07112022 Flashcards

Question

TFO and plaque induced periodontitis articles

Answer 1

Fleszar Burgett Nun and Harrel

Answer 2

Read Lindhe Chapter on occlusion Chap 13

Answer 3

Bone loss from TFO is horizontal and cause horiz tooth movement but CALoss TFO is reversible but CALoss is not

Answer 4

Results: At 8 months, all implants were osseointegrated. The mean probing depth was 2.5+/-0.3 and 2.6+/-0.3 mm at unloaded and loaded implants, respectively. Radiographically, the mean distance from the implant shoulder to the marginal bone level was 3.6+/-0.4 mm in the control group and 3.7+/-0.2 mm in the test group. Control and test groups were compared using paired non-parametric analyses. There were no statistically significant changes for any of the parameters from baseline to 8 months in the loaded and unloaded implants. Histologic evaluation showed a mean mineralised bone-to-implant contact of 73% in the control implants and 74% in the test implants, with no statistically significant difference between test and control implants. Conclusion: In the presence of peri-implant mucosal health, a period of 8 months of excessive occlusal load on titanium implants did not result in loss of osseointegration or marginal bone loss when compared with non-loaded implants.

Answer 5

Heins and Weider 1986 \>0.5 mm – cancellous bone \<0.5mm – no cancellous, only lamina dura \<0.3 mm – Only PDL space

Answer 6

PIM: - Presence of peri-implant signs of inflammation (redness, swelling, line or drop bleeding within 30 seconds of probing) - No additional bone loss PI: - Presence of peri-implant signs of inflammation (redness, swelling, line or drop bleeding within 30 seconds of probing) - Radiographic evidence of bone loss following initial healing (\> 2 mm after 1 year following prosth delivery. - Increasing PD compared to PD collected after prosth. delivery. In the absence of previous radiographs ==\> RBL of ≥ 3mm with PD of ≥ 6 mm + BOP

Answer 7

(Zander 1953) RISP 1- Areas of cementum resorption 2- Microscopic irregularities 3- Secondary cuticle 4- Microbial penetration (Refuted by Canis)

Answer 8

Community Periodontal Index for Treatment Needs (CPITN) The dentition is divided into six sextants (one anterior and two posterior tooth regions in each dental arch). Third molars are NOT included except where they are functioning in place of second molars. When only one tooth is present in a sextant, it is included in the adjacent sextant. Probing assessments are performed either around all teeth in a sextant or around certain index teeth Only the most severe measure in the sextant is chosen to represent the sextant.

Answer 9

Vertical distance at papilla between - Tooth & implant: 5 mm (additional 2 mm for distance from CEJ) - 2 implants: 3 mm (Implants have no CEJ)

Answer 10

Spray article (1.8 mm minimum) --\> dog study (Benic et al. 2012) – Clinical prospective study examining the buccal bone 7 years after immediate implant placement. Result: 24 patients started the study, and 14 completed the follow-up. 5 had no buccal bone, 9 had some buccal bone present (as determined by CBCT). The cases without buccal bone had an average of 1mm less soft tissue level compared to those with the buccal bone. (Chappuis, Araújo, and Buser 2017)— “Clinical studies indicated that thin bone wall phenotypes exhibiting a facial bone wall thickness of 1 mm or less revealed progressive bone resorption with a vertical loss of 7.5 mm” (Buser, Martin, and Belser 2004) – Implant “saucerization” is usually 1.0 – 1.5 mm in the horizontal direction. The purpose of GBR is to create a thick facial bone of 2 – 3 mm thickness, to allow sufficient bone to remain on facial plate after resorption. (That's why Buser does ridge crest prep)

Answer 11

For both tissue level??? and bone level implants???

