Published in September 1987
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
web site


Key words
blood coagulation, fibrin, thrombin, tissucol

Use in difficult anatomical sites
30. Root of a 3.3 in foreground seen from the vestibular side; in the background (reflected in the mirror) seen from the lingual side; it is surrounded by very little adhering gum and the destruction of the hard tissues of the tooth extends well below the gum. 31. A vestibular flap and a lingual flap are sculpted and repositioned apically. The lingual flap is sutured with single stitches.
32. The lingual flap after suturing with fibrin glue. 33. After one month the root can be attacked: a fixed gold core and a temporary denture are prepared.
34. After 4 months the tissues are perfectly healed. 35. After another 4 months the fixed denture with attachments can be constructed.
36. The two elements mesial to the attachment have been milled.
37. The actual milling and the drive bar during insertion of the mobile prosthesis on the fixed gold-platinum-porcelain one.
38. Insufficient adhering gum at 1.5. 39. Two mucoperiosteal flaps are sculpted.
40. They are sutured with Tissucol at 4 I.U./ml and a coronal safety stitch is also applied (the area undergoes very strong muscular tension).
41. The sites from which the mucoperiosteal flaps were taken are protected with amniotic membrane sutured with Tissucol.
42. Appearance of the tissue after 6 months. The increase in adhering gum is slight but sufficient. 43. After 12 months the gold-platinum-porcelain denture is constructed.

1.GOTTLOW, J., NYMAN, S., LINDHE, J., KARRING, T. & WENNSTROM, J.; "New attachment formation in the Human periodontium by guided tissue regeneration. Case reports", J. Clin. Periodontol, 6: 604-615, 1986
2. KARRING, T., NYMAN, S. & LINDHE, J.; "Healing following implantation of periodontitis affected roots into bone tissue", J, Clin. Perio- dontol., 7: 96-105, 1980
3. MAGNUSSON, I., NYMAN, S., KARRING, T. A ELGEBERG, J.; "Connective tissue attachment formation following exclusion of gingival connective tissue and epithelium during healing", J. Period. Res., 20: 201-208, 1985
4. NYMAN, S., GOTTLOW, J., KARRING, T. & LINDHE, J.; "The regenerative potential of the periodontal ligament. An experimental study in the monkey", J. Clin. Periodontol., 9: 257-265, 1982
5. NYMAN, S.,KARRING, T., LINDHE, J., & PLANTEN, S.; "Healing following implantation of periodontitis affected roots into gingival connective tissue", J. Clin. Periodontol, 7: 394-400, 1980
6. PETTI, G.; "L'impiego di membrana amniotica a protezione della zona donatrice di un innesto libero", Il Dentista Moderno, (IV) 5: 895-897, 1986
7. PETTI, G.; "Le metodiche attuali per il trattamento chirurgico ricostruttivo dei difetti ossei", Il Dentista Moderno, (IV) 5: 817-832, 1986
8. PETTI, G.; "L'impiego della membrana amniotica in chirurgia ossea", Il Dentista Moderno, (IV) 9: 1677-1682, 1986
9. PETTI, G.; "Considerazioni sull'uso della membrana amniotica", Il Dentista Moderno, (V) 1: 97-102, 1987
10. PETTI, G.; "Lembo trapezoidale mucoperiosteo e innesto libero di gengiva per il trattamento di una fistola oro antrale cronica", Il Dentista Moderno, (III) 5: 865-870, 1985