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Video Details
Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation

Description:
One standard approach for wound closure after ridge augmentation is coronal flap advancement. Coronal flap advancement results in displacement of the mucogingival junction and reduction of the vestibulum. In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.

Date Added:
9/30/2020

Author(s):

Snježana Pohl, MD, DMD Snježana Pohl, MD, DMD
Zagreb Faculty of medicine, Munich Faculty of Dental Medicine. Work experience at the General surgery and Orthopedics in Munich. Oral Surgery residency in Munich. Doctorate in...
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Online Videos / Surgery / Periodontic Surgery / Buccal Sliding Palatal Pedicle Flap Technique for Wound Closure After Ridge Augmentation




Questions & Comments
snjezana pohl - (9/24/2020 5:52 AM)

Dear Lalith Vivekananda, thank you, I appreciate your feedback very much! Once we see advantages of ROBINHOOD concepts, we open our eyes and discover countless opportunities to utilize the patient own tissue without doing any harm with an additional donor site. Thank you again!

snjezana pohl - (9/24/2020 5:47 AM)

Thank you for your nice comment, dear Farhan Durrani. The other technique is the coronally flap advancement of the buccal flap in the low jaw. Periosteum incision is 1 mm and "brushing" using the blade is utilized to further release the buccal flap. BSPPF technique has the goal to avoid or reduce the coronally buccal flap advancement. In cases where 4-5 mm of exposed buccal sliding flap are not sufficient for the wound closure, BSPPF is combined with the coronally buccal flap advancement. Thanks to the Ronda & Stacch paper and later Choukroun and Simonpieri popularization, I prefer a shallow initial periosteum incision, followed by brushing. In cases where only a minor buccal flap advancement is required, periosteum detachment from the bone is sufficient to advance the flap coronally.

Lalith Vivekananda - (9/24/2020 3:19 AM)

Awesome lecture Sjnezana 🤝....appreciate the intricacy in your work...following your ROBINHOOD concepts ----its working out great 😊

snjezana pohl - (9/23/2020 7:54 AM)

Thank you, Howie, I am honored that you took your time to watch this video. It is always good to hear from you and get your smart questions. Apically repositioned flap is easier to perform then BSPPF, although BSPPF does not require great surgical skills.When BSPPF technique is utilized, the MGJ is not displaced or it is displaced minimally. It means that at second stage surgery we don`t have to deal with flattened vestibulum and can uncover implants 1. minimally invasive, especially if guided soft tissue augmentation was performed, or 2. thicken the soft tissue with roll flap or FCTG. A few months after the first CT detachment and displacement, the CT quality and quantity is even better. Apically repositioned flap allows for the horizontal tissue thickening, but not for the vertical. What I dislike about the apically repositioned flap is the exposed bone between the implants and flap management on adjacent teeth.  I find apically repositioned flap more useful in full arch cases, but in the most esthetic cases, there is no application for this flap. Nowadays I use apically repositioned flap only if the soft tissue thickness does not allow for BSPPF. 

FARHAN DURRANI492 - (9/22/2020 10:28 AM)

Great Presentation with innovative skill Snježana Pohl Please can you explain the advantage over another technique mentioned in same journal Marco Ronda, Claudio Stacchi;A Novel Approach for the Coronal Advancement of the Buccal Flap;Int J Periodontics Restorative Dent . Nov-Dec 2015;35(6):795-801

Howard Gluckman - (9/22/2020 3:18 AM)

grit lecture and work Sjnezana I love your work. Thanks for sharing will be trying the technique ASAP. How do you think this compares to the use of the apically repositioned flap. with regards to ease of use, tissue thickening and replacement of the MGJ. thanks

snjezana pohl - (9/19/2020 1:46 PM)

Thank you, dear Feras Awad!

Feras Awad - (9/18/2020 12:16 PM)

Great Presentation as Usual :)

snjezana pohl - (9/18/2020 9:50 AM)

Thank you so much for your kind comment, dear Rita! I am looking forward to your BSPPF cases! Warmly, Snjezana

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