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Clinical Cases in Periodontics


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5.2.16 (A, B) Covering lingual recession.Figure 5.2.17 (A, B) Root coverage and ridge augmentation prior to a fixed b...

      25 Chapter 5.3Figure 5.3.1 Initial presentation: mandibular anterior area.Figure 5.3.2 Probing pocket depth, keratinized gingiva, and recession measur...Figure 5.3.3 Periapical radiographs depicting the interproximal bone levels....Figure 5.3.4 Preparation of the recipient site.Figure 5.3.5 Harvesting of epithelio‐connective tissue graft from the palata...Figure 5.3.6 Epithelio‐connective tissue graft sutured to the recipient bed....Figure 5.3.7 Recipient and donor sites were protected with periodontal dress...Figure 5.3.8 Postoperative follow‐up: (A) two weeks; (B) one month; (C) four...Figure 5.3.9 (A) Preoperative site demonstrating unfavorable soft tissue ana...Figure 5.3.10 (A) Implant site with deficient keratinized tissue. (B) FGG pl...Figure 5.3.11 (A, B) FGG after implant placement, but prior to implant resto...Figure 5.3.12 Epithelio‐connective tissue palatal pedicle graft performed du...Figure 5.3.13 Connective tissue used as a free graft. (A) Recession associat...Figure 5.3.14 Connective tissue used as a free graft. (A) Recession associat...Figure 5.3.15 Root coverage with FGG. (A) Recession and mucogingival involve...Figure 5.3.16 Long‐term stability (over 15 years) of FGG #22–27. Note buccal...

      26 Chapter 5.4Figure 5.4.1 Preoperative presentation.Figure 5.4.2 Probing pocket depths and recession measurements.Figure 5.4.3 Bitewing radiographs.Figure 5.4.4 Periapical radiographs of area of teeth #6–11.Figure 5.4.5 Initial incisions and tunneling procedure.Figure 5.4.6 Tunneling procedure complete and full release of the buccal fla...Figure 5.4.7 Passive placement of buccal flap.Figure 5.4.8 Contouring ADM try‐in on area of teeth #6–11 and being inserted...Figure 5.4.9 Subpapillary continuous sling suturing method completed.Figure 5.4.10 One‐week follow‐up visit, frontal view.Figure 5.4.11 One‐week follow‐up visit, right and left side views.Figure 5.4.12 Six‐week follow‐up visit, frontal view.Figure 5.4.13 Six‐week follow‐up visit, right and left side views.Figure 5.4.14 Four‐month follow‐up visit.

      27 Chapter 5.5Figure 5.5.1 Preoperative presentation: (A) buccal view; (B) occlusal view....Figure 5.5.2 Probing pocket depth measurements during initial visit.Figure 5.5.3 Maxillary labial frenectomy. (A) Preoperative presentation. (B)...Figure 5.5.4 Mandibular lingual frenectomy: (A) preoperative presentation; (...Figure 5.5.5 Mandibular lingual frenectomy using carbon dioxide laser surger...Figure 5.5.6 Vestibuloplasty clinical photos taken (A) preoperatively; (B) d...

      28 Chapter 5.6Figure 5.6.1 Clinical presentation.Figure 5.6.2 Periodontal chart.Figure 5.6.3 Periapical radiographs.Figure 5.6.4 Vertical vestibular incision to provide access.Figure 5.6.5 Use of specific instruments designed for the VISTA procedure.Figure 5.6.6 Preparing and adapting the soft tissue alternative (ADM).Figure 5.6.7 Subpapillary suturing technique.Figure 5.6.8 Presentation at four weeks post surgery.Figure 5.6.9 Presentation at 12 weeks post surgery.

      29 Chapter 6.1Figure 6.1.1 Initial picture of the bridge.Figure 6.1.2 Periapical radiographs: (A) teeth #2–5; (B) tooth #2; (C) tooth...Figure 6.1.3 Complete mouth series of radiographs taken a year following the...Figure 6.1.4 Periodontal chart illustrating the full‐mouth probing depth mea...Figure 6.1.5 Initial picture of the maxillary right bridge of teeth #2–4.Figure 6.1.6 Periapical radiograph depicting the gutta percha in the distal ...Figure 6.1.7 Periapical radiograph of the right‐side molar region depicting ...Figure 6.1.8 Periapical radiograph of tooth #2.Figure 6.1.9 Periapical radiograph of the right‐side molar region following ...Figure 6.1.10 Bitewing radiograph of the right‐side molar region one year af...Figure 6.1.11 Chronologic six‐year sequence showing no apparent radiographi...Figure 6.1.12 Tooth #2 with a 10‐mm pocket in the distal with a gutta perch...Figure 6.1.13 Clinical picture with gutta percha point.Figure 6.1.14 No soft tissue inflammation.Figure 6.1.15 Abrasion.Figure 6.1.16 Thermal injury: large uninsulated metallic restoration.Figure 6.1.17 Chemical irritation.Figure 6.1.18 Bacterial effect: caries. Source: courtesy of Dr. Victor Ratk...Figure 6.1.19 Bruxism (parafunctional habit).Figure 6.1.20 Apical foramen communication.Figure 6.1.21 Lateral accessory canal. Source: courtesy of Dr. Victor Ratkus...Figure 6.1.22 Dentinal tubules containing bacterial organisms. Source: cour...Figure 6.1.23 Furcation involvement lateral canal. Source: courtesy of Dr. ...Figure 6.1.24 (A–C) Cracked teeth (roots) and vertical fracture.Figure 6.1.25 Draining sinus tract.

