Given the location, it seems to me that using a continuous suture would not present the same danger of popping open that other suture locations would because that area of tissue does not stretch much. Other than for closing gums after tooth removal do you ever find a need to use a non-continuous suture technique?
Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.
i had this twice, doesnt happen because you dont take care of you teeth. my gums were receding due to excessive grinding and brushing (due to OCD I think). Each section was around $3800 (3 teeth or so covered). I have insurance. 2nd procedure cost me $175 out of pocket (3 insurance policies).
@reddsofine1 if you live in a country with socialized medicine/dentistry it should be free! However here in the Bay Area of California it costs about $1200 (or more).
@fatma619 omg of course the patient was anesthetized. He was also premedicated with a pain med, Anaprox which he took for a day only. It is amazing to have patients heal with very little discomfort, if any. Microscopic procedures heal faster and preemptive pain management makes a big difference. Dr. Kwan
@Habiat23 mouthwash is good for tissues that it can reach. For periodontal pocketing it does little. Non-alcohol based mouthwashes are less desicating to the mucosa.
Great suture technique, thanks for passing that on. At the recipient site the apical mucosal margin is not sutured and allowed to passively adapt to the superior edge of the sutured graft or do you tack it down also? Could you please share the video camera brand/setup you are using also? The quality is great and I would like to do some video in my office to share with my patients. Thanks!
@tzucuskie the apical margin of the mucosa is not tacked down separately; it just heals by secondary intention to the apical margin of the graft. I use a Global scope with a beam splitter to a Sony camcorder. I record on DV tapes and keep a library of tapes/pts. Each pt has their own tape so I can record post ops and other follow ups.
AlloDerm does not increase the keratinized gingiva. This is a palatal gingival graft (not CT), which is noted in the harvest of the donor tissue. CT is from under a flap on the palate. See CTG videos on periEau channel. With such floppy mucosa, gingival grafting gives you bound down keratinized gingiva.
The graft was thinned to a uniform thickness with the scalpel and what I was removing was fat from the palate. AlloDerm is an alternative graft material that MUST be COVERED and can be used as an alternative to CT grafting from the palate. In certain instances CTG is still preferred.
Don't get too aggressive with the tooth brush because we know the more fastidious the patient the more recession we see. Recession is not just a plaque related issue.
Given the location, it seems to me that using a continuous suture would not present the same danger of popping open that other suture locations would because that area of tissue does not stretch much. Other than for closing gums after tooth removal do you ever find a need to use a non-continuous suture technique?
azreal289 1 week ago
@azreal289 other than this type of suturing I hardly ever use continuous suturing. Either single interrupted or single sling is what I use normally.
perieau 1 week ago
Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.
Dental40 2 months ago
gross.
v81234567 4 months ago
gj doc looks very good...
fighter199212 4 months ago
i had this twice, doesnt happen because you dont take care of you teeth. my gums were receding due to excessive grinding and brushing (due to OCD I think). Each section was around $3800 (3 teeth or so covered). I have insurance. 2nd procedure cost me $175 out of pocket (3 insurance policies).
WolffFinancial 4 months ago
How much does this surgery cost?
reddsofine1 5 months ago
@reddsofine1 if you live in a country with socialized medicine/dentistry it should be free! However here in the Bay Area of California it costs about $1200 (or more).
perieau 5 months ago
Now I bet he can eat only herbalife after ...
MrGottmog 5 months ago
Omg, please tell me this person didn't feel all that! Now I don't think I want to go back to the dentist, I'd rather have no teeth!
fatma619 5 months ago
@fatma619 omg of course the patient was anesthetized. He was also premedicated with a pain med, Anaprox which he took for a day only. It is amazing to have patients heal with very little discomfort, if any. Microscopic procedures heal faster and preemptive pain management makes a big difference. Dr. Kwan
perieau 5 months ago
-shivers- WTF
BluegemFreak 6 months ago
i think ima go brush my teeth now.........
coolcat10fromecobuds 7 months ago
After seeing this, i brushed my teeth, flossed, and used mouthwash... I don't want this to happen to me
128BitProductions 7 months ago
I'm having a gum graft soon. I probably shouldn't have watched this video..
glamagogo 9 months ago
My gingivitis isn't this bad, but I think I need grafting on my bottom gums. YIKES!
