Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Module 8 > perio surgery > Flashcards

perio surgery Flashcards

(99 cards)

Start Studying
1
Q

name 3 types of perio surgery instruments

A

microsurgical instruments
microsurgical scalpel blades
magnification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name 3 flap design dont’s

A

dont cut max bulbosity of root
dont cut diagonal relieving insicions
dont cut vertically through papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why are black silk sutures not used anymore

A

baterial colonisation
wicking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what sutures are used now

A

synthetic mono-filament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what should pts be told when sutures are present

A

no brushing in the region
use chlorhexidine mouthwash to reduce plaque formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

why are periodontal dressings not used so much now

A

pts dont like them - aesthetics and function
corners can get bacterial growth underneath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the 3 types of perio surgery

A

resective
repair/reattachment
regenerative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are 2 resective surgeries

A

gingivectomy
root resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are 2 repair/reattachment surgeries

A

Open flap debridement (OFD)
modified widman flap (MWF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are 3 regenerative surgeries

A

GTR guided tissue regeneration
grafts
emdogain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is resective surgery

A

pocket elimination procedure which establsihes a morphologically normal attachment but with apical displacement of the dento-gingival complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is repair/reattachment surgery

A

pocket reduction surgery but without replication of the normal attachment
healing is by formation of a long juctional epithelim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what flap is used for repair/reattachment

A

partially reflected flap
crevicular incision without relieving incisiosn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe the open flap debridement procedure

A
  1. pt consent and LA
  2. 1 min chlorhexidine
  3. incision in gingival sulcus
  4. raise full thickness flap, limited to 1mm below alveolar crest
  5. remove granulation tissue
  6. scale tooth surface
  7. suture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the modified widman flap

A

resection of soft tissue collar from ginigival margin
incision 0.5-1mm from gingival margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the indications for partially reflected flaps

A

excellent maintenance
site >6mm with BOP or suppuration
horizontal bone loss pattern
vertical defect<3mm
isolated perio pockets remain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are containdications for partially reflected flaps

A

asesthetic region
need for graft/membrane
complex furcation/bone defects
lack of/limited attached ginigvae (MWF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are advantaged of partially reflected flaps

A

healing by primary intention
minimal crestal bone resorption
effective in pockets 6-7mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are disadvantages of partially reflected flaps

A

can be unpredictable
no new attachment
risk of recession
interdental craters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is regeneration

A

recreation of the complete attachment apparatus of bone/cementum/functionally orientated periodontal ligament against previously exposed root surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the difference between repair and regeneration

A

repair causes long junctional epithelium and crestal remodelling
regenerations causes new cementum pdl and alveolar bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the 3 aims of regenerative surgery

A

regenerate defect
remove factors associated with disease progression
enhance access for plaque control and maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is needed for regeneration?

A

PDL cells
wound stability
space provision
primary intention healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what cells are available to repopulate the root for healing

