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7/24/2019 Periodontia Cirurgica
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FLSF
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Envolvem a excisão e a remoção dos tecidos
moles e duros das estruturas de suporte dos dentes.
FLSF
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FLSF
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* Técnica cirúrgica mais utilizada
* Rebatimento do tecido mole, para obtermos acesso ásestrut. periodontais mais profundas ou reposicionamento
da gengiva
* ucoperi!steos de espessura total "suprimento vascularsofre m#nima interrup$%o cicatriza$%o ideal
* &omple'o de tecido mole gengival " gengiva, mucosa alveol. e peri!steo ( s%o rebatidos das superf#cies radicular e !ssea
FLSF
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FLSF
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* )idman "+-( modificado por e/man e 0ir1land
* Ramf2ord e issle "+34(
* Retal5o em campo aberto sem deslocamento apical desse
retal5o nem recontorno !sseo para obter a elimina$%o 67
* Remo$%o do tec. mole ad2acente 8 parede mole da 67 permitir visualiza$%o da raiz reposicionar o retal5o para revestir completamente o osso alveolar
* Trauma cirúrgico m#nimo durante a cirurgia
* 9steticamente superior 8 gengivectomia e ret. rep. apical:
FLSF
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;ndica$<es* 67 com bases localiz. coronárias 8 2un$%o mucogengival
* 67 com envolvimento de furca$<es* 9stética importante "lin5a de sorriso alta(
* 67 profundas "= >mm( anteriores e vest. sup. post.
* 67 intra?!sseas e crateras
* 9n'ertos !sseos
FLSF
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&ontra?indica$<es
* 7resen$a de acentuado aumento gengival " gengivectomia(
* 7ouca ou nen5uma gengiva inserida
* @randes espessamentos !sseos ou e'ostoses !sseas
FLSF
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Aantagens
* Rápida e pouco desgradável para o paciente
* Besconforto p!s?operat!rio m#nimo
* Tecnicamente muito simples
* 6om resultado estético
FLSF
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Técnica
( Cssepsia do campo operat!rio
( Cnestesia infiltrativa terminal
D( ;ncis%o com bisel invertido "67 lEmina ou >( , ? mm
da margem gengival acomp. o contorno com o bisturi até o
osso sub2acente
FLSF
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Técnica4( Beslocamento do retal5o de espessura total até ue
as ra#zes fiuem completamente vis#veis
>( 9limina$%o do anel secundário com o bisturi de Grban
H( 9limina$%o do tecido de granula$%o e rasp:alis. radicular
3( Sutura interrompida apro'imando as papilas interdentais
FLSF
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&uidados p!s?operat!rios* Não escovar a área durante dois dias
* Fazer bochechos de 1’/1 dias !di"luconato de
clorexidina #$1%&'
* (ieta pastosa
* )nal"sicos !%+ horas'
* ,emoção das suturas ap-s dias
FLSF
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R9C9S&9T9 KSS9G , B979B9BG BC FC;C B9 @9@;AC;S9R;BC 9 R9LCMIG CG GSSG CLA9GLCR
**** SJ&9SSG BC &;RJR@;C 79R;GBGTCL ;&;SN9S
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SJTJRCS
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T&;&C &;RXR@;&C
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79R;T9 G B9SLG&C9TG BG &GWJTG J&G79R;GST9CL
A;SCBG 9L;;CR 6GLSCS 9 7R9S9RACR JCS9 TGTCL9T9
C @9@;AC ;S9R;BC
;B;&CMN9S ? CJ9TG B9 &GRGC &L;&C
? C&9SSG V &UR;9S SJ6@9@;AC;S
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T&;&C &;RXR@;&C
( C9ST9S;C "6LGJ9;G R9@;GCL Y ;F;LTRCT;AC T9R;CL(
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3( SJTJRCS 7CRC C7;&CL
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&;RJR@;C 9STT;&C B9T9S CT9R;GR9S
7RGGA9 C &G69RTJRC B9 RCQ9S 97GSTCS
? R9CL;QCBC 9 UR9CS GB9 C JCT;BCB9 B9 @9@;AC
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?7GB9 S9R R9CL;QCBG C7KS J 99RTG @9@;ACL L;AR9
T&;&C &;RXR@;&C
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T&;&C &;RXR@;&C
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( ;&;SIG PGR;QGTCL
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>( R96CT;9TG BG R9TCLPG
H( R9GMIG BG T9&;BG B9 @RCJLCMIG
3( B9SLG&C9TG BG R9TCLPG &GRGCR;C9T9
Z( SJTJRC
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0rocedimento cirr"ico 2ue consiste em eliminar
"en"iva e osso $ para criar uma coroa cl3nica maior
no sentido apical 4 mar"em "en"ival
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Gb2etivo
5bter estrutura dental sadia para a boa retenção da
6utura restauração sem alterar o espaço biol-"ico
de inserção
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;ndica$<es
* 7iperplasia "en"ival
* Fratura dental sub"en"ival* 8árie sub"en"ival
* 8oroa cl3nica curta
* 0er6uraç9es
* ,eabsorção radicular externa* (entes não irrompidos
FLSF
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Aantagens
* Reten$%o cl#nica é mel5or para coloca$%o de coroa ou para pilar de pr!tese fi'a
* 9vita a coloca$%o em margens gengivais e subseuente deterioza$%o da gengiva
* Facilita a PG em dentes com restaura$<es ou pr!teses
* 7rolonga a vida útil do tratamento restaurador e do pr!prio dente
FLSF
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Besvantagens
* )lteração na proporção coroa/raiz
* 5s dentes ad:acentes tambm perdem suporte -sseo
* 5 di;metro da raiz menor 2ue o da coroa
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Técnica
( Cssepsia do campo operat!rio
( Cnestesia infiltrativa terminal
D( ;ncis<es submarginais e onduladas "papila interdental( ? LEmina ou > * &onsiderar [ ? uantidade de gengiva ueratinizada
? profundidade da bolsa ? forma e número de ra#zes
? uantidade de aumento da coroaFLSF
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Técnica
4( Beslocamento do retal5o de espessura total
>( Raspagem e aplainamento radicular "se necessário(
H( Gsteoplastia e ostectomia "espa$o biol!gico(
3( Suturas interrompidas buscando a má'ima adapta$%o
das papilas
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&uidados p!s?operat!rios
* <ochechos 1’$ % vezes ao dia / 1 dias
* Escovação suave na re"ião ap-s dois dias
* ,emoção das suturas ap-s dias
* =tilização de escova interproximal
* )nal"sicos nas primeiras %+ horasFLSF
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