DbleBubbleBish 9 months ago
watching this makes me want to go brush my teeth. Infact, brb.
noobcake19 10 months ago 6
@noobcake19 and floss.
perieau 10 months ago 3
@perieau What's your view on mouthwash?
Habiat23 8 months ago
@Habiat23 mouthwash is good for tissues that it can reach. For periodontal pocketing it does little. Non-alcohol based mouthwashes are less desicating to the mucosa.
perieau 8 months ago
@perieau so you're saying non-alcohol mouth wash is better?
PeriquinTV 7 months ago
@PeriquinTV if you feel compelled to use it.
perieau 7 months ago
Is it possible to use alloderm in this case?
yoyoimut 10 months ago
I had a gum graft too. it sucks
connordance 1 year ago
@connordance I guess anything is possible but in this case I felt this would give us the most stable and predictable result.
perieau 10 months ago
A wouldn't this be a bit easier with a Castroviejo instrument from Hu-Freidy?
MsSun123 1 year ago
Great suture technique, thanks for passing that on. At the recipient site the apical mucosal margin is not sutured and allowed to passively adapt to the superior edge of the sutured graft or do you tack it down also? Could you please share the video camera brand/setup you are using also? The quality is great and I would like to do some video in my office to share with my patients. Thanks!
tzucuskie 1 year ago
@tzucuskie the apical margin of the mucosa is not tacked down separately; it just heals by secondary intention to the apical margin of the graft. I use a Global scope with a beam splitter to a Sony camcorder. I record on DV tapes and keep a library of tapes/pts. Each pt has their own tape so I can record post ops and other follow ups.
perieau 1 year ago
nice job
keep uploading vids on youtube
tnx
i am a dentistry student
so long
sportmaniravoote 1 year ago
great work.
but plz tell me how to place a perio pack at that palatal's donor site.?
drabod 1 year ago
@drabod , we do not place perio pack on the palate, we use an acrylic stent
perieau 1 year ago
@perieau
sorry ,i think i have to refresh my knowledge in periodontolgy field.
but i remeber when i was in egypt that the acrylic stent dosent stick as well.
drabod 1 year ago
i think the result with gingiva not attached with teeth make me sad :)
wael7t7 1 year ago
sushi chef ??? that's nice hahaha, what do you want to be in the next? a fisher man? or why do you manipulate so nice that suture??? hahaha.
thank you for the video is very nice? do you use a microscope when you make this surgeries?????
fenrrirjosr 2 years ago
great video! just few questions..
did u use Aloderm to increase the amount of keratinized ginigva? if so, why did take graft from the palate.
the graft from the palate: was it a ct graft?
sorry i didnt understand the rational and steps in this procedure.
looking forward to ur answers.. ty
unicorneto 2 years ago
AlloDerm does not increase the keratinized gingiva. This is a palatal gingival graft (not CT), which is noted in the harvest of the donor tissue. CT is from under a flap on the palate. See CTG videos on periEau channel. With such floppy mucosa, gingival grafting gives you bound down keratinized gingiva.
perieau 2 years ago
of course.. sorry for the stupid question,,the movie stopped before the ending,,now i understand:
it was a free gingval graft taken from the palae. what was it that u cleaned away from the graft with the scalpel before placing it?
and just to clear 1 point, alloderm comes to replace ct grafing from the palate right?
ty and once again u work amazing
unicorneto 2 years ago
The graft was thinned to a uniform thickness with the scalpel and what I was removing was fat from the palate. AlloDerm is an alternative graft material that MUST be COVERED and can be used as an alternative to CT grafting from the palate. In certain instances CTG is still preferred.
perieau 2 years ago
Thank you for this video!
rubikbg 2 years ago
Wow, that looks really bad. Thank god for the man who invented the toothbrush, cause thats what ill be using to prevent this.
Yoshi4d 2 years ago
Don't get too aggressive with the tooth brush because we know the more fastidious the patient the more recession we see. Recession is not just a plaque related issue.
perieau 2 years ago