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Preprosthetic surgery 40

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Preprosthetic surgery 45

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http://refimgshow%283%29/http://refimgshow%284%29/http://refimgshow%282%29/

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Suture Type Resorption Rate Tensilestrength Tissuereaction Uses

Chromic Gut 7-10 days by

proteolytic enzymatic

digestive process

+ Moderate Rapidly healing

mucosa

Avoid suture

removal

Coated Vicryl 56-70 days, by slow

hydrolysis

+++ Minimal Resist muscle pull,

subepithelial

mucosal surfaces,

resorbable

Surgical Silk Non-resorbable(gradual

encapsulation by

fibrous CT)

++ Moderate Mucosal surfacesNon-resorbable

ePTFE

(Gore-Tex)

Non-resorbable +++ Extremely

low

All types of tissue

approximation

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Silverstein LH. Principles of Dental Suturing

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Silverstein LH. Principles of Dental Suturing

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Silverstein LH. Principles of Dental Suturing

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Silverstein LH. Principles of Dental Suturing

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Silverstein LH. Principles of Dental Suturing

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The basic methods used for sterilization ofinstruments are: dry heat, moist heat(autoclave), chemical means, and sterilizationwith ethylene oxide.

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The first principle is that a sharp blade of the proper size should be used.

The second principle is that a firm, continuous stroke should be used when incising. The base of the flap must be broader than free margin to preserve an adequate blood

supply. generally the length of a flap should be no more than twice the width of the base. when possible, an axial blood supply should be included in the base of the flap. the base of flaps should not be excessively twisted, stretched, or grasped The flap must be of adequate size.

Adequate access must be there for insertion of instrument. The flap must be held out of the operative field by retractor must be on intact bone. The incision should be sharp. Incisions should be long, straight with adeqaute flap reflection. Envelop flap should be adequate in size i.e. two tooth anterior and one tooth posterior. releasing incision should be on one tooth anterior and one tooth posterior. Flap should be full thickness mucoperiosteal flap. Incision must be made on intact bone. Outline of flap should be atleast 6 to 8 mm away from pathologic condition. If bone is to be removed then incision should be made away from the bony defect. Flap should be designed to avoid injury to local vital structures in the area of the surgery. Vertical releasing incision should be avoided. Vertical releasing incision should cross the free gingival margin at the line angle of the

tooth. Should not be directed on facial aspect or on papilla.

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Silverstein LH. Principles of Dental Suturing

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