A

epithelial cells
gingival connective tissue cells
bone cells
mesenchymal cells from PDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what to epithelial cells do in healing
long junctional epithelium
26
what to ginigval connective tissue cells do in healing
CT attachment or root resoprtion
27
what to bone cells do in healing
root resorption and ankylosis
28
what to mesenchymal cells do in healing
regeneration
29
what is the case selection criteria for regeneration
infrabony defect with pocket >6mm, depth >3mm, <25 degrees, high number of walls class 2 furcation mandibular molars single class 2 furcation maxillary molars
30
what are the 4 regenerative techniques
guided tissue regeneration bone graft materials enamel matrix proteins (EMD) combinations (GTR&bone, EMD&bone)
31
what is guided tissue regeneration
use of mechanical barrier (membrane) to selectively enhance the establishment of PDL and peri-vascular cells in osseous defects to initiate periodontal regeneration
32
what are the 3 aims of GTR
1. stop rapid downgrowth of epithelial cells 2. create space for pluripotent cells from PDL to access root surface 3. improve local anatomy, function and prognosis of teeth
33
what is the function of a membrane
act as a barrier to prevent cells apart from PDL migrating into site
34
what is an autograft
from donor site of same person
35
what is an allograft
from a different person but human bone
36
what is a xenograft
from animal source
37
what is alloplast
synthetic material
38
what does emdogain do
mimics the development of tooth supporting apparatus during tooth formation
39
what is the effect of EMD on epithelial cells
decreased cell proliferation and migration
40
what is the effect of EMD on gingival fibroblasts
reduced cell migration
41
what is the effect of EMD on bone
increased cell proliferation and migration, support of bone formation but not osteoinductive
42
what is the effect of EMD on PDL fibroblasts
increased cell proliferation, migration and attachment
43
what is the effect of EMD on cementoblasts
increased in vivo mineralisaton
44
what is the outcome of EMD and GTR
no additional benefit compare with each alone
45
what is the outcome of EMD and graft
improved outcomes with EMD and xenograft/autogenous bone no improvement with alloplastic materials
46
what is the outcome of graft and GTR
best combination for non-contained defects
47
what is the outcome of EMD, graft and GTR
no additonal benefit compared to 2 combined
48
what are the advantaged of regeneration
- successful in tx of deep sites >6mm - healing by primary intention - improvement in volume of supporting tissues of tooth - less recession for pt
49
what are the disadvantages of regeneration
- technically challenging to get a good outcome - can be unacceptable for some pts depending on materials used - expensive materials
50
what are 3 causes of gingival overgrowth
inflammatory drug-induced related to systemic conditions
51
what healing is after gingivectomy
secondary
52
what are indications for gingivectomy
gingival enlargement/overgrowth persists despite non-surgical care supra-bony periodontal pocketing excellent at home care wide zone of attached gingivae
53
what are contraindications for gingivectomy
narrow attached gingivae planned osseous recontouring infra-bony periodontal pockets medical contraindications - bleeding disorder
54
what are advantages of gingivectomy
simple good vision can achieve ideal soft tissue morphology
55
what are disadvantages of gingivectomy
limited indications heal by secondary intention risk bone exposure wastes attatched gingivae excessive recession in PD disease
56
what is surgical crown lengthening
surgical procedure which apically repositions the soft tissue and alveolar bone to expose more tooth structure, and increase the length of the clinical crown
57
what is the aim of surgical crown lengthening
surgically maintain biologic width whilst apically repositioning the gingival level
58
7 indications for surgical crown lengthening
1. toothwear 2. poor gingival aesthetics 3. restoration of subgingival lesions 4. replacement of crowns with deep margins 5. management of coronal third fractures 6. management of infringement of biologic width 7. develop ferrule for pulpless teeth restored with posts
59
6 contraindications for SCL
1. poor plaque control 2. poor compliance 3. non-functional teeth or teeth of poor strategic value 4. periodontal destruction 5. endodontic compromise 6. medical history considerations
60
5 SCL complications
1. poor aesthetics due to black traingles 2. transient mobility of teeth 3. root sensitivity 4. rebound of marginal tissues 5. root resorption
61
what is odontoplasty
reshaping tooth surface
62
what can odontoplasty increase
sensitivity and caries
63
when is OFD effective
shallow defects to eliminate pockets
64
when is tunneling done
mandibular molars with deep degree 2 and 3 furcations
65
what is root resection
removal of one root of a multi-rooted tooth where there is uneven bone loss
66
what are the indications for root resection
class 2/3 furcation involvement severe bone loss on 1 or more roots root fracture/perforation/deep caries failed endo or inoperable canals
67
what are contraindicaitons for root resection
