Classificação dos Retalhos Periodontais e Incisões Periodontais - Aula de Cirurgia Periodontal

Summary

In this video, the presenter provides a comprehensive lesson on periodontal flaps, covering essential topics like classifications, types of incisions, and their clinical significance. The first part explains the types of periodontal flaps based on bone exposure, positioning after surgery, and papilla manipulation. It delves into the key surgical techniques, including full-thickness and partial-thickness flaps, as well as different incision methods such as bisel, sulcular, and interdental incisions. The video is informative for both clinical practice and competitive exams, with a promise of further detailed content in upcoming lessons.

Takeaways

• 😀 Takeaway 1: The video introduces the second part of a series on periodontal flaps, focusing on classifications and incisions used in periodontal surgery.
• 😀 Takeaway 2: Periodontal flaps are classified into three groups based on bone exposure after flap displacement, flap positioning post-surgery, and handling of the papilla.
• 😀 Takeaway 3: The first group of classification refers to flaps based on bone exposure after displacement, with two types: full-thickness flap (total thickness) and partial-thickness flap.
• 😀 Takeaway 4: A full-thickness flap (mucoperiosteal flap) exposes the bone completely by detaching the entire soft tissue, including the periosteum.
• 😀 Takeaway 5: A partial-thickness flap (mucosal flap) only detaches the epithelium and a layer of connective tissue, keeping the bone covered by connective tissue and periosteum.
• 😀 Takeaway 6: Flaps can also be classified based on their positioning post-surgery: displaced or non-displaced flaps.
• 😀 Takeaway 7: Displaced flaps are sutured in a position different from the original tissue, and can be moved coronally, apically, or laterally.
• 😀 Takeaway 8: Non-displaced flaps are sutured back in their original position and are often used for excess gum removal procedures.
• 😀 Takeaway 9: Flaps are also classified based on how the papilla is managed during surgery, with two categories: conventional flaps and papilla-preserving flaps.
• 😀 Takeaway 10: Incisions used in periodontal surgery include horizontal and vertical incisions, such as internal bevel incisions, sulcular incisions, and interdental incisions, each with specific purposes for tissue displacement and access.

Q & A

What are periodontal flaps and why are they important in dental surgery?

Periodontal flaps are a type of surgical procedure used to access the underlying structures of the gums and bone. They are essential for various dental surgeries, such as bone grafting and the treatment of periodontal disease, as they allow the dentist to have direct access to the affected tissues for treatment.

What are the main classifications of periodontal flaps?

Periodontal flaps can be classified based on three criteria: exposure of bone after flap displacement, positioning of the flap after surgery, and handling of the papilla. These classifications help guide the selection of the appropriate surgical technique for different clinical situations.

How is the classification of periodontal flaps based on exposure of bone defined?

Flaps based on bone exposure are divided into two groups: full-thickness flaps, where both the gum tissue and the underlying periosteum (connective tissue covering the bone) are displaced to expose the bone, and partial-thickness flaps, where only the gum tissue is moved, leaving the bone covered by a layer of connective tissue.

What is the difference between full-thickness and partial-thickness periodontal flaps?

A full-thickness flap involves the displacement of both gum tissue and the underlying periosteum, exposing the bone. A partial-thickness flap, on the other hand, only displaces the gum tissue, leaving the bone covered by a layer of connective tissue and periosteum.

What is the purpose of classifying periodontal flaps based on positioning after surgery?

This classification helps determine whether the flap will be repositioned after surgery. The flap can be displaced coronally (toward the crown), apically (toward the root), or laterally, depending on the clinical needs, such as treating gum recession or preparing for a restoration.

What is the main purpose of a coronal displacement flap?

A coronal displacement flap is used primarily to treat gum recession, where the gum is repositioned towards the crown to cover exposed root surfaces, reducing sensitivity and improving aesthetics.

How does a lateral displacement flap differ from a coronal one?

In a lateral displacement flap, the gum tissue is moved sideways, often to cover exposed root surfaces in areas of gum recession. This technique is commonly used when access to the root surface is needed without affecting other areas of the gum line.

What is the significance of papilla preservation in periodontal flap surgery?

Papilla preservation is important for maintaining the aesthetic and functional integrity of the gums. It helps in avoiding the loss of gum tissue between the teeth, which can lead to a less aesthetic result and reduced functionality, particularly in the interdental space.

What types of incisions are used in periodontal flap surgery?

Incisions in periodontal surgery are primarily horizontal or vertical. Horizontal incisions include internal bevel (bisel invertido), sulcular, and interdental incisions, while vertical incisions are made at the ends of horizontal incisions to allow easier flap displacement and better access to the bone.

What are the key characteristics of an internal bevel incision in periodontal surgery?

The internal bevel incision, also known as the primary incision, is the first cut made in periodontal surgery. It is used to separate the gum tissue from the underlying structures and remove diseased or inflamed tissue, including the epithelial lining of a periodontal pocket.