RU2207072C1 - Method for making plastic repair of gingiva - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves making two incisions in recession area and connecting them with single horizontal incision in apical area under infiltrative anesthesia. Separated flap is thrown aside in crown manner. Donor palatal flap is transferred to bare periosteum area and fixed around the tooth with single ring-shaped suture, covered with separated flap and sutured in perimeter with 1.0-1.7 mm long steps. EFFECT: enhanced effectiveness of surgical treatment. 4 cl _

Description

 The invention relates to the field of surgery, in particular to oral surgery.

 A solution is known (see Pat. 2167619, MKI A 61 B 17/24, 05.27.01.) "Method for the formation of the upper arch of the vestibule of the mouth": ... including ... the formation of a flap from the mucous membrane of the upper lip in the region of the maxillary bone. .. (essence, basically, well-known: the mucous flap is detached to the level of the attached gum, the periosteum is cleared bluntly from the scar tissue, connective tissue cords and muscles that move apecally, the periosteum is dissected along the entire length of the deepening of the vestibule of the mouth, exfoliated by the size of the mucous flap excess scar new tissue and the free edge of the periosteum are excised, the flap is placed on the skeletonized bone and is fixed with a finger pressing).

 The above solution does not allow comprehensively and as efficiently as possible to provide the results of surgical intervention with the possibility of using the donor-recipient potential of the operated cavity.

 The solution is also known (see 2128016, MKI A 61 B 17/24, 05/07/00).

 However, in this decision, the comprehensive and most effective provision of the results of surgical intervention with the possibility of using the donor-recipient potential of the operated cavity with the provision of satisfactory postoperative results is not achieved.

 The Sullivan Surgery Technique is also known (see AE Stepanov, Surgical Interventions for Periodontal Diseases, M., 1991, p. 132.), including anesthesia, preparation of the recipient area in the area of the exposed tooth root, formation transplant for placement in the recession area, its fixation with suture material around the perimeter to the mucosa and periosteum.

 However, even with this method, the comprehensive and most effective provision of the results of surgical intervention with the possibility of using the donor-recipient potential of the operated cavity with the provision of satisfactory postoperative results is not achieved.

 The said method, according to the applicant, can be considered as a prototype.

 The objective of the invention is to comprehensively and efficiently provide the results of surgical intervention with the possibility of using the donor-recipient potential of the operated cavity with the ability to provide satisfactory postoperative results.

 The essence of the invention lies in the fact that when implementing the method of gum plastic surgery, including performing under vertical recession anesthesia in the area of recession, two vertical incisions, detachment of the mucous flap with a raspator or smoothing machine, formation of a donor flap from the palatal layer, its placement and fixation in the recession area, made in the area two vertical incisions in the apecal part are connected by one horizontal incision, the exfoliated flap is folded coronary, donors are placed on the exposed periosteum the palatal flap, which is fixed around the tooth with one annular suture, is overlapped with a peeled flap and sutured along the perimeter in increments of 1.0-1.7 mm, and for the formation of a donor flap in the area of chewing teeth in the sky, a longitudinal incision is made of the required size, then a second incision is made in parallel the first, two vertical sections connect the previous ones, fold the mucous flap, release the subepithelial flap, fold the mucous flap back into place, fix it with sutures, a longitudinal section is necessary about the size in the field of chewing teeth is done, departing 2-4 mm from the teeth, and the second, parallel to the first, the incision in the field of chewing teeth is made at a distance of 0.5-2.0 mm from the first cut.

 The invention is illustrated by the following description of operations.

 Two vertical incisions are carried out under infiltration anesthesia in the recession area, the mucosal flap is peeled off by a rasp or smoothing machine from the bone, the donor flap is formed, its location and fixation in the recession area, the donor flap is formed from the subepithelial palatal layer, two vertical incisions made in the recession area are connected into the apical part in one horizontal incision, the exfoliated flap is folded coronary, a donor palatal flap is placed on the exposed periosteum, which iksiruyut around the tooth with one annular seam, overlap with a peeled flap and sutured around the perimeter in increments of 1.0-1.7 mm.

 To form a donor flap in the area of chewing teeth in the sky, a subepithelial flap is cut from the sky, for which a longitudinal incision is made of the required size, 2-4 mm apart from the teeth, then a second incision is made, parallel to the first, at a distance of 0.5-2.0 mm from the first, the previous ones are connected with two vertical cuts, the mucous flap is folded out, the submucosal flap is released, the folded flap is put back in place and fixed with sutures, the palatal flap is placed on the periosteum in the recession area, it is fixed with one ring the suture around the tooth, then the palatal flap is closed with a previously exfoliated, coronally folded flap and sutured along the perimeter in increments of 1.0-1.7 mm.

 After careful hemostasis and drug treatment of the surgical field, a pressure dressing is applied to the lip for 12-24 hours. When suturing, use silk, vicryl or any other non-absorbable material with a diameter of 4.0, not higher on an atraumatic needle.

 Postoperative care, as with conventional vestibuloplasty: after surgery, a pressure bandage is applied to the lip area, approximately 12 hours. Sutures, if any, are removed on the 7-8th day. The first 2 days sparing regimen when eating.

 Clinical example 1.

 Patient K. 1970, medical history 14744. The diagnosis is a local gum recession in the region of the central incisor on the lower jaw on the left, complicated by the absence of an attached gum below the apical margin of the recession.

 The preoperative preparation of the patient.

 The operation itself was performed, postoperative care was performed.

 The proposed method, including plastic closure of the recession using a donor flap from the sky and a coronary flap flipped back, allows you to get a high cosmetic effect and create a high level of attached gums, fundamentally changing the application of the palatal flap.

Claims (4)

 1. A method of gum repair including infiltration anesthesia in the area of recession of two vertical incisions, peeling with a rasp or smoothing mucous flap, formation of a donor flap from the palatal layer, its placement and fixation in the area of recession, characterized in that two vertical ones made in the area of recession section, connected in the apecal part with one horizontal section, the exfoliated flap is folded coronary, a donor palatal flap is placed on the exposed periosteum, which is fixed in the tooth circle with one circular seam, overlap with a peeled flap and sutured along the perimeter in increments of 1.0-1.7 mm.  2. The method according to claim 1, characterized in that for the formation of a donor flap in the area of chewing teeth in the sky, a longitudinal incision is made of the required size, then a second incision is made parallel to the first, the previous ones are connected with two vertical incisions, the mucous flap is folded, a subepithelial flap, reclined the mucous flap is laid in its original place, fixed with sutures.  3. The method according to claim 1, characterized in that a longitudinal section of the required size in the area of the chewing teeth is made, departing 2-4 mm from the teeth.  4. The method according to claim 1, characterized in that the second, parallel to the first, an incision in the field of chewing teeth is made at a distance of 0.5-2.0 mm from the first incision.