Root Coverage with Connective Tissue Grafts
Root Coverage with Connective Tissue Grafts
A beautiful case demonstrating use of connective tissue grafts for root coverage. Surgery performed by Paul Rosen, DMD, MS of Yardley, Pennsylvania, USA.
Presurgical view demonstrating gingival recession on both maxillary incisors.
Mucoperiosteal flap created to facilitate placement of connective tissue graft. Note that the papilla between the maxillary central incisors is left intact and is tunneled.
Placement of connective tissue graft into prepared recipient site.
Connective tissue graft covered with coronally positioned gingival flap.
Healed graft.
Before and after comparison. Note excellent defect coverage and improved biotype.
Case provided by:
Paul Rosen, DMD, MS. Practice limited to periodontics and dental implants. Yardlely, Pennsylvania, USA.
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Comments
James I couldnt agree more: Experience is key
Dr. Laney,
I couldnt agree more with your comments. As a practicing periodontists for more then 15 years experience is key. My connective tissue grafts are far better now then when I first started.
I appreciate your comments when you said "It took me a couple of years of private practice to get to where I was not thinking about the graft on my schedule while on my way to work."
I think that is a testimate to your concern for the outcome of the case and to the patient.
I think these weekend courses give people a false sense. Whether it be implant course or soft tissue. Thats not to say that a GP shouldnt do these cases. But you should know your limitations and refer when needed.
I work with alot of gp that do their on implants and they refer me the hard one.
Great comments.
Sergio
GRAVITY
very strong GRAVITY...
don't want to loss pilot drill...
miss MIS implant...
Did you secure the CTG subgingivally?
Dr. Rosen,
Did you secure the graft subgingivally with sutures or did you simply place and then cover with the gingiva?
Courses
Just because you go to a CE course ,and pay heaps of time and lose income, does not make one an expert or specialist. There is an issue here for potential litigation if something goes wrong. Obviously, it is wise to see a dental guru or company to get the finer details of the new procedure. Of course, to stay ahead, you need to think progressively and take on cases, and thus, new approaches and outlooks to the new procedure.
Just my chin-wag.
Cheers,
Eugene
CE Coures: Agree with Eugene
A weekend course does not make a expert. Work with a specialist, do what you are comfortable with and no when to consult or refer. Better for you and the patient.
Courses
When learning a new procedure, especially something as technique sensitive as soft tissue grafting, you must consider how many cases you will get to do.
It took me a couple of years of private practice to get to where I was not thinking about the graft on my schedule while on my way to work.
It would be an unusual general practice that gives the GP enough grafts so that the appropriate level of comfort is developed. I think this is true of sedation, grafts, and many other procedures.
Your average GP will get to do enough bridges and restorative to achieve comfort ( and therefore competence), but most will not do enough grafts to ever really get there.
Why make life miserable? Your goal should be to get to the point where you don't care what's on the book as you leave home to go to work - its all the same to you if you're enjoying your work.
appreciate JIACD
WE are studing entire life and it is always better to learn the subject under supervision of experience specialists,to discuss someone mistakes to avoid owns.....and i am always remembering phrase "seven times to measure,than... one time to cut."
I AM VERY APPRECIATE JIACD that it teach us to think progressively,new approaches,new procedures.
PERFECT
everything are perfect;YOUR BOOK,YOUR CONTINUE EDUCATION...your thought...innovation
Could you have used Alloderm here?
Could Alloderm have been used here? Is it easy to use? I received an advertisement for an Alloderm course. I was thinking about attending. I am not a surgeon, am a General Dentist. The course makes root coverage look so easy and you do not need to go to the palate.
Alloderm for Root coverage.
Yes I have done Alloderm in these cases and it works. Take the course by Pat Allen.
A course needed? That is my big beef.
If a product is so technique sensitive that one needs to take a course in order to use it successfully, that raises big red flags in my book.
When speaking of this product to many of my colleagues, anytime anyone says "I did not have good success with XXXXX." the other person responds, "Oh, you need to take the course. Dr. XXX shows you the secrets on how to make that stuff work."
If this is the case, which I am guessing that it is since this one Doc puts on a very successful course, why doesn't the company just give this course to its customers for free?
Course are needed....CE is critical
Look I am a surgeon and I see the benefits of CE. There are new products that hit the market every day and its nice to go to a course taught by someone that gets success to see what they do to achieve success.
CE is one thing, this is another.
Of course, CE is needed. You must keep up with the latest techniques. What I am saying is that if a product is so technique sensitive that you have to pay a guy thousands of dollars to show you how to make it work, that is a problem in my book.
Nice CTG case
Great results on the CTG case. I like how you tunneled it.
Brooke
Nice case Dr. Rosen. One question for you
Very nice case Dr. Rosen. Thank you for posting.
I do have one quesiton. It looks like the ridges are slightly deficient at the lateral incisors. I am guesssing that they were congenitally missing. Would you consider augmenting those ridges at the same time as the CTG on 8,9?
Thanks