Answer 12

look up Jose 07/18/2022

Answer 13

- SupraG scaling - Baking Soda + H2O2 --\> Keyes technique https: //www.cap-acp.ca/en/public/keyes.html#:~:text=In%20the%20late%201970s%20an,salt%2C%20baking%20soda%20and%20peroxide. CAP position on Keyes technique In the late 1970s an oral hygiene program called the Keyes technique was widely promoted as a nonsurgical alternative for treating advanced periodontal disease (pyorrhea)\*. The technique includes: Microscopic examination of the plaque. Cleaning the teeth and gums with a mixture of salt, baking soda and peroxide. Use of antibiotics. As in any medical field, treatment approaches vary according to the condition being treated. The Keyes technique attempts to treat all periodontal conditions the same way. This brings some risks and limitations: Bacterial monitoring using a phase contrast microscope is a technique sensitive, inaccurate and outmoded technology, which does not accurately differentiate between bacteria associated with a healthy periodontal environment and that associated with aggressive periodontal disease. Local therapy, consisting of scaling and root planing (deep cleaning) has always been part of conventional periodontal therapy. However numerous studies, short and long term, have shown that the adjunctive use of baking soda and hydrogen peroxide have not demonstrated any particular added benefit over conventional techniques. The use of systemic antibiotics in conjunction with root planing has shown minimal or no added value over local therapy alone in treating adult periodontitis. In addition, the possible minor benefit would only be of short duration and the use of antibiotics significantly increases the chances of developing bacteria resistant to many antibiotics. In conclusion, the Keyes technique offers a single treatment approach, with limited benefits and substantial disadvantages, to a multifactorial disease requiring different therapeutic responses. The Canadian Academy of Periodontology recommends a thorough assessment of any periodontal condition followed by an informed, comprehensive therapeutic approach. A 'one size fits all' approach offers a significant risk of under or over treatment and the CAP therefore cannot endorse or recommend this technique.

Answer 14

Kaldahl 1996: ## Footnote Periodontal Abscess : may occur in perio maint, after scaling may be due to incomplete scaling but coronal tissue heals and occludes pocket

Answer 15

Listgarten 1965 1) Superficial bacterial area, 2) neutrophil-rich zone, 3) necrotic zone, 4) spirochaetal infiltration zone Loesche 1982: constant flora (Prevotella intermedia, Fusobacterium, Treponema, Selenomonas) + variable flora (array of types)

Answer 16

bone loss in PI 0.36 mm/ year 3.5 mm after 9 years

Answer 17

PRP/ PRP --\> WITH or without anti-coagulant L-PRF or A-PRF? PDGF and VEGF TGF-B1 --\> or Epidermoid GF (soft tissue healing) TGF-B2 --\> more for bone healing

Answer 18

attahment migrate proliferate differentiate Maturation

Answer 19

- Primary: OFG - Secondary: APF - Tertiary: Marsupalization

Answer 20

longer than 1 mm??

Answer 21

15-20% of the graft at max should be on non-vital/non vascularized root surface

Answer 22

Epith migration rate 0.5 mm/day

Answer 23

## Footnote “in other words, a relatively limited periodontal wound might not reach functional integrity until 2weeks postsurgery.” “wound integrity during the early healing phase depends primarily on the stabilization of the gingival flaps achieved by suturing”

Answer 24

Periodontitis Case definition..is there a cutoff for PD??

Answer 25

Mascarenhas Janet 07.20.2022 Assignment Oral contraceptives --\> accelerated progression of Perio

Answer 26

R: areas of cemental resorption I: Areas previously occupied by previous Sharpey's fibers S: secondary cuticles P: penetration of bacteria (Refuted by Canis) 1st layer of calculus --\> octacalcium 2nd layer --\> hydroxyapatite SubG --\> Whitlockite

Answer 27

Genetic testing for PI

Answer 28

S. Aureus Heitz-Mayfield 2010 Liana's 07202022 Assignment

Answer 29

Marquis color coded probe --\> 3, 6, 9, 12 UNC probe --\> 1-15 Michigan "O" probe --\> 3, 6, 8 WHO probe --\> 0.5 mm ball, 3.5, 5.5, 8.5 and 11.5

Answer 30

Mombelli 1987: dot, line and drop bleeding French 2015: Suppuration

Answer 31

Teeth --\> yes (Lang and Miyasato) Implants: KM - Pure Ti surface --\> no need (Wennstrom) - Rough implant surface --\> KM is essential (Thoma,

