Preprosthetic surgery

40

Preprosthetic surgery

43

Preprosthetic surgery

45

Suture Type Chromic Gut

Resorption Rate 7-10 days by proteolytic enzymatic digestive process 56-70 days, by slow hydrolysis

Tensile strength +

Tissue reaction Moderate

Uses Rapidly healing mucosa Avoid suture removal Resist muscle pull, subepithelial mucosal surfaces, resorbable Mucosal surfaces Non-resorbable

Coated Vicryl

+++

Minimal

Surgical Silk

Non-resorbable (gradual encapsulation by fibrous CT) Non-resorbable

++

Moderate

ePTFE (Gore-Tex)

+++

Extremely low

All types of tissue approximation

Silverstein LH. Principles of Dental Suturing

Silverstein LH. Principles of Dental Suturing

Silverstein LH. Principles of Dental Suturing

Silverstein LH. Principles of Dental Suturing

Silverstein LH. Principles of Dental Suturing

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

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.

Silverstein LH. Principles of Dental Suturing