Why do we do a 4 week reline after periodontal corrective surgery? Why do we temporize at all?
Temporizing a patient prior to periodontal corrective procedures allows 3 things:
1. Determine the apical extent of the caries so that the correct biologic width can be established with out guessing where the future margin will be. If we know where the margin will be established, we will know exactly where to create the osseous architecture in establishing the biologic width.
2. It allows us to determine the prognosis of the tooth BEFORE a patient goes through additional procedures such as crown lengthening. All too often, I have seen cases that wasted a patients time, discomfort and money because an endodontic or periodontal procedure was performed before the prognosis of the tooth was determined and the tooth would up being removed in favor of an implant.
3. It gives the periodontist the opportunity t have 360 degree access to treat the condition. Try doing surgery on these cases when full contour restorations are present.
BUT, WHY THE 4 WEEK RELINE?
Very simple… it closes margins that were left open at the time of surgery, allows for a comfortable transition healing period and respects the coronal migration of the attachment during healing.
That the reline leaves the marginated area 1mm shy of the healing tissue. In this image, you are seeing a full maxillary case temporized, biologically shaped and at the conclusion of the 4 week reline. Perfect all the way around. This makes the final restorative a walk in the park!!!!
So what is the protocol?
1. Prep, core and temporize.
2. Referral for periodontal corrective surgery.
3. 4 Week reline 1mm shy of the tissue to respect the coronal migration of the attachment.
4. Final margination and final impression/IOS at 12-20 weeks.