Answer 32

Pure Smooth surface --\> negative Rough Surface --\> no impact

Answer 33

Probing of implants results in a short-term trauma that is repaired completely over 5-7days (etter et al. 2002)

Answer 34

With Perio pockets --\> only in pditis patients Without Perio pockets --\> in Perio and non-perio patients **In Perio patients:** **Either Acute exacerbation:** unttt perio, refractory perio, during SPT **After treatment:** Post SRP, post Sx, after medication **In non-Perio patients:** - Impactions, Ortho factors - Gingival overgrowth - Alteration of root surface - Harmuful habits

Answer 35

There is a best evience article on Frucation treatmemt **Superior alveolar artery likely passes through the outer/inner surface of the sinus wall and should be evaluated. (percentage of detection on CBCT)**

Answer 36

TFO, open contact, VRF Nibali (look depth, angulation, # of walls)

Answer 37

PD miller lecture

Answer 38

Jad's answerACPA Merkado 2001 --\> Results: No differences were noted for the plaque and bleeding indices between the control and rheumatoid arthritis groups. The rheumatoid arthritis group did, however, have more missing teeth than the control group and a higher percentage of these subjects had deeper pocketing. When the percentage of bone loss was compared with various indicators of rheumatoid arthritis disease activity, it was found that swollen joints, health assessment questionnaire scores, levels of C-reactive protein, and erythrocyte sedimentation rate were the principal parameters which could be associated with periodontal bone loss. Conclusions: The results of this study provide further evidence of a significant association between periodontitis and rheumatoid arthritis. This association may be a reflection of a common underlying disregulation of the inflammatory response in these individuals. Both affect the joint and the one that showed benefit of TNF blockers on Perio disease

Answer 39

Pontoriero and Carnevale 2001 https://pubmed.ncbi.nlm.nih.gov/11495130/ Conclusions: The results of the present clinical investigation demonstrated that during a 1-year period of healing following surgical crown lengthening, the marginal periodontal tissue showed a tendency to grow in a coronal direction from the level defined at surgery. This pattern of coronal displacement of the gingival margin was more pronounced (P \< 0.001) in patients with "thick" tissue biotype and also appeared to be influenced by individual variations in the healing response (P \< 0.001) not related to age or gender. Thin phenotype --\> recession Thick phenotype --\> pocket ratio of thin vs thick phenotype --\> 15 to 85% (Lindhe

Answer 40

1 mm (Waerhaugh 1981) vs, Youngblood

Answer 41

yodalis Underdcontour is better than overcontour

Answer 42

Regular vs wide base E dimension o.33 mm for plaform switching

Answer 43

residual PD 6 mm ==\> access flap 4-5 mm ==\> repeated non Sx

Answer 44

Stambaugh 1981 ## Footnote (Stambaugh et al. 1981) average curette efficacy 3.73 mm, instrument limit 6.21 mm

Answer 45

Critical probing depth ● Critical PD for non-surgical therapy: 2.9mm (Lindhe et al. 1982) ● Critical PD for access flap surgery (MWF): 4.2 mm (Lindhe et al. 1982) ● Critical PD for surgical procedure indication: 5.4 mm (Heitz-Mayfield et al. 2013)

Answer 46

Review papilla preservation techniques

Answer 47

Bower et al 1979: 81% of furcation entrances of 1st molars are \< 1.0 mm and 58% are \< 0.75 mm

Answer 48

Class I: why not try GTR You don't treat it because you don 't have a deep enough defect to contain the bone graft or even enough blood supply Class III --\> you don't have a contained defect

Answer 49

Adv and disadv of local antimicrobials

Answer 50

ttt options mucosal incision Z-plasty Rhomboid flap Laser ..

