Osseous surgery- Regeneration - Review

Question 1

Tissue transfered from one site to another in the SAME individual:

Answer 1

Autograft

Question 2

Tissue transferred between individuals of the SAME SPECIES:

Answer 2

Allograft

Question 3

1. Freeze-dried bone
2. Demineralized freeze-dried bone
3. Solvent-treated

All of these are types of:

Answer 3

Allograft

Question 4

INERT material graft:

Answer 4

Alloplast

Question 5

1. Calcium sulfate
2. Calcium phosphates
3. HTR
4. Bioactive glass ceramics
5. SRM

All of these are types of:

Answer 5

Alloplast

Question 6

Tissue transferred between individuals of DIFFERING SPECIES:

Answer 6

Xenograft

Question 7

1. bovine bone
2. bovine bone + cell-bindign peptide 15
3. fetal pig enamel matrix derivative

All of these are types of:

Answer 7

Xenograft

Question 8

Combition of different types of grafts:

Answer 8

Composite

Question 9

25% hydroxyapatite & 75% freeze dried bone is an example of:

Answer 9

Composite graft

Question 10

Bone sources for grafting can be:

Answer 10

Intraoral or extraoral

Question 11

Intraoral sources for bone grafting:

Answer 11

1. cortical bone chips
2. osseous coagulum
3. healing extraction socket
4. chin or ramus block graft

Question 12

Extraoral sources for bone grafting:

Answer 12

1. iliac crest
2. ribs

Question 13

When calcium sulfate is added to FDBA:

Answer 13

CaSO4 regeneration

Question 14

In CaSO4 regeneration, what is added to FDBA?

Answer 14

Calcium sulfate

Question 15

What is the rationale behind CaSO4 regeneration?

Answer 15

Calcium sulfate binds bone particles to prevent bone washout and also accelerates bone formation by enhancing BMP and providing a source of calcium ions to aid in mineralization

Question 16

Indications for regeneration/bone replacement grafts include:

Answer 16

1. deep vertical defects
2. esthetic considerations
3. teeth critical to prosthesis
4. when anatomy precludes other procedures
5. GTR

Question 17

Contraindications for regeneration/bone replacement grafts include:

Answer 17

1. poor plaque control
2. medically compromised
3. poor maintenance compliance

Question 18

Advantages of regeneration/bone replacement grafts include:

Answer 18

1. restores lost periodontal tissue
2. maintains teeth in healthy functional state
3. enhances long term prognosis of teeth

Question 19

Disadvantages of regeneration/bone replacement grafts include:

Answer 19

1. technique and material sensitive
2. expensive
3. may require two surgeries
4. unpredictable outcome
5. requires ideal wound closure
6. longer/more frequent post op care
7. second surgical site sometimes required
8. success decreases significantly in furcation
9. defect dependent
10. expensive

Question 20

Connective tissue is the coding to determine the type of tissue you obtain from a graft. Free gingival grafts will end up revascularizing with the underlying connective tissue. This is the ____ to bone graft replacement.

Answer 20

Biologic response

Question 21

What is the coding to determine the type of tissue you obtain from a graft:

Answer 21

Connective tissue

Question 22

T/F: Free gingival grafts will end up revascularizing with the underlying connective tissue

Answer 22

True

Question 23

Biological response when viable osteoBLASTS are transplanted:

Answer 23

Osteogenic

Question 24

Scaffold for bone formation (freeze-dried bone allograft, bioactive glass)

Answer 24

Osteoconductive

Question 25

Release of material to induce bone formation:

Answer 25

Osteoinductive

Question 26

Production of bone by a biologic mechanism:

Answer 26

Osteoproductive

Question 27

1. viable osteoblasts are transplanted 2. scaffold for bone formation 3. release of material to induce bone formation 4. production of bone by a biologic mechanism

Answer 27

1. osteogenic 2. osteoconductive 3. osteoinductive 4. osteoproductive

Question 28

Describe the healing sequence:

Answer 28

1. incorporation (clot formation) 2. revascularization 3. resorption of graft material with slow release of BMP to induce bone formation 4. bone formation 5. bone remodeling and maturation

Question 29

Graft success is dependent on _____

Answer 29

Defects

Question 30

What type of defects have little to no success with grafts?

Answer 30

Suprabony defects (horizontal bone loss)

Question 31

List in order the success rates of inrabony defects (most to least):

Answer 31

1. three walled 2. two walled 3. one walled

Question 32

List some complications of grafting:

Answer 32

1. no regeneration 2. sequestra 3. root resorption (rare) 4. donor site problems (at second site) 5. infection (less than 1%)

Question 33

Variables that can affect grafting success can include:

Answer 33

1. pre-scaling or scaling at time of surgery 2. local drug delivery at time of surgery 3. flap design 4. intramarrow penetration 5. hydration of graft material 6. root treatment or modification 7. use of antibiotics 8. endodontics & graft success 9. smoking & graft success