E2

Question 1

Root trunk length for maxillary molars?

Answer 1

F 4mm
M 3mm
D 5mm

Question 2

Root trunk length for mandibular molars?

Answer 2

F 3mm

L 4mm

Question 3

Root trunk length for maxillary bicuspids?

Answer 3

M 7mm

D 7mm

Question 4

What is defined as a short root trunk length?

Answer 4

1-2 mm

Question 5

What is defined as a long root trunk length?

Answer 5

> 4mm

Question 6

Why do premolars with furcation involvement have a very poor prognosis?

Answer 6

bc of their long root trunk length

Question 7

What is the average root trunk length? And what teeth commonly have this length?

Answer 7

3 mm

Facial Mandibular 1st molar

Question 8

Bifurcation ridges are present in ___% of _____ molars

Answer 8

73%

mandibular

Question 9

From what aspect would you probe a mesial maxillary furcation?

Answer 9

from the palate

Question 10

Glickman’s Class I Furcation Involvement

Answer 10

Incipient bone loss
Radiographically not evident

(defined as incipient bone loss in the furca opening)

Question 11

Glickman’s Class II Furcation Involvement

Answer 11

Partial bone loss (cul-del-sac)
Depth will vary: early or advanced
Radiograph may or may not appear

Question 12

Glickman’s Class III Furcation Involvement

Answer 12

Through-and-through bone loss (all the way through the furca to the other side)
Inter-radicular bone is completely absent
Radiographic evidence is a usual finding

Question 13

Glickman’s Class IV Furcation Involvement

Answer 13

Through-and-through with furcation exposure due to gingival recession
Almost always shows on radiographs

Question 14

What are the 4 root anatomy modifying factors of furcation involvement?

Answer 14

form
proximity
grooves & concavities
bifurcation ridges

Question 15

How is the Hamp classification system for furcations different from Glickman?

Answer 15

Hamp is the same except is doesnt recognize a class IV.  
Hamp combines class III and IV so the hamp system only goes up to class III
(i.e. class I 2mm; class III is through-and-through)

Question 16

CEP Grade I

Answer 16

Distinct changes in the CEJ that projects toward the furca

Question 17

CEP grade II

Answer 17

CEP approaching furcation

Question 18

CEP grade III

Answer 18

CEP at the roof of or into the furcation

Question 19

Noted CEPs in > __% of isolated mandibular molars with furcation involvement

Answer 19

90%

Question 20

__% associated b/w the presence of a CEP and furcation involvement

Answer 20

50%

Question 21

Where are enamel pearls most common?

Answer 21

third molars (75%)

Question 22

Percentage of molar teeth with accessory canals that exit in the roof of the furca:
\_\_% max 1st molars
\_\_% mand 1st molars
\_\_% mand 2nd molars
\_\_% max 2nd molars

Answer 22

36%
32%
24%
12%

Question 23

In non-vital teeth or those with pulpitis, accessory canals are often associated with…

Answer 23

Abscess “blow-outs” of the furcal bone

Question 24

What are the top four teeth most frequently lost?

List in order starting with most frequent

Answer 24

Max 2nd molar
Max 1st molar
Mand 2nd molar
Mand 1st molar

Question 25

Top two types of teeth LEAST frequently lost? List in order from more frequently to least

Answer 25

``` Maxillary cuspid (2nd least frequently lost) Mandibular cuspid (least frequently lost tooth) ```

Question 26

Treatment options for increasing the width of attached gingiva?

Answer 26

1) apically positioned flap (APF) - full thickness flap 2) free autogenous gingival graft (FGG) 3) Subepithelial connective tissue graft (CTG)

Question 27

Treatment options for obtaining root coverage?

Answer 27

1) Subepithelial connective tissue graft (CTG) 2) Semi-lunar incision + coronal positioning (Tarnow Procedure) 3) Lateral pedicle flap (LPF)

Question 28

Indications for The Free Autogenous Gingival Graft (FGG)?

Answer 28

``` increase width of attached gingiva remove abnormal frenulum attachment deepen oral vestibule ridge augmentation procedures cover exposed roots (*****rarely used for this purpose) ```

Question 29

Advantages of FGG?

Answer 29

Not technically demanding May be accomplished with partial or full-thickness flap reflections Wide variety of clinical applications

Question 30

Disadvantages of FGG?

Answer 30

Poor ability to provide blood supply to graft for root coverage Esthetic results are comprised due to scarring during healing resulting in poor color match Surgery required at two intraoral sites Donor site may present problems with bleeding, pain, and slow healing

Question 31

Indications for The Subepithelial Connective Tissue Graft (CTG)?

Answer 31

``` Acquire a width of attached gingiva Deepen oral vestibule Remove frenulum and muscle attachment Acquire esthetic attached gingiva (color match) Cover exposed root surface ```

Question 32

Advantages of CTG?

Answer 32

High predictability Graft received abundant blood supply Palatal wound (donor site) can be surgically closed, thereby facilitating rapid healing with little to no discomfort or bleeding Good color match Applicable for recession on multiple teeth

Question 33

Disadvantages of CTG?

Answer 33

Technically demanding | Gingivoplasty may be necessary after healing to obtain better tissue contours and to decrease thickness

Question 34

Indications for Semi-lunar incision with coronal positioning (Tarnow Procedure)?

Answer 34

Maxillary anterior teeth with no more than 2mm of recession and 3-5mm of remaining keratinized gingiva A complimentary procedure for small areas of gingival recession remaining after other procedures were used for root coverage

Question 35

Advantages of Tarnow Procedure?

Answer 35

``` No tension or coronal positioned flap No narrowing of the oral vestibule Good esthetics due to color match Papillary height is preserved Simple surgical procedure Minimal post-op discomfort Applicable to minimal gingival recession across multiple teeth ```

Question 36

Disadvantages of Tarnow Procedure

Answer 36

Not applicable in cases of moderate to advanced gingival recession, i.e greater than 2mm Requires 3-5mm of thick keratinized tissue Healing is by secondary intention and therefore some contraction occurs May require a second procedure depending on occurrence of tissue contraction Where osseous dehiscence or fenestration exists apical to the gingival recession area, a FGG or CTG should be performed after coronal positioning of the semi-lunar flap