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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
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Soft Tissue Surgery
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Microsurgical Training
10-0 SuturesMock Ligation of an Artery
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Patient MB
Localized Juvenile Spongiotic Gingival Hyperplasia
Initial Excisional Biopsy Histopathology
Courtesy of Dr. Katrina Cordell, LSU Oral Pathology
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Connective Tissue Graft Coronally Advanced Flap
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Lack of Attached Keratinized TissueLack of Vestibular Depth
Patient RB
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Recipient site prepared FGG harvested
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Initial 4 weeks2 weeks
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Patient LPInitial
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Recipient site preparation Lateral positioning of pedicle
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Esthetic Crown Lengthening
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10 mm7.5 mm
9 mm 8.5 mm
7 mm7.5 mm
Asymmetrical Gingival Contour
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GingivectomyInitial
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Osseous RecontouringFlap Reflection
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Guided Tissue Regeneration
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Initial- Buccal Initial- Lingual
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Defect Grafted w/ FDBA + Collagen membrane
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Tissue Regeneration: Posterior Teeth
Initial
Initial
8 months
8 months
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Tissue Regeneration: Anterior Region
Initial 8 months Initial 8 months
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• 2015: Patient presented to LSU Periodontics for evaluation
• 2015 – 2017: Patient undergoes non-surgical therapy
• Late 2017: Presented unannounced with unusual request…
Patient JS
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Patient LC Horizontal and Vertical Ridge Deficiencies
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Initial Flap Reflection
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Degranulation of lesion Defect Grafted with FDBA
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Amnion-chorion membrane adaptation Closure
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Initial 3 months post op
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Guided Bone Regeneration, Sinus Augmentation,
& Dental Implants
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Initial Reflection Intramarrow Penetrations FDBA + BioGuide + PRGF
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Initial Two weeks Sectional CT confirming ridge augmentation
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Pre-RAG 4 months Implant placement Closure Final Restoration
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Patient AFInitial
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CBCT Guided Implant Surgery - Anatomage
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Surgical Guide Anchor Pins and Tissue Punches Implant Placement
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4x implants placed at depth Post-placement Panorex
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Closure with tissue punches 4 months post op 2 weeks post uncovery
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Surgical ResultDigital plan
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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
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Extraction ridge preservationInitial
Extraction & Ridge Preservation
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Maxillary Right- Lateral Window Sinus Lift
6 weeks post extraction Reflection
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Window Preparation Lifting of Schneiderian Membrane
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PRF + BioOss Xenograft BioGuide Membrane PRF Membrane
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Primary Closure Graft Stability Verified
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Hybrid Restoration: Mandible
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Flap extension and reflection
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Bone Reduction GuideCourtesy of Dr. Katie Chang
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Osteotomy Preparation Implant Placement Verifying Primary Stability
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6 x implants placed Multi-unit abutments seated Closure
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Interim Hybrid Prosthesis DeliveredCourtesy of Dr. Katie Chang
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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