Evolucija dizajna režnja u parodontnoj kirurgiji

master's thesis

• Title (english): Evolution of flap design in periodontal surgery
• Author: Mirjam Nižetić
• Mentor: Darije Plančak (mentor)
• Committee member: Darije Plančak (predsjednik povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Committee member: Larisa Musić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Periodontology); Zagreb
• Defense date and country: 2022-09-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Periodontology

Abstract

Pojam parodontne kirurgije podrazumijeva kirurške postupke čiji je cilj ponovno
uspostavljanje normalne funkcije ili izgleda potpornih tkiva zuba kao posljedice parodontitisa
ili drugih neupalnih uzroka. Uspjeh parodontološkoga kirurškog zahvata ovisi o različitim
faktorima, uključujući vještine operatera i odabir pacijenta, te adekvatan odabir tehnike s
obzirom na individualan klinički nalaz. U regenerativnoj, rekonstruktivnoj parodontološkoj
kirurgiji odabir dizajna režnja i prigodne tehnike šivanja preduvjet su za uspješan ishod. Cilj
im je osigurati uvjete za odgovarajuću stabilnost rane, primarno zatvaranje te time i primarno
cijeljenje tkiva, što omogućuje nesmetano formiranje te sazrijevanje podležećega tkiva. U
tome smislu, dizajn režnja i tehnika šivanja čine najveću ulogu u postizanju maksimalnoga
potencijala rekonstruktivnih materijala kao što su membrane, nadomjesni materijali i biološki
agensi. Iz povijesne perspektive, evolucija kirurških tehnika započinje tehnikama
gingivektomije u drugoj polovici 19. stoljeća, nakon čega kreće razvoj ranih kirurških tehnika,
tzv. operacije režnja. Glavna problematika klasičnih pristupnih režnjeva jest nemogućnost
postizanja primarnoga zatvaranja rane, što je potaknulo evoluciju dizajna režnja u smislu
očuvanja suprakrestalnih interdentalnih mekih tkiva. Kirurške tehnike “očuvanja papile”
mogu podrazumijevati obostrano odizanje režnja uz uključivanje cijele papile u jedan od
režnjeva (PPT, ITM, MPPT i SPPT), jednostrano odizanje režnja uz neodizanje
interdentalnoga tkiva (SFA i M-MIST) ili čak potpuno očuvanje integriteta papile uz
intrakoštani defekt (EPPT). Posljednje tehnike upotrebom mekotkivnih transplantata
omogućuju, uz koštanu regeneraciju, i mekotkivnu rekonstrukciju.

Abstract (english)

The term periodontal surgery includes surgical procedures that aim to restore the normal
function or appearance of the supporting tissues of the teeth that are affected by periodontitis
or other non-inflammatory causes. The success of periodontal surgery depends on various
factors including operator's skills, patient selection and appropriate choice of techniques when
considering an individual's clinical findings. In regenerative, reconstructive periodontal
surgery, the choice of flap design and appropriate suturing techniques are a precondition for a
successful outcome of the surgery. Their goal is to ensure the conditions for the appropriate
stability of the wound and primary closure hence primary healing of the tissue, which enables
unhindered formation and maturation of the underlying tissue. In this sense, both flap design
and suturing technique play the greatest role in achieving the maximum potential of
reconstructive materials such as membranes, replacement materials and biological agents.
From a historical perspective, the evolution of surgical techniques begins with gingivectomy
techniques in the second half of the 19th century, after which the development of early
surgical techniques, commonly named flap operations, began. The main problem of the
classic access flaps is the inability to achieve primary wound closure, which prompted the
evolution of the flap design in order to preserve the supracrestal interdental soft tissues.
Surgical techniques of "preservation of the papilla" can include bilateral flap elevation with
the inclusion of the entire papilla in one of the flaps (PPT, ITM, MPPT and SPPT), unilateral
flap elevation without lifting interdental tissue (SFA and M-MIST), or even complete
preservation of the integrity of the papilla with an intraosseous defect (EPPT). With the use of
soft tissue grafts, the latest techniques enable, in addition to bone regeneration, also soft tissue
reconstruction.

• Keywords: parodontitis; oralnokirurški postupci; cijeljenje rane; kirurški režnjevi
• Keywords (english): Periodontitis; Oral Surgical Procedures; Wound Healing; Surgical Flaps
• Language: croatian
• URN:NBN: urn:nbn:hr:127:190167
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Promjena prezimena u Blaguški, Mirjam
• Created on: 2022-11-29 10:08:18