inadequate bone support on remaining roots unfavourable anatomy - fused root, long root trunk significant discrepancies in bone height remaining roots not restorable
68
what is hemisection
root resection usually in mandibular molars with portion of crown
69
what is the most predictable way to regenerate furcations
GTR with bone graft
70
what is ginigval recession
location of the marginal tissue apical to the CEJ with exposure of root surface
71
what are the possible aetiological factors of recession
traumatic - toothbrushing, partial dentures, lip/tongue piercing, self-inflicted traumatic overbite periodontal disease poor restorative margins - plaque retention, encroach of biologic width
72
what are the factors related to increased risk of recession
high muscle attachment/frenal pull thin tissue phenotype alveolar dehiscence teeth outside alveolar bone after orthodontic treatment (proclination, arch expansion) lack of keratinised tissue
73
what is the non-surgical management of recession
monitoring and prevention composite restorations gingival prosthesis ortho?
74
what is the surgical management of recession
frenectomy pedicle flaps free gingival grafts subepithelial connective tissue graft coronally advanced flap & GTR
75
what are the indications for surgical management of recession
- prevention of continued recession - improve ability to perform OH measures - aesthetic concern - sensitivity/root caries?
76
what are the contraindications for surgical management of recession?
- poorly controlled diabetes - bleeding disorders - smoking - poor OH - active perio disease - previous failed procedures - self-inflicted injuries
77
what are the aims of a frenectomy
stabilise tissue improve access for OH measures
78
what are the indications for frenectomy
unstable local tissue blocking access for OH measures midline diastema shallow vestibule for prosthesis
79
what are the contraindications for frenectomy
medical/bleeding disorders scar formation will make further procedures more challenging
80
what are the aims of grafting
- improve/create band of keratinised, attached gingiva - avoid scarring - optimal tissue blend/colour match - improve access for OH - 100% root coverage
81
what is pedicle flap
local tissue maintaining own blood supply single site surgery surgery limited by local anatomy
82
what is a graft
material from distant donor site two site surgery larger quantity of ct more technically demanding no direct blood supply so graft can fail
83
what kind of flap is a pedicle flap
split thickness flap
84
what are the indications for a pedicle flap
narrow defect on single tooth adjacent teeth with thick phenotype or edentulous area deep vestibule
85
what are the contraindications for pedicle flap
deep perio pocketing loss of ID tissue large root prominences lack of relevant local anatomy deep root abrasion
86
what are the advanteges of pedicle flaps
one site surgery good vascularity to pedicle flap root coverage possible
87
what are the disadvantages of pedicle flaps
- limited by amount of adjacent keratinised, attached gingivae - risk of recession at donor site - risk of dehiscence at donor site - limited to a single tooth - not as likely to gain root coverage
88
what is a free gingival graft
graft from palate formed of epithelium and small amount of underlying connective tissue is placed into a region with localised recession
89
what are the aims of free gingival graft
- to create a band of keratinised mucose - remove frenal attachments - prepare site for second procedure to increase root coverage
90
what are the indications for free gingival graft
- discomfort during OH measures - ongoing local inflammation - lack of keratinised tissue in region of recession defect - prevention of further recession - insufficient local keratinised tissue pedicle flap
91
what are the contraindications for free gingival grafts
- aesthetic region - aim for complete root coverage - donor site tissue poor - medical containdications
92
what are the advantages of free gingival grafts
relatively simple surgery increases vestibular depth
93
what are the disadvantages free gingival grafts
secondary surgical site palatal wounds heals by 2ndry intention unaesthetic
94
what is a coronally advanced flap
surgical procedure where a split thickness flap is raised, released and then replaced in a more coronal position
95
what are the advantages of coronally advanced flaps
possible for 1 site surgery less technically demanding than tunnelling can be combined with GTR
96
what are the disadvantages of coronally advanced flap
often benefit from CT graft if used with GTR, higher risk of infection vertical releasing incisions mean delayed healing
97
what is a modified coronally advanced tunnel with CT graft
split thickness flap raised without any releasing incision and maintaining interdental papilla repositioned coronally with CT graft threaded through tunnel underneath ginigvae
98
what are the advantages of modified coronally advanced tunnel with CT graft
microsurgical technique excellent colour match better vascularisation of flap best root coverage
99
what are the disadvantages of modified coronally advanced tunnel with CT graft
secondary operative site technically demanding - thin phenotype, graft harvesting

Module 8 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions