Phase II Periodontal Therapy

principals of periodontal

surgery 12/4/2020 -امراض لثة -الفرقة الخامسة

1. Gingival Curettage

2. Excisional new attachment procedure

(ENAP)

3. Gingivectomy

Gingival Surgical Techniques

1. Gingival Curettage

• Definition :

• The term "gingival curettage" implies

directing an operative instrument against

the gingival wall of the periodontal pocket

in order to remove the ulcerated epithelium

covering the sulcus.

1. Gingival Curettage

• The curettes is used to scraping of the gingival

wall of a periodontal pocket to separate diseased

soft tissue.

1. Gingival Curettage

• TYPES

1. Gingival Curettage

• II. Surgical curettage,

• III. Chemical curettage,

• IV. ultrasonic curettage.

• V. Laser Tx

1. Gingival Curettage

• INDICATIONS

1. ?

1. Gingival Curettage

• However,

the need for curettage to

eliminate the inflamed

granulation tissue appears

to be questionable.

2. Excisional new attachment procedure (ENAP)

• A surgical procedure in which the sulcular and junctional epithelium is resected. The aim of the procedure is to remove the diseased tissue and allow healing of the dentogingival and periodontal attachments.

2. Excisional new attachment procedure (ENAP)

• advantages over traditional subgingival curettage is the definitive, clean excision of the junctional epithelium and the subjacent tissue with a greater probability of new clinical attachment

2. Excisional new attachment procedure (ENAP)

• Indications

2. Excisional new attachment procedure (ENAP)

• Contraindictions

2. Excisional new attachment procedure (ENAP)

• Advantages

• Disadvantages

3. Gingivectomy

• gingivectomy means “excision of the gingiva.”

By removing the pocket wall,

• gingivectomy provides visibility and accessibility

for complete calculus removal and the thorough

smoothing of the roots

3. Gingivectomy

• Types:

3. Gingivectomy

Step 1. bleeding points:

3. Gingivectomy

• Step 2. The primary incision on the facial and

lingual surfaces:(Kirkland knives or a scalpel blade 12 or 15)

3. Gingivectomy

• Step 3. the secondary incision interproximal soft

tissue is separated from the interdental periodontium by a using an

Orban knife

3. Gingivectomy

• Step 4. The incised tissues are carefully

removed by means of a curette or a scaler

3. Gingivectomy

• Step 5. Cover the area with a surgical pack

3. Gingivectomy

• Indications:

3. Gingivectomy

• Contraindications to gingivectomy

• Gingivoplasty is similar to gingivectomy, but its

objective is different.

• Gingivectomy is performed to eliminate periodontal

pockets, and it includes reshaping as part of the

technique.

• Gingivoplasty is a reshaping of the gingiva to create

physiologic gingival contours with the sole purpose of

recontouring the gingiva in the absence of pockets

Gingivoplasty

Classification of Flaps

Periodontal Incisions