Answer 51

V or Y shape

Answer 52

Co2 diode Er:YAG and Nd:YAG --\> bleeding but no thermal effect so faster healing Er, Cr: YSSG laser --\> you can do it w/t local anaesthesia

Answer 53

I --\> immediate (humoral) II --\> Cytotoxic (humoral) III --\> Immune complex (Arthus reaction) (humoral) VI --\> cell mediated V --\> Autoimmune VI --\> Tumor rejection,

Answer 54

COX 2 --\> CONTRAINDICATED for hypertensive patients CVS disease CYP 450 is inhibited by erythromycin

Answer 55

* _Deep and narrow intrabony defects_ at either vital or endodontically treated teeth are the ones in which the most significant and predictable outcomes can be achieved with GTR treatment. * Number of walls and width of the defect are influential when non‐supportive biomaterials are used. * The influence of defect anatomy appears to be reduced to some extent when a more stable flap design is applied. * Severe, uncontrolled dental _hypermobility (Miller class II or higher)_ may impair the regenerative outcomes. * Significant clinical improvements can be expected only in _patients with optimal plaque control, with reduced levels of periodontal contamination, and who are non__‐__smokers_.

Answer 56

Crater depth Root Trunk length Buccal upper/lower bucc and lingual : leave behind at least 2 mm KG Palatal: PD is most crucial

Answer 57

high risk of exposure when it's touching the tooth

Answer 58

Proliferation and migration effect

Answer 59

need to leave at least 0.4 mm thickness (There is a high chance of sloughing) That's why Zucchelli does full thickness on the mid-facial

Answer 60

Fickle article on partial thickness flap showed more resorption that full thickess. When you do split you traumatize the blood vessels more with more osteoclastic activity.

Answer 61

Avascular --\> 15-20% Vascular --\> 75-80%

Answer 62

FGG then CAF

Answer 63

Etiological factors for recession in ABP exam --\> list all factors then mention the specific cause relating to the case at hand

Answer 64

The reported prevalence of recessions at the end of orthodontic treatment ranges between 5%-12%; i.e. according to Kim and Neiva’s systematic review in 2015. Of course, in thinner phenotypes, much higher numbers were reported, such as by Yared in 2006, showing 93% of teeth developed recession and were \<0.5 mm in gingival thickness. Consequently, grafting procedures may likely to precede the initiation of orthodontic therapy (Boyd 1978, Hall 1981). As long as the movement of teeth is within alveolar bone, soft tissue recession is not to be anticipated (Wennstrom 1987). **_Thus, the direction of tooth movement is key. Regarding soft tissues, the thickness rather than the quality of the marginal soft tissue on the pressure side of the tooth is the determining factor for the development of recession. Plaque control in these situations is key as well._**

Answer 65

Dynamics of bone tissue formation

Answer 66

Pablo Galindo The bevel of the foceps has to be congruent with the root anatomy

Answer 67

* _Deep and narrow intrabony defects_ at either vital or endodontically treated teeth are the ones in which the most significant and predictable outcomes can be achieved with GTR treatment. * Number of walls and width of the defect are influential when non‐supportive biomaterials are used. * The influence of defect anatomy appears to be reduced to some extent when a more stable flap design is applied. * Severe, uncontrolled dental _hypermobility (Miller class II or higher)_ may impair the regenerative outcomes. * Significant clinical improvements can be expected only in _patients with optimal plaque control, with reduced levels of periodontal contamination, and who are non__‐__smokers_.

Answer 68

“In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection” ~2015 clinical guideline by the ADA Council on Scientific Affairs In cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and when reasonable write the prescription: Medically compromised patients patients with a history of complications associated with their joint replacement surgery patients with immunocompromising disease

