Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Video Details
The Free Gingival Graft...Back to Basics: Why Do It?

Description:
The lower incisor area is the site of the most common mucogingival deficiencies: Gingival recession, high frenum attachments, and thin tissue. Because of the local anatomy, this area is a challenge to treat surgically. Common treatment options often include the subepithelial connective tissue graft, acellular dermal graft, free gingival graft, as well as several other methods/materials. In this video, a free gingival graft is demonstrated to address a recession defect as well as to augment the soft tissue while eliminating the high frenum pull in order to aid in the orthodontic treatment plan of a young patient. While commonly shunned for the morbidity associated with palatal grafts, the free gingival graft is making a comeback with the popularity of implant dentistry due to it's relative simplicity and predictability for augmenting thin tissue. This "back to basics" video takes the free gingival graft back to its roots: The lower incisor area.

Date Added:
10/13/2012

Author(s):

David Wong, DDS David Wong, DDS
Dr. David Wong is a board-certified Periodontist in private practice in Tulsa, Oklahoma.

Dr. Wong received his undergraduate education and dental training at the Un...
[read more]




Online Videos / Surgery / Periodontic Surgery / The Free Gingival Graft...Back to Basics: Why Do It?




Questions & Comments
michael melkers - (5/29/2018 12:51 PM)

Thank you Dr. Wong-that was great.

david wong - (4/18/2014 10:38 AM)

I second what Dr. Salama says regarding periodontal dressings. I also rarely use a dressing. For my typical free gingival graft such as this, I typically do not suture the bottom portion of the graft to the periosteum IF the graft is immobile. If I am uneasy about the graft's stability I will utilize a periosteal anchoring sling suture that more firmly adapts the graft to the recipient bed.

Maurice Salama - (4/16/2014 9:28 PM)

Helena; Not always, only to help extend the vestibule. Dr. Salama

Helena DeLuca - (4/16/2014 8:28 PM)

Thank you for your great presentations! Do you use periodontal dressing with your FGG'S?

Maurice Salama - (4/16/2014 4:26 PM)

Helena; Barricade is Light Cured Material and very popular or you can you select Perio Pak. Dr. Salama

Helena DeLuca - (4/16/2014 4:23 PM)

WHICH PERIODONTAL DRESSING IS BEST TO USE WITH FREE GINGIVAL GRAFTS, THANK YOU

Spencer Sarue - (2/16/2014 6:44 AM)

Excellent video. Thanks for posting it

Charlie Chen - (3/29/2013 5:05 PM)

Dr.Wong, I also have the same question as Hector. I notice you did not suture the bottom portion of the graft to the periosteum. I would think it would lead to increase in mobility of the graft, especially if the patient move his/her lip. Wouldn't suture the bottom portion of the graft to the periosteum be more secure?

saadou khalaf - (12/26/2012 3:46 PM)

thank u very much dr wong, my question , is it important to cover the site with a perio pack

Related Videos
 The Critical “Pink” Interface in Esthetic Dentistry—A Cross-Disciplinary Approach: Options, Limitations, and Solutions Premium Member Content

The Critical “Pink” Interface in Esthetic Dentistry—A Cross-Disciplinary Approach: Options, Limitations, and Solutions
This program is a perspective into how cross- disciplinary interface planning has become and integral part of clinical esthetic dentistry, in particular implant diagnostics. Today it is essential to combine “white” tooth esthetics with “pink” gingival aspects. Understanding the individual prosthetic, surgical, and biologic limitations is part of innovative treatment-planning protocols developed in an approach to provide, simplify, and expedite minimally invasive limited therapy. Preemptive CBCT and 3D CAD/CAM planning of soft and hard tissue procedures, implant placement, ridge reduction, and restorative design now utilize new innovative protocols for the entire restoration from top to bottom - implant, abutment, and restoration - and the interfaces in between.

Presented By:: David Garber, DMD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Treatment of Refractory Periodontal Disease Premium Member Content

Treatment of Refractory Periodontal Disease
The Key to Understanding the Refractory Case.

Presented By:: Ed Rosenberg, DMD
Presentation Style: Lecture
Community Rating:
 
Watch Now>>
Contemporary Bio-Materials and Combined Techniques for Esthetic Reconstruction Premium Member Content

Contemporary Bio-Materials and Combined Techniques for Esthetic Reconstruction
State-of-the-art technology offers conservative and esthetic alternatives to re-establish the shape and color of anterior teeth as well as the white and pink harmony. Tooth reduction for any restorative technique obliges us to be as conservative as possible. In this presentation we will share a short description of different material options developed in esthetic dentistry. We will present a case managed with a combination of techniques including: monolithic lithium-silicate ceramic veneers and cut-back/layering.

