Block and Gingival Grafts

In addition to preparation for gingival graft, a block graft from the chin may be needed.  Prepare consent for periodontal surgery and write down the procedures.  Make a relatively extensive incision (Fig.1) and raise the buccal flap to expose and measure the defect. (Fig.2)  Use a 2nd #15 for the donor site incision.  A surgical bur is used to make a shallow cut and take PA to determine whether the apices of the lower incisors will be truncated or not.  Harvest the block graft according to the shape of the defect (Fig.3,4 green outlines).  Insert collagen plug in the donor site and press a 2x2 for hemostasis.  Trim and place lace the block graft in the defect and over the surface the abutment.  Use a fixation screw mesially (Fig.3,4 white circle with a cross).  PA will be taken to confirm the position of the screw tip.  Gingival graft will cover the cervix of the crown (Fig.3 blue curved line).  Use 27" Chromic gut suture for closure of the 3 wounds.  Prepare several carpules of 2% Xylocaine 1:50,000 Epinephrine for hemostasis.

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Xin Wei, DDS, PhD, MS 1st edition 01/24/2016, last revision 01/25/2016