osseous surgery- resective

Question 1

types of surgeries

Answer 1

 Resective procedures
(subtractive)
 Regeneration procedures
(additive)

Question 2

Osteoplasty:

Answer 2

Osteoplasty: The reshaping of bone
to achieve a more physiologic form
without removal of alveolar bone
proper.

Question 3

Ostectomy:

Answer 3

Ostectomy: The removal of alveolar
bone proper (supporting bone

Question 4

tooth/bone anatomy and histo picture

Answer 4

Question 5

why does perio dx start interprox

Answer 5

non-keratinized col

Question 6

classes of osseous defects

Answer 6

supra and infrabony

Question 7

infrabony pockets
classes?
most common?
additional names?

Answer 7

apical to the alveolar crest
 One-wall:(can be a hemiseptum)
 Two-wall:(crater-the most common
defect)
 Three-wall:(true intrabony defect)
 Combination:(of any of the above)

Question 8

Suprabony versus Infrabony defects based on distance btwn roots

Answer 8

 If the distance between the roots of the teeth is ≥2.5 mm then the defects will be a vertical defect (amount of cancellous bone present).
 If the distance is less than 2.5 mm then horizontal bone loss will occur.

Question 9

Answer 9

2 wall bony defect

Question 10

should bone be removed to access defects?

Answer 10

no, may compromise tooth support

Question 11

Inconsistent margins

Answer 11

the interdental crestal bone is located apical to the level of the radicular bon

Question 12

other osseous defects

Answer 12

 Interradicular defects (furcation defects)
 Dehiscences
 Fenestratons

Question 13

Answer 13

fenestration

Question 14

Answer 14

dihesence

Question 15

should we scale a fenestration root surface?

Answer 15

no, could be viable PDL cells capable of reattachment

Question 16

Bone Morphology forms

Answer 16

 Positive architecture (physiologic architecture)
 Negative architecture (reverse architecture, or inconsistent margins)
 Flat architecture

Question 17

Architecture type?

Answer 17

flat

Question 18

Architecture type?

Answer 18

negative, interprox bone more apical than radicular bone

Question 19

 Determinants of Gingival Contour-
(Not necessarily the underlying bone)

Answer 19

 Interdental space
 Position of tooth in the arch (facial or lingual position in the alveolus)
 Root shape
 Crown shape

Question 20

Rationale of osseous surgery

Answer 20

A reduced probing depth will both increase the effectiveness of oral hygiene by the patient and also facilitate the ease of maintenance by the therapist

Question 21

Indications for osseous surgery
 type of defects?
 Osseous structures?
 Furcation?
 margins?

Answer 21

 Shallow infrabony defects
 Osseous ledges and tori
 Furcation invasions-Class I or shallow Class II
 Inconsistent margins

Question 22

what type of removal would be used here?

Answer 22

osteoplasty, removal of non-supportive bone

Question 23

Contraindications for osseous surgery
 Maxillary anteriors?
 Three-wall defects ?
 deep defects?
 Generalized ?

Answer 23

 Maxillary anteriors (esthetics)
 Three-wall defects (regeneration can be done)
 Isolated deep defects
 Generalized advanced bone loss

Question 24

 Contraindications to osseous
surgery

Answer 24

 Local anatomic factors
 Sinus
 Ascending ramus
 Flat palate
 External oblique ridge
 High caries rate
 Dentinal sensitivity

Question 25

sx?

Answer 25

no, sinus

Question 26

is this an issue post-op, why or why not?

Answer 26

no, craters can form post-op but tend to remodel

Question 27

 Advantages to osseous surgery  Predictable?  staged?  sx sites?  healing time?  Ease of?

Answer 27

 Predictable  One-stage  Single surgical site  Minimal healing time  Ease of post-operative maintenanc

Question 28

 Disadvantages of osseous surgery  Root? looks?  dependent on?  Loss of ?

Answer 28

 Root sensitivity and esthetics (especially in the maxillary anterior)  Defect dependent  Loss of attachment (by ostectomy, However, ostectomy is usually limited)

Question 29

alt tx's to osseous sx

Answer 29

 Regenerative procedures  Root amputation or hemisection  Non-surgical therapy  Extraction

Question 30

 Interrelationship of factors of osseous sx  Gingival?  Bone factors?  Anatomic?  Dentition?  Adjacent?  Position in?  Root and crown?

Answer 30

 Gingival contours  Bone thickness and contour  Anatomic factors  Dentition  Adjacent teeth  Position in the arch  Root and crown anatom

Question 31

Osseous Surgery Surgical Technique  location of incision technique?  incisions where?  flap reflection?  debridement?

Answer 31

 Bone sounding  Intra-sulcular incisions on facial and lingual of mandible and facial of maxilla  Mucoperiosteal flap reflection  Root and defect debridement

Question 32

Osseous surgery technique  Vertical interproximal?  Reduction of?  Elimination of?  Removal of ?  Removal of?

Answer 32

 Vertical interproximal grooving  Reduction of marginal radicular bone  Elimination of lips of craters  Removal of “widow’s peaks”  Removal of marginal radicular bone

Question 33

osseous surgery closure

Answer 33

 Based on tissue placement  At the alveolar crest = pocket elimination  Coronal to alveolar crest = pocket reduction

Question 34

palatal approach for osseous surgery  embrasures?  bone type?  Defect?  tissue type?  roots?  Furcations location?

Answer 34

 Wider embrasures  More cancellous bone  Defect location  All keratinized tissue  One root vs. two roots  Furcations more apical

Question 35

Osseous Surgery Lingual Approach  Furcations location?  Defect?  inclination of molars?  embrasures?  Avoids what structure?

Answer 35

 Furcations more apical  Defect location  Axial inclination of molars  Wider embrasures  Avoids external oblique ridge