Treatment Of Gingival Enlargement
Enumeration of Techniques Performed to Increase Width of Attached Gingiva.
- Gingival augmentation apical to area of recession:
- Free epithelial autograft
- Free connective tissue autograft
- Apically positioned flap
- Fenestration
- Vestibular extension.
- Gingival augmentation coronal to recession or root coverage
- Free epithelial autograft
- Free connective tissue autograft
- Pedicle autografts
- Rotational, i.e. lateral pedicle flap and double papilla flap
- Advanced, i.e. Coronally displaced flap and semilunar flap
- Subepithelial connective tissue graft
- Subpedicle connective tissue
- Pouch and tunnel technique
- Envelope technique
- Apically displaced flap surgery
- Guided tissue regeneration technique
Used for both pocket eradication and widening of zone of attached gingiva:- Step 1: Internal bevel incision is made 1 mm from the crest of the gingiva and directed towards the crest of the bone
- Step 2: Crevicular incision is made followed by initial elevation of flap and than interdental incision is performed, the wedge of the tissue containing the pocket wall is removed.
- Step 3: Vertical releasing incisions are made extending beyond the mucogingival junction and flap is elevated with a periosteal elevator.
- Step 4: Remove all the granulation tissues, root planning is done and flap is positioned apically at the tooth bone junction.
- Step 5: Flaps are sutured together.
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