MODIFIED VERTICAL MATTRESS SUTURING TECHNIQUE FOR FLAP APPROXIMATION AFTER RAMPING – A MODIFIED RESECTIVE OSSEOUS SURGICAL PROCEDURE

Purpose of this study is to evaluate the efficacy of modified vertical mattress suturing technique for flap approximation after ramping – a modification of resective osseous surgical procedure. Eighteen patients requiring periodontal surgery for pocket therapy were included in the study. The preoperative gingival and periodontal conditions were evaluated and intraoral radiographs were taken to identify the osseous defect. Shallow Craters present in the interdental regions towards the palatal surface were treated by ramping. On completion of the procedure, flaps were approximated for the final suturing. Suturing is done by a modification of vertical mattress suturing method using 4-0 silk sutures. The surgical sites were evaluated at the conclusion of the surgery, during suture removal and one month post-operative. The outcomes were evaluated in terms of patient’s comfort, surgical flap approximation, complications and post– operativerecessions. Complete closure of wound and good flap approximation was achieved in all cases immediately after the surgery. Except for three patients with delayed wound healing at suture removal, all other patients displayed rapid healing without any discomfort. No noticeable defect was seen in the healing of the interdental papilla on the buccal aspect. Embrasure spaces on the buccal surface were completely filled by interdental papilla during the one month review period. In patients undergoing resective osseous surgery by ramping that result in two different planes for flap approximation, the modified vertical mattress suturing technique proves to be a reliable and an effective method of suturing.