mrzperio.com/
Gingival recesion - Gingival Grafting
MOHAMAD ABOUALNASER-OUSSAMA SANDID
4-Periodontics-Gingival recesion -Gingival GraftingMOHAMAD ABOUALNASER-OUSSAMA SANDID
5-Periodontics- Surgical Exposure of Impacted Tooth For Orthodontics
O.SANDID- O.Migault
Surgical Exposure of Impacted Tooth For Orthodontics
MOHAMAD ABOUALNASER-OUSSAMA SANDID
5-Periodontics- Surgical Exposure of Impacted Tooth For Orthodontics
Surgical Exposure of Impacted Tooth For Orthodontics
http://www.mrzperio.com/
MOHAMAD ABOUALNASER-OUSSAMA SANDID
6-Extraction supernumerary teeth- mesiodens
Dr O.SANDID
MOHAMAD ABOUALNASER-OUSSAMA SANDID
7-Periodontics- Impacted Wisdom teeth
Pericoronitis
Impacted Wisdom teeth
www.orthofree.com
MOHAMAD ABOUALNASER-OUSSAMA SANDID
7-Wisdom tooth extraction-Bone Loss Distal to the 2nd Molar
www.orthofree.com
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Repositioning - impaction lower second molarMOHAMAD ABOUALNASER-OUSSAMA SANDID
Interdisciplinary approach to improve smile esthetics
http://www.gummysmile.com/
The problem: The combination of the overgrown gum tissue and the high lip line are working together to reduce the beauty of this smile.
The solution: Following minimally-invasive surgery, where the patient had no post-surgical pain, we can now see the fullness of her smile. Her high lip line is not a severe problem and is less of a concern.
Gummy smile
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Interdisciplinary approach to improve smile esthetics
http://www.gummysmile.com/
Gummy smile
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Gingivectomy to reduce bulk of excess gum tissue
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Periodontics-Gingival esthetics
A, B) Smile esthetics affected by disharmonious gingival contours although anterior teeth look well aligned and leveled. C, D) Improved gingival contour after periodontal surgery and orthodontic
movement. Gingivectomies were performed on teeth #12 and 21, as well as intrusion of #11 with subsequent restoration of its incisal edge. During orthodontic intrusion, tooth #11 moved apically,
carrying with it the entire periodontium, while maintaining biological distances.
Máyra Reis Seixas1, Roberto Amarante Costa-Pinto2, Telma Martins de Araújo3, Dental Press J Orthod. 2012 Sept-Oct;17(5):190-201
MOHAMAD ABOUALNASER-OUSSAMA SANDID
7-Periodontics- Mini-implant
Anchorage control with mini-implant has become an important part of the clinical management of the orthodontic patients.
L. Massif, L. Frapier, EMC
www.orthofree.com
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Corticotomy facilitated orthodontics
http://parkell.cdeworld.com/
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Periodontics- Black triangle
http://www.oralhealthgroup.com/news/treating-the-dreaded-black-triangle/1002990029/?&er=NA
www.orthofree.com
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Median dark space caused
A) Median dark space caused by alveolar bone crest loss B) Interproximal stripping performed with diamond steel disk at low rotation; C) polishing of the stripped surfaces with flexible strips of sandpaper and whiting D) space created between incisors; E, F) bringing teeth closer together with elastomeric chains, showing improvement in papillary esthetics.
Máyra Reis Seixas1, Roberto Amarante Costa-Pinto2, Telma Martins de Araújo3, Dental Press J Orthod. 2012 Sept-Oct;17(5):190-201
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Combined endodontic-orthodontic and prosthodontictreatment of fractured teeth
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Periodontics Tmj dysfunctionsMOHAMAD ABOUALNASER-OUSSAMA SANDID
Supracrestal FiberotomyFrenectomy Gingival Grafting
Surgical Exposure Extraction supernumerary teeth Wisdom tooth
Mini-implant Gummy smile Repositioning - impaction
MOHAMAD ABOUALNASER-OUSSAMA SANDID
Periodontal Surgery for theOrthodontic Patient O.SANDID