Periodontal dressing on top of a membrane?

I do this routinely. It helps with protection during the initial phase of healing. However, if I have tension free primary closure, I disregard the periodontal dressing. I do not usually trust patients with compliance or understanding postoperative instructions.

How long do you leave it on? Never have used it would appreciate some suggestions / tips. Thanks

I can see this being beneficial in smokers and bigger cases.

I think it slows down the healing and compresses the tissue.

CRS you are correct. however it does protect the edges of the flap and does give the gingiva a protected site for healing. I let it stay in till it falls out. I do not replace the perio dressing.

Agree CRS , we need to think Biology Peter

I have found the periodontal dressing is a good tool when the flap suturing may not be perfect and allow the soft tissues to evert or open while healing. Sometimes it can help the sutures keep the soft tissue in place. Also useful when the membrane is not able to fully protect and avoid loss of graft material particles.

"DAMNED IF YOU DO....DAMNED IF YOU DON'T" ...... was it Shakespeare or Rudick who said that....... All the above comments are very valid. It is nice to protect the surgical site with a periodontal dressing...... it keeps the food particles away, keeps the area clean, protects the site from the forces of mastication during the initial healing period.....however... The periodontal packing is placed when it is in a sticky state in order to bind to the tissues and teeth and at the same time it will incorporate the ends of the sutures ...... if it becomes loose or falls off, there is a good chance of it pulling out some of the sutures , opening the wound and exposing the membrane. In my experience, even if the dressing falls off, and the incision is opened and the membrane is exposed, the patient must be instructed to stay away from the area with a toothbrush, and to use a Q tip dipped in Chlorhexidine to swab the area several times a day until new soft tissue coverage can be formed or until the membrane has served its function. Gerry Rudick Montreal, Canada

In situations with a grafted area between remaining teeth, I usually cover the membrane (and sutures) with a custom cut piece of clear plastic (from the cover on the suture package), then cover that with Photocore (Kuraray) composite that starts as a cylinder formed to just fit the site, then compressed down onto the site gently while adapting the material into undercuts under contacts and wrapping it just a bit to buccal and lingual. When you get the touch, you can light it up to cure it and now you have a rigid, esthetic (virtually invisible), and very durable cover for the graft site. You can sometimes get the clear plastic out by gently teasing it away; other times it is locked in and you can leave it with no problems (cut away any excess that would bother the pt). Before I started doing this I sometimes had problems with grafts washing out. Now I NEVER have problems with graft washout. Your mileage may vary.... BTW you have to cut this out (even though it is not bonded), and you will use a round end tapered diamond stone with irrigation. It's just like taking a cast off a broken arm - be careful and just section it in B-L plane right in the middle of it. Works like a charm...