      30 Chapter 6.2Figure 6.2.1 Preoperative right view of centric occlusion.Figure 6.2.2 Preoperative photo of articulated diagnostic casts.Figure 6.2.3 Preoperative frontal view of centric occlusion.Figure 6.2.4 Preoperative occlusal view of maxilla.Figure 6.2.5 Preoperative occlusal view of mandible.Figure 6.2.6 Initial periodontal probing measurements.Figure 6.2.7 Preoperative full‐mouth series radiographs.Figure 6.2.8 Occlusal view of maxillary teeth on removal of crowns. Note sho...Figure 6.2.9 Maxillary teeth immediately following crown lengthening.Figure 6.2.10 Clinical view of gold dome coping at time of solder relation....Figure 6.2.11 Right view of metal frameworks showing tooth #31 shortened and...Figure 6.2.12 Left view of metal frameworks showing gold dome coping on toot...Figure 6.2.13 Facial postoperative view.Figure 6.2.14 Right postoperative view.Figure 6.2.15 Left postoperative view.

      31 Chapter 6.3Figure 6.3.1 Maxillary occlusal view.Figure 6.3.2 Mandibular occlusal view.Figure 6.3.3 Intraoral frontal view.Figure 6.3.4 Intraoral right buccal view.Figure 6.3.5 Intraoral left buccal view.Figure 6.3.6 Panoramic radiograph.Figure 6.3.7 Lateral cephalogram.Figure 6.3.8 Start of orthodontic treatment.Figure 6.3.9 Four weeks later.Figure 6.3.10 Canine exposure.Figure 6.3.11 Gold chains attached to exposed canines.Figure 6.3.12 Gold chains ligated to the maxillary archwires.Figure 6.3.13 Periodontal pack placed over the exposure.Figure 6.3.14 One‐week follow‐up.Figure 6.3.15 Two‐week follow‐up.Figure 6.3.16 Both maxillary and mandibular arches are bonded.Figure 6.3.17 Retraction of palatally displaced canines and occlusal view of...Figure 6.3.18 Periapical radiographs showing a displaced right maxillary can...Figure 6.3.19 A three‐dimensional reconstructed image of the patient’s teeth...Figure 6.3.20 CBCT images of a patient with impacted maxillary anterior teet...Figure 6.3.21 CBCT image showing impacted maxillary central incisors with po...

      32 Chapter 6.4Figure 6.4.1 Initial examination: (A) extraoral images; (B) panoramic radiog...Figure 6.4.2 Intraoral photographs.Figure 6.4.3 Intraoral photographs: tunneling and bone grafting procedure.Figure 6.4.4 (Top left) Preoperative radiograph. (Top right) Postoperative r...Figure 6.4.5 After orthodontic treatment.

      33 Chapter 6.5Figure 6.5.1 Pretreatment periodontal charting.Figure 6.5.2 Pretreatment full‐mouth radiographs.Figure 6.5.3 (A, B) Maxillary and mandibular occlusal views.

      34 Chapter 6.6Figure 6.6.1 (A) Occlusal radiograph of maxilla. (B) Periapical radiograph....Figure 6.6.2 Periapical radiograph after splinting.Figure 6.6.3 Periapical radiograph after root canal therapy.Figure 6.6.4 Periapical radiograph.Figure 6.6.5 (A) Extraction; (B) bone graft; (C) suturing.Figure 6.6.6 Temporary prostheses.Figure 6.6.7 Postoperative view at one week.Figure 6.6.8 Temporary prosthesis.Figure 6.6.9 Five‐month postoperative radiograph.Figure 6.6.10 Five‐month postoperative view.Figure 6.6.11 Fourteen‐month postoperative view.

      35 Chapter 7.1Figure 7.1.1 Facial view of the maxilla and the mandible.Figure 7.1.2 Occlusal view of the maxilla.Figure 7.1.3 Probing pocket depth measurements.Figure 7.1.4 Radiographic evaluation: the periapical radiograph of the maxil...Figure 7.1.5 Cone beam CT scan of the maxillary right sinus. The Schneideria...Figure 7.1.6 Preoperative condition, buccal view.Figure 7.1.7 The lateral window is outlined with a piezotome.Figure 7.1.8 The Schneiderian membrane is elevated. A resorbable collagen me...Figure 7.1.9 The bone grafting material is placed into the sinus between the...Figure 7.1.10 A collagen membrane is placed over the lateral window.Figure 7.1.11 The flap is repositioned and sutured to achieve primary closur...Figure 7.1.12 Panoramic radiograph the day of the procedure.

      36 Chapter 7.2Figure 7.2.1 Facial view of the maxilla and the mandible.Figure 7.2.2 Occlusal view of the maxilla.Figure 7.2.3 Probing pocket depth measurements of the maxillary left quadran...Figure 7.2.4 Cone beam CT scan of the maxillary right sinus. The Schneideria...Figure 7.2.5 Full‐thickness palatal flap raised on #14 and #15 site.Figure 7.2.6 Pointed trephine to mark the osteotomy site.Figure 7.2.7 After the removal of bone core using ASBE trephine.Figure 7.2.8 Mushroom elevator is used to identify and lift sinus membrane....Figure 7.2.9 Mushroom elevator is used to pull out sinus floor (bone).Figure 7.2.10 Bone graft (FDBA) placed.Figure 7.2.11 Use of spreader to condense bone laterally as well as mesiodis...Figure 7.2.12 After use of spreader.Figure