The purpose of this paper will to be to review indications, objectives, and technique of the double papilla flap.
Indication: trauma from incorrect toothbrushing, labial version to the approximate teeth., Prominent muscle attachment or frenulum, orthodontic movement, in treatment of root sensitivity. Choosing the double over the sliding: reduction of tension and pull on the repositioned flap and greater amount of gingiva in the interdental locations than on the adjacent labial or buccal surfaces.
Technique: it is like transplanting tissue by using two interdental pedicle flaps. Description as follows: donor site, preparation of the recipient site, suturing technique utilized to maintain the graft in position, placement of dressing to insure immobilization of the graft and causes of failure.
Initial prep: Sc/RP, tooth movement, OH, temporary stabilization, occlusal therapy, elimination of local factors. Labial version teeth cause undue stress on a graft.
Design: V-shaped wedge for the marginal tissue, partial thickness grafts consisting of vertical incisions at the line angles of adjacent teeth which extend into the mucosa. Horizontal incisions at the tip of the interdental papilla. Possible low-cut -back incision for mobility. Suture papilla starting at base, then papilla tips are slinged around the tooth. Dressing is placed for one week. Pressure is applied to eliminate dead space.
85% success in 5 years. Post-op probing 1 mm.
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