Excisional New Attachment Procedure
It was developed by US Naval Corps, yukna (1976).
ENAP is a definitive subgingival curettage procedure performed with a knife.
Indications
Suprabony pockets in the presence of convex root surfaces, normal gingival form and width.
“Importance Of Enap For Treating Periodontal Pockets”
Contraindications
- Soft tissue:
- Hyperplastic tissues.
- Inadequate keratinized gingiva.
- Hard tissue:
- Furcations
- Osseous defects.
- Malposed teeth.
- Close root approximation.
- Developmental tooth defects.
“What Is Excisional New Attachment Procedure (Enap)”
Excisional New Attachment Advantages
- Removal of epithelial pocket lining, junctional attachment and adjacent granulation tissue.
- Improved visualization and access to the root surfaces.
- Connective tissue attachment is left intact.
- Minimal trauma to gingiva.
- Does not affect the bone.
- Facilitates new attachment.
- Minimal postoperative recession.
“Indications For Excisional New Attachment Procedure In Dentistry”
Excisional New Attachment Disadvantages
- Limited application
- Technically exacting to determine the apical extent of the epithelial attachment, and epithelial-connective tissue junction.
Excisional New Attachment Procedure
- Deposition of few drops of the anesthetic solution into the lateral wall of pocket will help to reduce bleeding and make the tissue more firm.
- An internal bevel incision is made from margin of free gingiva apically below the base of the pocket.
- Incision is carried all around the tooth surface. Care should be taken to retain as much interdental gingiva as possible.
- Excised tissue is removed with a curette and the root surface is planned to a smooth hard consistency. Pocket is flushed with normal saline.
- Wound edges are approximated with finger pressure. Interdental sutures and periodontal pack is placed.
- A long junction epithelium is formed in about 7 days.
“Best Ways To Understand Enap Procedure Steps”
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