More Periodontal Surgeries

Question 1

purpose of bone replacement graft surgery

Answer 1

surgery used to encourage the body to rebuild alveolar bone lost from perio disease

Question 2

what is involved in bone replacement graft surgery

Answer 2

• elevation of a flap
• treating roots as needed
• placement of grafting material into defect
• flap returned to original position

Question 3

what can cause challenged in bone grafts?

Answer 3

• subject to contamination from bacteria and saliva traveling along the roots adjacent to graft site
• healing of bone can be disrupted by growth of epithelium into the wound

Question 4

define osteogenesis

Answer 4

potential for new bone cells to develop following bone graft

Question 5

two types of osteogenesis and features; which is better?

Answer 5

1. osteoconductive-grafting materials form a framework outside the graft during the formation of the new bone
2. osteoinductive-cells within the grafting material are converted into the bone-forming cells to form the new bone

onsteoinductive is the best way

Question 6

what materials are used for bone grafts and which are osteoinductive or osteoconductive

Answer 6

autograft-inductive
allograft-inductive
xenograft-conductive
alloplast-conductive

Question 7

is it possible for the reformed bone to not actually be attached to cementum by PDL fibers?

Answer 7

yes

Question 8

what is important for hygienist to know after bone grafts?

Answer 8

• do not probe until appropriate interval has lapsed

- plaque control is critical to maintain health in the area

Question 9

what is a guided tissue regeneration surgery?

Answer 9

encourages regrowth of lost periodontal structures (lost cementum, alveolar bone, and PDL)

Question 10

why is a barrier membrane placed on the graft material?

Answer 10

to keep the graft material in place and it keeps the epithelium from forming where we want graft to form

Question 11

what happens if epithelium covers the wound?

Answer 11

it prevents the slower growing cells from growing

Question 12

what is periodontal plastic surgery’s healing method?

Answer 12

new attachment

Question 13

what are common plastic surgery procedures

Answer 13

1. free gingival graft
2. laterally positioned flap
3. frenectomy
4. crown lengthening surgery

Question 14

purpose of free gingival graft

Answer 14

increase width of the attached gingiva and cover areas of recession of the gingival margin

Question 15

two wounds associated with free gingival graft

Answer 15

1. donor site

2. recipient site

Question 16

where is the donor tissue usually obtained from?

Answer 16

patient’s palate

Question 17

does the color match at the free gingiva?

Answer 17

no

Question 18

what is different from the subepithelial CT graft and free gingival graft

Answer 18

there is an excellent tissue color match from subepithelial CT graft compared to the free gingiva graft

Question 19

what is a semilunar flap?

Answer 19

used to repair minor recession and where there is adequate thickness of keratinized tissues

Question 20

what is a frenectomy surgery?

Answer 20

-used to remove a renum including the attachment of frenum to bone

Question 21

what can result if the frenum is attached too close to the gingival margin?

Answer 21

it can pull the gingival margin away from the tooth surface resulting in persistent inflammation to the tissues

Question 22

what is a crown lengthening surgery?

Answer 22

surgery that creates a longer clinical crown for a tooth by removing gingival and alveolar bone from necks of teeth

Question 23

difference between functional and esthetic crown lengthening

Answer 23

functional-existing tooth strucutre is inadequate to support necessary restoration
esthetic-improve appearance of teeth when there is excess gingiva in relation to clinical crown

Question 24

what is a gingivectomy surgery?

Answer 24

removal of the gingival tissues

-allows better self-care in select sites

Question 25

what surgery is hardest to perform?

Answer 25

gingivectomy

Question 26

disadvantages of gingivectomy

Answer 26

1. leaves large open CT wound
2. slower healind
3. more discomfort
4. teeth appear larger

Question 27

what is gingival curettage? is it used today?

Answer 27

removal of the lining of a periodontal pocket using a periodontal curet
-not used today

Question 28

what is a dental implant?

Answer 28

artificial tooth root placed into the alveolar bone to hold a replacement tooth

Question 29

what is biological enhancement?

Answer 29

attempts to enhance the outcome of perio surgery by using chemical or biological mediators to influence healing of alveolar bone, cementum, and PDL fibers

Question 30

methods of biological enhancement?

Answer 30

• root surface modification
• enamel matrix derivative EMD
• growth factors
• platelet rich plasma PRP

Question 31

example of a growth factor

Answer 31

platelet derivative growth factor

Question 32

purpose of sutures

Answer 32

stabilize position of the soft tissues during early phases of healing

Question 33

two types of materials used for sutures

Answer 33

1. nonresorbable: must be taken out

2. resorbable: dissolves into body fluids

Question 34

how do you remove a suture?

Answer 34

cut material near the knot and grasp the knot with pliers and gently pull through the tissue
count number of sutures placed and enter in treatment notes

Question 35

what is the largest suture and the smallest

Answer 35

3-0 is largest

5-0 is smallest