Int J Stomatol

Int J Stomatol ›› 2020, Vol. 47 ›› Issue (3): 318-327.doi: 10.7518/gjkq.2020043

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Application of periodontal plastic surgery in the preservation and reconstruction of gingival papilla

Liu Jiamei,Wu Yanmin()   

  1. Dept. of Oral Medicine, The Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310009, China
  • Received:2019-08-06 Revised:2020-02-06 Online:2020-05-01 Published:2020-05-08
  • Contact: Yanmin Wu E-mail:wuyanmin@zju.edu.cn
  • Supported by:
    Public Welfare Research Program of Science and Technology Department of Zhejiang Province(LGF18H140003)

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Abstract:

Papilla loss due to periodontal tissue defects could lead to aesthetic problems, food impaction, gingivitis, and pronunciation problems. Periodontal surgery and non-surgical treatment are the major solutions to preserve or reconstruct the gingival papilla. Relative periodontal surgery includes special surgical incisions to reduce papilla loss and application of soft tissue grafts or substitutes for papilla reconstruction. Sufficient blood supply is the key to successful periodontal mucogingival surgery. This article aims to review the specific role of periodontal surgery in the preservation and reconstruc-tion of gingival papilla.

Key words: gingival papilla preservation, gingival papilla reconstruction, subepithelial connective tissue graft

CLC Number: 

  • R781.4 +5

TrendMD: 

Fig 1

Schematic view of the papilla preservation flaps"

Tab 1

Papilla preservation flaps of periodontal plastic surgery"

手术术式 切口设计 操作步骤 主要适用手术
沟内 龈乳头 垂直
切口 切口 切口
保留牙龈乳 保留牙龈乳头切口 + - - 绕邻牙一周作沟内切口,在腭侧作弧形切 引导组织再生术（牙间隙
头切口 口,将完整保留的龈乳头连在唇瓣上 充分时）
改良的保留牙龈乳头切口 + - - 绕邻牙一周作沟内切口,在唇侧作弧形切
口连接邻牙近中轴角,将完整保留的龈乳
头连在腭瓣上
简化的保留牙龈乳头切口 + + - 绕邻牙一周作沟内切口,在牙间龈乳头上作 引导组织再生术（牙间隙
一牙颊侧近中轴角向邻牙邻面中点的切口 不充分时）
“鲸尾”技术 “鲸尾”技术 + - + 在骨缺损累及的2颗患牙的远缺损处,沿远 引导组织再生术（前牙区
中轴角各作一垂直切口,垂直切口延伸至 垂直骨缺损）
膜龈联合,其终点作水平切口相连,绕邻
牙一周作沟内切口,龈乳头保留在唇瓣上
改良 “鲸尾”技术 + - + 在骨缺损累及的2颗患牙的远缺损处,沿远
中轴角作2个半月形切口代替垂直切口和水
平切口至膜龈联合处
全牙龈乳头 + - + 在颊侧做沟内切口,然后在远离患牙骨缺 引导组织再生术（后牙区
保留技术 损处作一垂直切口,翻开全厚瓣,用显微 垂直骨缺损）
器械分离骨缺损处牙龈乳头,提升完整的
牙龈乳头
非牙龈乳头 - - - 仅作一颗患牙颊侧根方的水平切口,切口 引导组织再生术（颊侧骨
切口 尽可能远离骨缺损和龈缘,冠向翻起黏骨 壁吸收）
膜瓣
隧道技术 + - + 沿患牙颈部作沟内切口,然后在非直视下 根面覆盖
利用隧道专用显微器械分离颊侧半厚瓣至
膜龈联合处

Fig 2

Schematic view of whale’s tail techniques"

Fig 3

Schematic view of entire papilla preservation technique"

Fig 4

Schematic view of nonincised papillae surgical approach"

Fig 5

Schematic view of tunnel technique"

Fig 6

Schematic view of papilla preservation flaps in second-stage implant surgery"

Fig 7

Schematic view of Beagle’s technique"

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