Papilla reconstruction (7 marks)

Introduction-
ü Gingiva
ü Parts of gingiva
ü Definition
Classification-
Norland and Tarnow classification
Need for papilla reconstruction
Keratinized tissue
Col-
Anterior- triangular Easiest way for the periodontal
Posterior- pyramidal disease to start
Procedures-

Techniques to cover black triangles

• Introduction
• Definition of Perio plastic surgery
• Procedures in PPS
• Techniques for black triangles:
1. Introduction – Gingiva, Parts of gingiva
2. Classification : Norland and Tarnow classification
3. Need to cover black triangles
4. Techniques
1) Sclar (2003) 2) Azizi (2001)
3) Takei and Han (1996) 4) Beagle
FGG (7 marks)
ü Introduction
Done to increase the width of the attached gingiva.
ü FGG- Coronal to the recession- for root coverage
Apical to the recession- increase the width of attached gingiva.
ü History
ü Indications
ü Contraindications
ü Advantages
ü Disadvantages
ü Techniques
ü Reasons for failure
ü Variants for the technique
Width of attached gingiva
1. Problems associated with the width of attached gingiva
2. History of the width of attached gingival surgical technique
3. Indications to increase width
4. The surgical techniques to increase the width of attached gingiva
Apically Positioned flap
Laterally positioned flap
FGG
C.T Free Autograft
§ Indications
§ C/I (Modifications)
§ Advantages
§ Disadvantages
§ Diagram (Surgical Technique )
Management of gingival recession (20 marks)

• Introduction
• Definition
• Pathogenesis of recession: Diagrammatic
• Classification : Millers, Sulivan and Atkins classification
• Indications
• Contraindications
• Root coverage aesthetic score: Miller, Rotundo, Cairon et al
• Classification for treatment: as described earlier
• Pre-requisite for successful root coverage ( Miller 1985)
• Techniques for root coverage:
- Every technique explain with author name, year and diagram,
explain variants or modifications.
- Predictability (Lindhe), look for systematic reviews, metaanalysis,
consensus reports and postion papers.
• Newer techniques attempted for root coverage.
• Conclusion
Soft tissue grafting -7 marks
• Introduction
• Need for soft tissue grafting

Soft tissue graft

Apical to recession - FGG
Coronal to recession - RC techniques
Papilla preservation
Ridge augmentation- Based on Siebert defect
CLP
Around Implants - FGG

• Soft tissue grafts and barrier membranes

• Recent advances and Conclusion
High frenum attachment
• Classification of frenal attachment
• History- Kazanjian teeth, modified Kazanjian technique
• Indication/ CI
• Technique- Frenectomy, Frenotomy (Laskin Book- Classic and Variant technique )
• Recent advances:
1. LLLT + MG procedure
2. Tissue engineering
3. MIST
4. Emdogain, PRF
• Mucogingival therapy in Implantology
• Conclusion
Perioplastic and esthetic surgical procedure
• Introduction
• Mucogingival to perioplastic : why????
• Procedures in PPS
• Root coverage: as above
• Width of attached gingiva : FGG as above
• High frenal attachment: as above
• Ridge augmentation : techniques, Diagrams
• CLP
• Prevention of ridge collapse (Socket preservation)
1. Socket shield technique
2. Ice cream cone technique
3. Other techniques
• Perioplastic and implants
• Conclusion

Mucogingival Surgical Procedure (20 marks)

Introduction- why the name mucogingival (Friedman 1957) Miller (1993)

Mucogingival surgical procedure (Friedman 1957)
ü Root coverage
ü Inadequate width of the attached gingiva
ü High frenal attachment
Root coverage
1. Classification (Lindhe 2008)
2. Pre requisite for successful root coverage
3. Criteria for successful root coverage (Miller 1985)

4) Techniques for root coverage-

Pedicle graft Soft tissue graft
1)Epithelised
Advanced Regenerative Rotational 2) Subepithelial

Coronally advanced Lateral Sliding flap

Semilunar Double papilla flap
Oblique rotated flap

5) Every technique-
Indication Diagram explaining the technique
C/I
Disadvantage
Healing Pedicle graft, FGG, CT in short)
Root surface in periodontics 20 marks
• Introduction:
- Anatomy of the periodontium with diagram.
• Terminologies related to root:
---- Root length
---- Root divergence
---- Root trunk
----- Root fornix
----- Root canal
• Changes seen on the root wall during pocket formation
• Role of root surface irritants like calculus, endotoxins
• Root diseases:
1. recession: etiology, definition, pathogenesis
2. Dihescene: etiology, definition, pathogenesis
3. Fenestration: etiology, definition, pathogenesis
4. Furcation: etiology definition, pathogenesis
• Management of root surface:
1. root planing
2. root conditioning
3. root coverage
• Conclusion