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Video Details
Papilla Management in a Severe Periodontal and Cosmetic Deformity: Combining Veneer into Full Graft (ViFG) and Veneer into Split Graft (ViSG)

Description:
Bone defects and periodontal disease can create challenging defects in the anterior area. The esthetic compromise of the anterior regions takes us to the difficult task of trying to solve our patient´s problems as rapidly as possible, with minimum discomfort. When we have such severe defects as the one presented here, it´s essential to plan in advance and to be sure of what is possible to correct with bone grafting and with soft tissue management. The key question in this clinical case is to be able to place the soft tissue graft exactly where you want it to heal. You also have to know in advance, and of course inform your patient, that you will have to perform at least one additional soft tissue graft, besides the one which has been done simultaneously with implant placement and immediate load. In our clinical practice we use routinely PRGF ENDORET grafts, not only as vehicle for particulate graft transportation, but also as a biological enhancer of both oseointegration and soft tissue healing. The quality of the final soft tissue contour was provided by the quantity of keratinized gingiva derived from the two soft tissue procedures as well as from the preservation of the epithelial band attached to the connective tissue graft collected from the palate. This innovative procedure allowed the creation of a better papilla like formation between implants and a maintainable end result.

Date Added:
11/13/2013

Author(s):

Filipe Lopes, DDS, DMD Filipe Lopes, DDS, DMD
Filipe Lopes DDS, DMD

Dental degree in Oporto’s Dental University - Hospital de S. João - FMDUP.

Member of BTI´s International Scientific Committe...
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Bernardo de Mira Corrêa, DDS, DMD Bernardo de Mira Corrêa, DDS, DMD
Bernardo de Mira Corrêa DDS, DMD

Dental degree in Oporto’s Dental University - Hospital de S. João - FMDUP.

CEO of Clínica Mira Corrêa, Oporto’s ...
[read more]


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Online Videos / Surgery / Soft Tissue / Papilla Management in a Severe Periodontal and Cosmetic Deformity: Combining Veneer into Full Graft (ViFG) and Veneer into Split Graft (ViSG)




Questions & Comments
ricardo auer - (4/13/2020 5:32 PM)

Good result

filipe lopes - (1/13/2014 6:17 AM)

How about thickness after healing? Don´t you think it´s more stable through time?

Bernardo Mira Correa - (1/11/2014 1:27 PM)

I totally agree with you Maurice, with ACDM horizontal soft tissue enhancement can be achieved, but this kind of both vertical and horizontal need, would not work properly with ACDM.

filipe lopes - (11/24/2013 2:19 PM)

Dear Vinh Nguyen and Maurice, I´ve just posted a small video, as promised, where it´s possible to see the end result 4 years after surgery. Hopefully the video will be available soon. I think the result was pretty acceptable from an aesthetic and smile point of view. She´s quite happy and much more smiley (so tells her husband! :) ) without being afraid of doing so. That´s our real reward, trying to help, in some way, other people.

Maurice Salama - (11/18/2013 11:28 AM)

Filipe; No way that ACDM would work here like autologous tissue. I agree with your approach and hope to see more from you and your TEAM. regards Maurice

filipe lopes - (11/18/2013 11:24 AM)

Bernardo thank you for showing up! I know you also like this wedge palatal graft technique. Bernardo and I have discussed, during this patient´s treatment wether or not we could reach the same results with accelular dermal matrix. What do you guys, both think about this issue?

filipe lopes - (11/18/2013 11:18 AM)

Hello Maurice. An "Excellent job" from Dr. Salama is really a compliment for me. In fact in these kind of clinical situations we can never expect 100% regeneration. I´d love to have done orthodontics to bring all the tissues to the coronal... but when I told the patient that she would still probably have to go through soft tissue management procedures she refused to wear braces.

filipe lopes - (11/18/2013 11:14 AM)

Thank you for your kind remark Vinh Nguyen. I´ll be posting soon, in the posts area of dental xp, a smile of this same patient & intra-oral photo records 4 years after treatment. I think it´ll be nice to see how things have been evolving since then. Dr. Filipe Lopes Portugal

Bernardo Mira Correa - (11/18/2013 10:07 AM)

Very challenging situation indeed! Great peri-implant soft tissue's enhancement! Nice job Filipe Lopes!!

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