Answer 69

## Footnote Becker et al 1979. Untreated periodontal disease: a longitudinal study - 30 moderate to advanced periodontitis p’t without treatment - T0: initial, T1: 1.5 ~ 9.5 years later - Increased PD: 0.24 ~2.46 mm/yr, esp DL, ML interproximal surfaces - Bone loss: posterior segments had the largest amounts - Molars had the greatest percentage of tooth loss - Tooth loss**_: 0.36 teeth / year_** Becker et al 1984. Periodontal treatment without maintenance. A retrospective study in 44 patients - 44 p’t, OHI + SRP + pocket reduction surgery 🡪 no maintenance - T0: initial, T1: 5.25 years later - Worsen bone level, esp furcation area - Tooth loss: **_0.22 teeth / year_** - Periodontal therapy without maintenance is of little value in terms of restoring periodontal health Becker et al 1984. The long term evaluation of periodontal treatment and maintenance in 95 patients - 95 moderate to advanced periodontitis p’t - OHI, SRP, pocket reduction surgery 🡪 3-4M SPT for average 6.5 years (3-11 years) - Tooth loss: **_0.11 teeth / year_** - Periodontal therapy and maintenance are successful in reducing moderate to deep periodontal pockets with minimal bone loss

Answer 70

1. Periodontitis must be treated. No Tx à Tooth loss: 0.36 teeth / year (Becker 1979) 2. Regular SPT is important. No SPTà Tooth loss: 0.22 teeth / year (Becker 1984) With SPT à Tooth loss: 0.14 teeth/ year (Graetz 2017, Pretzl 2018) 0.11 teeth/ year (Becker 1984) APT without SPT is of little value in restoring and maintaining periodontal health SPT regularity is more important that then quantity, esp in higher staging and grading

Answer 71

See caffesse paper

Answer 72

2 mm 1 - 1.25 mm --\> critical gap

Answer 73

Wall on Wall Off Wall gone

Answer 74

4 months according to Huang et al. 2006. (Lindhe Sinus Chapter) AAA diamter: 2 mm

Answer 75

Dr. Wang's lateral Sinus technique

Answer 76

Loma Linda Sinus Tear Technique

Answer 77

Wood 1972 Full Thickness --\> 0.62 Partial thickness --\> 0.98 The other article is Fickle which is a dog study

Answer 78

Stress distribution Soft bone (Sinus graft, max. posterior) Heavy Occlusal load (Bruxer, narrow or short implant) Long abutment/Long span to prevent tooth migration Minimize Biomechanical complications: - Prevent embrasure/Interproximal opening (diffcult to have good contact between 2 adjacent implant with non-splinted crowns)

Answer 79

Chrcanovic et al. (2018) Grade of titanium Bruxism Implants adjacent to cantilevers Increased implant length Decreased implant diameter

Answer 80

Ibuprofen. Competes with Aspirin for Cox binding sites on platelets

Answer 81

Critical mass theory Cobb

Answer 82

Listerine original 29% cut back --\> 16% now there is alcohol free listerine

Answer 83

Down hill 0-3 extreme dowhill

Answer 84

Clinda, Clari, Levo except Levofloxacin

Answer 85

Split-thickness flap for the management of a maxillary sinus wall bony fenestration during lateral window sinus augmentation: case reports and technical surgical notes **Testori paper**

Answer 86

50% chance, 1/3 is coming from septum (33% chance of patients have sinus septa)

Answer 87

Classification and Management of Antral Septa for Maxillary Sinus Augmentation Authors: Shih-Cheng Wen, Hsun-Liang Chan, Hom-Lay Wang Source: IJPRD 2013

Answer 88

Angle sinus floor configuration was most difficult to elevate

Answer 89

highly active osteoclastic activity so we freeze

Answer 90

Freeze dried vs solvent dehydration (Puros) Solvent dehydration preserves the structure

Answer 91

- Loss of an anterior tooth results in a natural healing process that yields undesirable esthetic outcomes - Facial mucosa recedes apically and palatally - A placed implant will look too long and have black triangles due to lost interdental papilla - In such a case, the goal will be to place and restore an implant with adjacent gingiva that harmonizes with the restoration and the adjacent teeth

Answer 92

CAL of \> 2 mm Socransky 1984

Answer 93

Ratio of non-motile to motile diseased sites 1:1 normal 1:49

Answer 94

slower because for implants you want the PDL to move with tooth movement

Answer 95

Use Atropine for symptomatic Bradychardia

Answer 96

Ostesarcoma Scleroderma

07112022 Flashcards

(137 cards)