Flashcards in Exam 3 -ch 14 Deck (71)
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1
what are examples of access flap procedures?
the modified widman flap, the excisional new attachment procedure and open flap curettage
2
why is thorough phase 1 therapy, including scaling, root planing and oral hygiene instruction, completed at least 4 weeks prior to periodontal surgery
for enough time to heal
3
window like openings in alveolar bone over a root surface
fenestration
4
this is the sliding of the gingival tissue from an adjacent tooth or papilla
lateral pedicle graft
5
this technique uses three incisions to separate the pocket lining from the tooth in a controlled manner
modified widman flap
6
produced by bone loss of interdental bone... facial and lingual plates without concomitant loss of tadicular bone
reversed architecture
7
what type of pockets are often best treated by flap surgery?
suprabony pockets
8
The primary reason to perform excisional periodontal surgery is to provide access to root surfaces for debridement. Debridement during surgery is necessary because it is very difficult to remove all the calculus and plaque on root surfaces during the pre surgical phase
both are TRUE
9
if bony ledges or non supporting bone is removed, the procedure is called....
osteoplasty
10
this flap technique does not involve elevating the flap past the mucogingival junction
new attachment procedure
11
what is the major benefit of periodontal surgery?
to gain access to the root surfaces for scaling and root planing
12
root is denuded of bone and portions of root surface covered by soft tissue
dehiscence
13
this type of procedure is to provide access to the root surfaces for the debridement and to create conditions for reattachment of the gingival tissues to the root
access flap procedure
14
The most important clinical measure of bone loss is
attachment loss
15
this includes a variety of periodontal plastic surgery procedure to augment the thickness of keratinized gingival tissues, increase the zone of the attached gingiva or augment endentulous spaces
mucogingival surgery
16
regenerative periodontal surgical procedures....
selectively encourage the growth of cells of the attachment apparatus
17
this is a deepened gingival sulcus with an infected root surfaces covered by an ulcerated epithelial surface with underlying inflamed connective tissue
periodontal pocket
18
this includes a variety of surgical techniques that attempt to restore the periodontal tissues lost through disease
regeneration surgery
19
what cells are the first to heal?
epithelial
20
what does regeneration surgery include?
a variety of surgical techniques that attempt to restore the periodontal tissues lost through disease
21
this is placed over sutures to hold the flaps tightly to the teeth and underlying bone when pocket reduction surgery has been performed.
periodontal dressing
22
what are the contraindications to periodontal surgery?
health statues or age of patient.
23
sever abscess containing multiple boils
carbuncle
24
surgical sites should not be probed for at least one week after surgery because the collagen fibers have not had sufficient time to heal to be able to resist the penetration force of the probe
the statement is NOT correct, but the reason is correct
25
what is the most often quoted ideal width of attached gingival tissue?
3 mm
26
what is the most successful material used in alloplasts?
porous hydroxyapatite
27
list the general factors that must be considered before periodontal surgery
general health
pocket depths
attachment loss
patient compliance
28
the types of periodontal surgery in which the periodontist shapes the alveolar bone with chisels or burs to remove bony defects are called procedures for...
treatment of osseous defects
29
these are created from donor bone from the patients own body... may be taken from i gra oral sites such as tori, maxillary tuberosity or bone removed during osteoplasty
Autograft
30
what are indications of access flap procedure?
to treat periodontal pockets aesthetically sensitive areas or where pocket reduction is not destined or indicated
31
this is a type of bone loss in which the interproximal bone is apical to the facial and lingual bone
reverse alveolar bony architecture
32
what is the most predictable method for regenerating lost periodontal tissues??
guided tissue regeneration
33
what types of surgeries do pocket reduction include??
excisional (gingivectomy and gingivoplasty)
incisional (periodontal flap procedures)
34
these extend epically beyond the crest of the bone
infrabony pockets
35
the most common oral site for donor tissue for free gingival graft procedure is the
palate
36
these are created from bone taken from another species such as bovine or cow, porcine or pig bone.
xenografts
37
what has been suggested as the best technique to attempt to cover exposed root surfaces?
lateral pedicle graft
38
if alveolar bone that contains periodontal fibers that support the tooth is removed, this procedure is called...
