In this case, deep periodontal defects are treated in the posterior region of the right mandible. For the planned guided tissue regeneration a full thickness flap is prepared. Using the modified papilla preservation technique, the incision on the facial side goes through the area of the papillae. Careful elevation of the flaps in the buccal and the lingual area is performed. According to the modified papilla preservation technique the papillae are mobilized with the lingual flap towards the lingual area.
Once the defects are accessible the exposed root areas are cleaned and granulation tissue has to be removed thoroughly. Proper root cleaning and wound debridement is crucial for a successful outcome of the regenerative treatment. Once the clean root surfaces are conditioned with Straumann PrefGel, Straumann Emdogain is applied while neither blood nor saliva should contaminate the pretreated root surfaces. The surgeon uses a mixture of “BioOss” (xenogenic hydroxyapatite) and autogenous bone, which is harvested from the mandible, to fill up the periodontal defects.
On top a “Bio-Gide” collagen membrane is placed to prevent any gingival cells from migrating into the defect area. Finally, a proper and tension-free flap reposition and wound closure is important to reduce the risk of postoperative infections. Since monofilament materials prevent plaque accumulation, the applied Gore-Tex (monofilament) sutures also help to avoid the development of infections. In addition, antibiotics are administered.