Show and Tell Department of Periodontics

David Long, DDSL S U S c h o o l o f D e n t i s t r y

J u n e 9 t h , 2 0 1 8

Soft Tissue Surgery

Microsurgical Training

10-0 SuturesMock Ligation of an Artery

Patient MB

Localized Juvenile Spongiotic Gingival Hyperplasia

Initial Excisional Biopsy Histopathology

Courtesy of Dr. Katrina Cordell, LSU Oral Pathology

Connective Tissue Graft Coronally Advanced Flap

3 weeks 6 weeks

Initial 6 weeks

Lack of Attached Keratinized TissueLack of Vestibular Depth

Patient RB

Recipient site prepared FGG harvested

Initial 4 weeks2 weeks

Patient LPInitial

Recipient site preparation Lateral positioning of pedicle

2 weeks 4 months

4 monthsInitial

Esthetic Crown Lengthening

Patient TH

10 mm7.5 mm

9 mm 8.5 mm

7 mm7.5 mm

Asymmetrical Gingival Contour

GingivectomyInitial

Osseous RecontouringFlap Reflection

Closure 6 Months

Initial

6 months

Guided Tissue Regeneration

Patient DT

Initial- Buccal Initial- Lingual

Flap Reflection

Defect Grafted w/ FDBA + Collagen membrane

Closure

8 monthsInitial

Tissue Regeneration: Posterior Teeth

Initial

Initial

8 months

8 months

Tissue Regeneration: Anterior Region

Initial 8 months Initial 8 months

• 2015: Patient presented to LSU Periodontics for evaluation

• 2015 – 2017: Patient undergoes non-surgical therapy

• Late 2017: Presented unannounced with unusual request…

Patient JS

Patient LC Horizontal and Vertical Ridge Deficiencies

Initial Flap Reflection

Degranulation of lesion Defect Grafted with FDBA

Amnion-chorion membrane adaptation Closure

Initial 3 months post op

Guided Bone Regeneration, Sinus Augmentation,

& Dental Implants

Initial Reflection Intramarrow Penetrations FDBA + BioGuide + PRGF

Initial Two weeks Sectional CT confirming ridge augmentation

Pre-RAG 4 months Implant placement Closure Final Restoration

Patient AFInitial

CBCT Guided Implant Surgery - Anatomage

Surgical Guide Anchor Pins and Tissue Punches Implant Placement

4x implants placed at depth Post-placement Panorex

Closure with tissue punches 4 months post op 2 weeks post uncovery

Surgical ResultDigital plan

Patient PE

Surgical Plan:

• Extraction + ridge preservation of hopeless maxillary teeth

• Maxillary Right: Lateral Window Sinus Lift

• Maxillary Left: Implant placement with crestal sinus lift•• Mandibular Arch: Implant supported hybrid restoration

Extraction ridge preservationInitial

Extraction & Ridge Preservation

Maxillary Right- Lateral Window Sinus Lift

6 weeks post extraction Reflection

Window Preparation Lifting of Schneiderian Membrane

PRF + BioOss Xenograft BioGuide Membrane PRF Membrane

Primary Closure Graft Stability Verified

Hybrid Restoration: Mandible

Flap extension and reflection

Bone Reduction GuideCourtesy of Dr. Katie Chang

Bone Reduction

Bone Reduction

Osteotomy Preparation Implant Placement Verifying Primary Stability

6 x implants placed Multi-unit abutments seated Closure

Interim Hybrid Prosthesis DeliveredCourtesy of Dr. Katie Chang

Thank you• D r. P a l a i o l o g o u - G a l l i s

• D r. E v a n s

• D r. M a n e y

• D r. O w e n s

• D r. D r a g o n a s

• D r. S p i n d l e r

• D r. S i m m o n s

• D r. M c C a b e

• D r. I s l a m

• D r. S a e n z

• D r. P e a r s o n

• D r. C o m e a u x

• D r. F i n l e y

• D r. S o i l e a u

• D r. Sw e i d a n

• D r. L e s t e r

• D e l e t h i a S c o t t

• M e l i s s a J o h n s o n

• A l a n a H a r r i s

• M e r y O r e l l a n a

• L i z M a ye r

• S h e l l y K a t t e n g a l

• B o n n i e S t e p h a n y

• M y C o - R e s i d e n t s

• D r. H e r n a n d e z

• D r. J a c k s o n

• D r. B r i s c o