Presented By:: Kenneth P. Valladares, DDS, CDT
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Managing the Extraction Site - Optimal Preservation and Enhancement Techniques Premium Member Content

Managing the Extraction Site - Optimal Preservation and Enhancement Techniques
There is rarely a day that clinicians do not have to deal with an extraction site. If implant therapy is a consideration, then bone and soft tissue quantity and quality must be factored into treatment options. The ideal opportunity for bone preservation exists at the time of tooth extraction. All too often this opportunity is lost. Extraction techniques will be demonstrated that not only preserve but augment the amount of alveolar bone. The importance of piezosurgery, atraumatic surgical technique, the use of bone grafts, resorbable membranes and growth factors will be elucidated along with soft tissue enhancement.

Presented By:: Michael Sonick, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy Premium Member Content

Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy
Platelet derived growth factors are now routinely utilized in reconstructive therapy. This presentation describes very detailed and evidence based guidelines for clinicians interested in enhancing their abilities in tissue engineering, especially as it relates to bone augmentation. Specifically, while successful bone augmentation requires the standard surgical parameters of space maintenance, low pressure on the grafts and tension-free flap closure, optimization of this goal requires management and enhancement of the local biological conditions with growth factors. Towards that end, platelet concentrates through the constant release of growth factors are able to promote and enhance new vascularization, provide plasma protein, normal lipidemia, as well as increased collagen and fibrin activity.

Presented By:: Joseph Choukroun, MD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Esthetic Periodontal Surgery: Making Recession Defects Disappear by Grafting Premium Member Content

Esthetic Periodontal Surgery: Making Recession Defects Disappear by Grafting
Expert discussion of soft tissue grafting; first an overview of current trends, the second showing a specific allograft technique for treating multiple adjacent recession defects.

Presented By:: Edward P. Allen, DDS, PhD.
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Related Articles
Surgical Crown Lengthening in a Population With Human Immunodeficiency Virus: A Retrospective Analysis

Surgical Crown Lengthening in a Population With Human Immunodeficiency Virus: A Retrospective Analysis
This report investigates the outcome of CLS procedures performed at an urban dental school in a population of individuals with HIV. Specifically, this retrospective clinical analysis evaluates the healing response after crown lengthening surgery (CLS). Of the 21 patients with HIV examined after CLS, none had postoperative complications, such as delayed healing, infection, or prolonged bleeding. Variations in viral load, CD4 cell count, smoking, platelets, and neutrophils did not impact surgical healing. In addition, variations in medication regimens (highly active anti-retroviral therapy; on pro-tease inhibitors; no medications had an impact. The results of this retrospective analysis show the absence of postoperative complications after CLS in this population with HIV. Additional investigation into this area will help health care practitioners increase the range of surgical services provided to this group of patients.

Author(s): Monish Bhola, DDS, MSD;Shilpa Kolhatkar, Suzanne A. Mason, Ana Janic, Shaziya Haque and James R. Winkler
View Article>>
The Socket-Shield Technique to Support the Buccofacial Tissues at Immediate Implant Placement

The Socket-Shield Technique to Support the Buccofacial Tissues at Immediate Implant Placement
Tooth loss and subsequent ridge collapse continue to burden restorative implant treatment. Careful management of the post-extraction tissues is needed to preserve the alveolar ridge. In-lieu of surgical augmentation to correct a ridge defect, the socket-shield technique offers a promising solution. As the root submergence technique retains the periodontal attachment and maintains the alveolar ridge for pontic site development, this case report demonstrates the hypothesis that retention of a prepared tooth root section as a socket-shield prevents the recession of tissues buccofacial to an immediately placed implant. The socket-shield technique is a highly promising addition to clinical implant dentistry and this case report is among the first to demonstrate the procedure in clinical practice with a 1-year follow up.

Author(s): Howard Gluckman, BDS, MChD;Maurice Salama, DMD;Jonathan Du Toit, BChD
View Article>>
Replacing the Natural Tooth System in the Esthetic Zone: Flapless Implant Placement and Simultaneos Restoration to Preserve Tissue Contours and Guarantee Esthetics

Replacing the Natural Tooth System in the Esthetic Zone: Flapless Implant Placement and Simultaneos Restoration to Preserve Tissue Contours and Guarantee Esthetics
Over the last decade, the number of cosmetic dental procedures performed in the general dental practice has increased steadily each year. Likewise, the use of dental implants as a tooth replacement options has become a more routine treatment alternative for patients missing teeth or requiring tooth removal.

Author(s): Paul S. Petrungaro, DDS
View Article>>
Contact Us | Privacy Policy | Terms of Use
©2018

Preferred Language: English Flag
Contact Us · Login · Register