Published in October 1995
Fibromatous epulis: deep surgical excision
GUSTAVO PETTI
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
web site www.gustavopetti.it
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Fig.12
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.
Fig.13
In the most delicate zone of the deep bone the operation continues with hand instruments such as bone scalpels, which are less damaging.
Fig.14
The operation is concluded. The problem is that there is not enough gingival tissue to close the wound and suitably protect the bone.
Fig.15
For this reason an amniotic membrane is prepared in a sterile physiological solution.
Fig.16
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.

 

References

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  2. Moniaci D.,Migliario M.,Abrate A.,"La biopsia diagnostica in Chirurgia Orale : indicazioni e tecniche di esecuzione" XXIICongresso Naz. S.I.O.C.M.F.,Roma 6-9 Dic.1989 ,Atti,635-640.
  3. PETTI G.: "Restauro conservativo di un elemento dentale recuperato con intervento parodontale gengivale ed osseo", II Dentista Moderno, 7, 1340- 1343, 1985.
  4. Petti G. (1986) "Il trattamento dei difetti ossei nella chirurgia resettiva parodontale". Il Dentista Moderno, 3, 403-411.
  5. PETTI G.: "II trattamento dei difetti ossei nella chirurgia resettiva parodontale", II Dentista Moderno, 3, 403-41 l, 1986.
  6. Petti G. (1987) "Chirurgia ossea conservativa e resettiva" Elle/bi 10,137-143.
  7. PETTI G.: "L'uso della colla di fribrina umana in parodontologia", II Dentista Moderno, 7, 1987.
  8. Petti G. (1987) " L'impiego della colla di fibrina in Odomtostomatologia". Il Dentista Moderno 9, 1885-1908.
  9. Petti G. (1987) " Le caratteristiche e l'attività della colla di fibrina". Il Dentista Moderno 9, 1889-1891.
  10. Petti G. (1987) " L'impiego del Tissucol in chirurgia mucogengivale". Il Dentista Moderno 9, 1893-1901.
  11. Petti G. (1987) " L'uso della colla di fibrina in chirurgia ossea".Il Dentista Moderno 9, 1903-1908.
  12. Petti G. (1987) " Blending dell'innesto libero di gengiva e protezione del sito donatore con colla di fibrina".
    Odontostomatologia e implantoprotesi 4.
  13. Petti G. (1987) " Amniotic membrane used in periodontal surgery". Dental Abstracts (D A) U.S.A. , vol.32,2,64.
  14. Petti G. (1987) " Considerazioni sull'uso della membrana amniotica". Il Dentista Moderno 1, 97-102.
  15. Petti G. (1988) "L' impacco parodontale" Il Dentissta Moderno 12