Show and Tell Department of Periodontics
David Long, DDSL S U S c h o o l o f D e n t i s t r y
J u n e 9 t h , 2 0 1 8
Soft Tissue Surgery
Microsurgical Training
10-0 SuturesMock Ligation of an Artery
Patient MB
Localized Juvenile Spongiotic Gingival Hyperplasia
Initial Excisional Biopsy Histopathology
Courtesy of Dr. Katrina Cordell, LSU Oral Pathology
Connective Tissue Graft Coronally Advanced Flap
Lack of Attached Keratinized TissueLack of Vestibular Depth
Patient RB
Recipient site prepared FGG harvested
Initial 4 weeks2 weeks
Patient LPInitial
Recipient site preparation Lateral positioning of pedicle
Esthetic Crown Lengthening
10 mm7.5 mm
9 mm 8.5 mm
7 mm7.5 mm
Asymmetrical Gingival Contour
GingivectomyInitial
Osseous RecontouringFlap Reflection
Guided Tissue Regeneration
Initial- Buccal Initial- Lingual
Defect Grafted w/ FDBA + Collagen membrane
Tissue Regeneration: Posterior Teeth
Initial
Initial
8 months
8 months
Tissue Regeneration: Anterior Region
Initial 8 months Initial 8 months
• 2015: Patient presented to LSU Periodontics for evaluation
• 2015 – 2017: Patient undergoes non-surgical therapy
• Late 2017: Presented unannounced with unusual request…
Patient JS
Patient LC Horizontal and Vertical Ridge Deficiencies
Initial Flap Reflection
Degranulation of lesion Defect Grafted with FDBA
Amnion-chorion membrane adaptation Closure
Initial 3 months post op
Guided Bone Regeneration, Sinus Augmentation,
& Dental Implants
Initial Reflection Intramarrow Penetrations FDBA + BioGuide + PRGF
Initial Two weeks Sectional CT confirming ridge augmentation
Pre-RAG 4 months Implant placement Closure Final Restoration
Patient AFInitial
CBCT Guided Implant Surgery - Anatomage
Surgical Guide Anchor Pins and Tissue Punches Implant Placement
4x implants placed at depth Post-placement Panorex
Closure with tissue punches 4 months post op 2 weeks post uncovery
Surgical ResultDigital plan
Surgical Plan:
• Extraction + ridge preservation of hopeless maxillary teeth
• Maxillary Right: Lateral Window Sinus Lift
• Maxillary Left: Implant placement with crestal sinus lift•• Mandibular Arch: Implant supported hybrid restoration
Extraction ridge preservationInitial
Extraction & Ridge Preservation
Maxillary Right- Lateral Window Sinus Lift
6 weeks post extraction Reflection
Window Preparation Lifting of Schneiderian Membrane
PRF + BioOss Xenograft BioGuide Membrane PRF Membrane
Primary Closure Graft Stability Verified
Hybrid Restoration: Mandible
Flap extension and reflection
Bone Reduction GuideCourtesy of Dr. Katie Chang
Osteotomy Preparation Implant Placement Verifying Primary Stability
6 x implants placed Multi-unit abutments seated Closure
Interim Hybrid Prosthesis DeliveredCourtesy of Dr. Katie Chang
Thank you• D r. P a l a i o l o g o u - G a l l i s
• D r. E v a n s
• D r. M a n e y
• D r. O w e n s
• D r. D r a g o n a s
• D r. S p i n d l e r
• D r. S i m m o n s
• D r. M c C a b e
• D r. I s l a m
• D r. S a e n z
• D r. P e a r s o n
• D r. C o m e a u x
• D r. F i n l e y
• D r. S o i l e a u
• D r. Sw e i d a n
• D r. L e s t e r
• D e l e t h i a S c o t t
• M e l i s s a J o h n s o n
• A l a n a H a r r i s
• M e r y O r e l l a n a
• L i z M a ye r
• S h e l l y K a t t e n g a l
• B o n n i e S t e p h a n y
• M y C o - R e s i d e n t s
• D r. H e r n a n d e z
• D r. J a c k s o n
• D r. B r i s c o