14 במרץ 2024 – סדנה מעשית עם Dr. Snjezana Pohl

The conventional approach for achieving primary wound closure following grafting procedures typically involves the coronally advanced flap (CAF) technique. However, CAF may lead to the mucogingival junction’s displacement, the vestibulum’s flattening, and a reduction in the width of the keratinized gingiva.

An alternative approach involves applying pedicle connective tissue flaps, where exposed palatal or buccal pedicled connective tissue is allowed to heal by secondary intention. This approach may reduce or eliminate the need for CAF.

The pedicle connective tissue graft maintains its blood supply, allowing graft survival even in poorly vascularized or nonvascularized recipient sites.

BSPPF (Buccal Sliding Palatal Pedicle Flap)

In the maxilla, a buccal sliding palatal flap can be utilized for primary wound closure after ridge augmentation. This technique involves exposing a portion of the palatal connective tissue, eliminating or reducing the need for coronal flap advancement, and increasing the amount of keratinized gingiva. Combined with guided soft tissue augmentation, this flap design enables three-dimensional peri-implant soft tissue augmentation.

mIVAN Technique (Modified Interpositional Vascularized Augmentation Neogenesis)

The mIVAN technique employs a palatal pedicle connective tissue graft for simultaneous hard and soft tissue grafting. It can be used for two main purposes:

1. Flap-less hard and soft tissue augmentation in extraction sockets with missing labial bone.
2. Hard/soft tissue augmentation with simultaneous implant placement for ridges demonstrating horizontal atrophy in the esthetic zone.