Periodontal Plastic Surgery Flashcards
What is access therapy in periodontal treatment?
Part of step 3
If certain sites still have deep pockets
What are the advantages of OFD?
Better vision, better access to complex pockets (direct access to bone crest)
What are the features of resective periodontal surgery?
- Used before regenerative therapy
- Contributes to bone loss
- Curettage to remove lining of pocket- does not accelerate healing (we want to remove biofilm)
What are the types of resective periodontal therapies that are still used?
Furcation resective tx (tunnel prep- easier to keep clean)
Gingivectomy for hyperplasia
CLS- before prosthetic tx (cheaper than implants?)
What is regenerative perio therapy used for?
- Augment using bone substitute with membranes
- Fix horizontal and vertical infra-bony defects
- Lose of alveolar bone is difficult due to anatomical structures (issues with implants)
What are the different types of mucogingival therapy in periodontal surgery? (focusses on ST)
Gingival preservation at ectopic tooth eruption
Preservation of ridge collapse associated with tooth extraction
What are the ADV/DIS of surgical periodontal treatment?
- Faster outcomes
- Requires good OH (as it is less useful if patient has poor OH- recontamination)
What are the steps in the periodontal treatment plan?
How does mucogingival deficiency present?
What is recession?
Gingival recession is the displacement of the gingival soft tissue margin apical to the cement-enamel junction which results in exposure of the root surface
What factors are involved in aetiology of recession? pt 1
- Inflammatory process- perio disease
- PMPR (HPT)- exposes recession, bone is already lost but inflammation is reduced (this may be amenable to reconstructive surgery- but consent patient to this)
- Vigorous tooth brushing esp in patients with thin biotype (teach correct technique)
- Hard bristled toothbrush
- Traumatic incisal relationship- stripping of gingival tissues
What factors are involved in aetiology of recession? pt 2
- Trauma from foreign bodies (piercings)
- Teeth out if alignment of arch- esp with thin biotype and overlying dehiscence
- Orthodontic treatment
- Aberrant frenal attachments- pull on gingival tissues
- High frenal attachment affecting OH
- Iatrogenic damage from restorative treatment- subgingival margins that impinges on SCA
What was the old classification for recession?
-> superseded by 2017 classification
What are the types of recession?
What types of recession can be surgically fixed?
We can only fix class 1 reliably
Class 2 may or may not be amenable to MG surgery (partially treatable)
-> may not be covered up fully
Class 3- not possible