ostectomy
39
the types of periodontal surgery that increase the predictability for growth of new tissues of the periodontal apparatus are called procedures for
guided tissue regeneration
40
what is root sensitivity following perio surgery caused by?
exposed root surfaces
apically positioned perio flaps
gingival shrinkage during healing
root planing with cementum removal
41
when is periodontal surgery indicated?
to control the progress of periodontal destruction and attachment loss when more conservative non surgical treatment is not successful
42
this includes a variety of periodontal plastic surgery procedures to augment the thickness of keratinized gingival tissues, increase the zone of attached gingiva, improve gingival aesthetics by covering recessed root surfaces, or augment edentulous spaces.
mucogingival surgery
43
periodontal surgery is most successful when pocket depths are between 5 and 9 mm. Indications for periodontal surgery are more effected by measurements of clinical attachment loss than those by pocket depths
both statements are TRUE
44
what are relative contraindications to periodontal surgery?
patient with certain systemic diseases
uncontrolled hypertension
recent history of heart attack
uncontrolled diabetes
certain bleeding disorders
kidney dialysis
patients non complaint
patients with high risk for caries
patients with unrealistic expectations
history of radiation to the jaws
HIV infections
45
pockets coronal to the horizontal bone loss are called
suprabony pockets
46
what is periodontal regeneration??
the formation of new alveolar bone, new cementum and new periodontal ligament on a tooth root surfaces that was previously diseased
47
what does guided tissue regeneration permit??
the healing cells to proliferate from bone and periodontal ligament rather than epithelium to and from bone and periodontal ligament rather than epithelium to more reliably gain new attachment to the tooth more reliably
48
this is measured from the cej to the base of the pocket
attachment loss
49
these types of grafts have donor sites located somewhere in the mouth away from
the site that requires grafting
free gingival graft
50
what are the most common mucogingival procedures?
lateral pedicle gingival graft
free autogenous gingival graft
subgingival connective tissue graft
51
this is 1-2 mm of connective tissue attachment covered by epithelium between the probing depth and the alveolar bone
biologic width
52
fissure in gingival tissues caused by abnormal frena, trauma from occlusion or pierce related trauma
gingival cleft
53
what are the goals of periodontal surgery?
pocket reduction
abscess drainage
correction of mucogingival defects
aesthetic improvements
access for restorative procedures
regeneration of lost tissue
placement of dental implants
54
what are the four healing categories
repair
reattach
new attachment
regeneration
55
what is an advantage of periodontal surgery?
better access to furcations, complex root surfaces and infrabony pockets.
56
these type of grafts has a variety of synthetic bone minerals... they may be made of hydroxyapatite mineral or ceramics, such as plaster of paris and tricalcium phosphate
alloplasts
57
what are some post operative instructions the hygienist must review with a patient after periodontal surgery??
limiting physical activity
controlling bleeding with finger pressure if needed
consuming a soft diet
filling and takin prescriptions for analgesics and antibiotics if needed
being aware of swelling that may occur
avoid smoking
follow plaque and biofilm instructions
58
this is created from bone that comes from another person...
allograft
59
this has become the procedure of choice when root coverage is the objective of mucogingival surgery
subgingival connective tissue graft
60
when prescribing periodontal surgery, what factors are considered?
probing pocket depth
amount of bone loss
importance of the tooth to function and aesthetics
patients level of plaque biofilm control
patients general health
61
what are some specific considerations in deciding to perform periodontal surgery?
pocket depth
bone loss
value of the tooth
plaque and biofilm control
health of the patient
patient preference
62
dome shaped lesion known as boil
furncle
63
this is the measurement from the crest of the gingival margin to the base of the pocket
probing depth
64
what pocket depths are most successfully treated by periodontal surgery procedures?
5-9 mm
65
when is the surgical wound well epitheliaized?
7-10 days
66
what does a blood clot act as?
matrix and scaffolding for healing cells to migrate into the wound area
67
how should a blood clot be? thick or thin
thin as possible because the inflammatory cells associated with wound healing are also required to remove the fibrin clot to complete healing
68
in studies of the healing of periodontal surgical wounds, the junctional
epithelium returned to its pre surgical appearance in...
10-12 days
69
maturation of newly formed bone can continunuo to...
6 months
70
what type of healing intention is gingvectomy?
secondary
71
