Published in October 1995

Fibromatous epulis: deep surgical excision
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
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Extended osteotomy and osteoplastics are performed with a tungsten carbide rotating instrument (which caused less necrosis and therefore leads to less bone reabsorption following surgery). By osteotomy is meant surgical removal of the bone to which the periodontal ligament is attached and osteoplastics is removal of bone to which the periodontal ligament is not attached.
In the most delicate zone of the deep bone the operation continues with hand instruments such as bone scalpels, which are less damaging.
The operation is concluded. The problem is that there is not enough gingival tissue to close the wound and suitably protect the bone.
For this reason an amniotic membrane is prepared in a sterile physiological solution.
With the wide portion of a Goldman periosteal separator the amniotic membrane is taken and laid on the instrument wet with physiological solution, being careful to position its trophoblastic side on the bone.
Fig. 17
The membrane carefully positioned on the bone with the edges inserted under the mucoperiosteal flap, thus completely covering the wound.
Fig. 18
The membrane is sutured to the flap and the two flaps to each other..
Fig. 19
The surgical pack is positioned to protect the wound.
Fig. 20
Result of the histological examination. Fibromatous epulis with phlogosis
Fig. 21
Healing is awaited.
Fig. 22
A denture is prepared, first temporary and later a gold-porcelain permanent one.



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