In this surgical video, Professor Hannes Wachtel repairs periodontal bone defects in the first quadrant (in the distal area of tooth 13 and 15) by filling them with Straumann Emdogain and autogenous bone chips. With a micro blade, Professor Wachtel first performs an incision along the sulcus and through the papillae in order to carefully lift a full thickness flap in the buccal area. He uses a papilla elevator to shift the buccal areas of the papillae towards the palatal region.
A full-thickness flap is also prepared in the palatal area to facilitate clear access to the bone defects in the interproximal spaces. The root surfaces are carefully cleaned, both using curettes and a diamond coated ultrasonic scaler. Complete removal of the granulation tissue is followed by the conditioning of the exposed root substance using EDTA (Straumann PrefGel). The surrounding bone is perforated in order to provoke bleeding into the defects.
Once Straumann Emdogain (enamel matrix proteins) is applied, autogenous bone chips are harvested from adjacent areas using piezoelectric surgery and are also inserted into the defects. Passive replacement of the two flaps and readaptation of the papillae without tension is essential to ensure long-term regeneration of the periodontal bone defects. Professor Wachtel completes the primary wound closure applying modified mattress sutures emphasizing that primary wound healing is a prerequisite for the success of regenerative periodontal surgery.