Comparison of the microvascular disruption and regeneration following full, partial, and modified partial thickness pedicle flaps in the alveolar mucosa of Macaca Mulatta
Price, Albert Merrill
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The microvascular disruption and regeneration following full, partial and modified partial thickness, replaced pedicle flaps was studied in the posterior buccal alveolar mucosa of nine adult Rhesus monkeys. The three flap types and six postoperative intervals ranging from zero to twenty-eight days were randomly distributed throughout seventy-two operative sites. Animals were perfused sequentially with physiologic saline, 10% neutral buffered formalin and black India ink through the right and left common carotids. After decalcification in Kristensen's solution the blocks were divided for histologic processing into stained microscope slides and thick cleared sections. Preoperative and postoperative quantitative measurements of mucogingival changes, bone crest level and clinical necrosis were correlated with microscopic and clinical observations and permitted the following conclusions: 1. There is no significant difference in crestal bone loss within the time period studied if supracrestal connective tissue is not disturbed; 2. A full thickness flap has about one-half the flap necrosis found in partial thickness flaps at four days, and this is related to minimal vascular disruption in full flaps; 3. The vascular disruption and subsequent flap necrosis found in partial thickness flaps is related to the total buccolingual thickness of the connective tissue covering the alveolus and this is related to site differences. The thinner this complex is, the more likely flap necrosis will occur; 4. The subpapillary plexus is continuous into the mucosal tissues and is an important supply to a pedicle flap; 5. The periosteal supply in the attached gingival zone is not the same as in the mucosa; 6. Attachment of full thickness flaps at twenty-eight days is by supracrestal connective tissue and scattered blood vessels which perforate the vestibular plate; and, 7. The microvascular net of the attached gingiva can be perfused from either coronal vessels (the supracrestal periodontal ligament extensions) or apical vessels (the vessels of corium or subpapillary plexus).
PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact firstname.lastname@example.org.Thesis (D.Sc.D.)--Boston University, School of Graduate Dentistry, 1974. Periodontics.Bibliography included.
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