Periodontal Surgery Terms

Question 1

general indications for periodontal or implant surgery

Answer 1

1. continued pocketing and inflammation following initial therapy with need for surgical access
2. infrabony (intrabony) osseous defects
3. grade 2 and 3 furcation involvement
4. unstable mucogingival defects
5. esthetic considerations
6. replacing missing teeth with implants
7. prescription surgery (requested by referring dentist)

Question 2

examples of prescription surgery

Answer 2

1. restorative: crown lengthening, gingival grafting

2. orthodontic: frenectomy and supracrestal circumfrential fiberotomy following ortho

Question 3

contraindications to perio surgery

Answer 3

1. uncontrolled medical problems
2. patient non-compliance
3. poor OH

Question 4

apically positioned flap

Answer 4

flap of tissue replaced apical to its original position on closure

Question 5

an apically positioned flap is important in establishing what?

Answer 5

surgical recession for pocket elimination or crown lengthening while preserving keratinized gingiva

Question 6

in order for a flap to be apically positioned, it must be elevated past what?

Answer 6

mucogingival jxn

Question 7

T/F: apically positioned flap may be performed on max facial, max palate, mand facial and mand lingual surfaces

Answer 7

false, not max palate

Question 8

coronally positioned flap

Answer 8

periodontal flap that is replaced coronal to its original position

Question 9

coronally positioned flap is used to cover what?

Answer 9

exposed roots but does not result in an increase in keratinized gingiva

Question 10

crown lengthening

Answer 10

exposure of clinical crown usually for restorative purposes

Question 11

distal wedge

Answer 11

periodontal surgical procedure for removal of excessive soft tissue distal to terminal molar with access gained to underlying bone

Question 12

how is tissue removal accomplished in a distal wedge procedure?

Answer 12

via internal thinning (undermining incisions)

Question 13

what is the goal of distal wedge procedure?

Answer 13

1. remove excessive tissue
2. reduce pocket depth
3. facilitate oral hygiene at the area

Question 14

free gingival graft (free soft tissue graft, detached gingival graft)

Answer 14

autogenous graft of masticatory mucosa or collagenous tissue completely detached from its original site and blood supply and placed in a prepared recipient bed

Question 15

what determines the success of the free gingival graft?

Answer 15

survival of CT

Question 16

frenectomy (frenulectomy)

Answer 16

surgical detachment and/or excision of a frenulum from its attachment into the mucoperiosteal covering of the alveolar process

Question 17

alveolectomy

Answer 17

removal of all or a portion of alveolar process of jaw bone(s)

Question 18

alveoloplasty

Answer 18

surgical procedure of altering alveolar ridge or its surrounding bony structures by cutting, smoothening, or reshaping to correct alveolar ridge external contour in preparation for prosthetic rehabilitation

Question 19

vestibuloplasty

Answer 19

plastic surgery of vestibular region of the mouth designed to restore alveolar ridge height (deepen the vestibular trough) by lowering the muscles that attach to the buccal, labial, and lingual aspects of the jaws

Question 20

full thickness flap (mucoperiosteal flap)

Answer 20

flap of mucosal tissue, which includes periosteum, reflected from bone

Question 21

guided tissue regeneration

Answer 21

barrier method for promoting selective re-population of periodontal defect multi-potential cells from the PDL or bone through exclusion of gingival epithelium and flap CT

Question 22

what type of flap will help insure flap coverage over the defect and GTR material in GTR procedure?

Answer 22

replaced or coronally positioned flap

Question 23

gingivectomy

Answer 23

excision of soft tissue wall of periodontal pocket is uncomplicated by extension into underlying bone

Question 24

the incision for gingivectomy forms what?

Answer 24

45 degree external bevel or surface that is exposed to oral cavity

Question 25

when is gingivectomy contraindicated?

Answer 25

when pockets reach MG jxn or osseous defects are present

Question 26

gingivoplasty

Answer 26

surgical procedure by which gingival deformities (particularly enlargements) are reshaped and reduced to create normal and functional form

Question 27

inverse bevel incision

Answer 27

an internal (reverse) incision (faces the tooth) as opposed to external

Question 28

what is used in most flap designs?

Answer 28

inverse beveled incision

Question 29

resection of gingiva without elevation of flap is sometimes called what?

Answer 29

internal-bevel gingivectomy

Question 30

modified widman flap

Answer 30

replace,d mucoperiosteal flap, accomplished with an internal bevel incision, that provides access for root preparation

Question 31

modified widman flap was designed to maintain what?

Answer 31

as much interdental papilla as possible in order to effect primary closure whenever possible

Question 32

mucogingival surgery

Answer 32

plastic surgical procedures designed to correct defects in morphology, position and/or amount of gingiva surrounding teeth

Question 33

open curettage (flap curettage)

Answer 33

surgical debridement of roots and removal of granulation tissue after reflection of soft tissue flap (includes modified WIdman flaps)

Question 34

osseous surgery

Answer 34

modification of bony support of teeth

Question 35

osseous surgery is designed to modify and reshape what?

Answer 35

deformities in alveolar bone surrounding teeth

Question 36

ostectomy

Answer 36

some supporting bone is sacrificed (with loss of attachment) to gain pocket elimination or crown lengthening

Question 37

osteoplasty

Answer 37

surgical procedure that modifies the configuration of bone (only non-supporting bone is removed)

Question 38

partial thickness flap (split thickness flap)

Answer 38

surgical flap of mucosa and CT but not including periosteum

Question 39

pedicle graft

Answer 39

graft elevated from a donor site that remains attached at its base for nourishment and is transferred to an adjacent recipient site

Question 40

suturing techniques commonly used in periodontics

Answer 40

1. simple interrupted 2. single sling 3. continuous sling

Question 41

simple interrupted suturing technique

Answer 41

interdental

Question 42

single sling suturing technique

Answer 42

engages lingual or facial flap for 2 interdental papillae

Question 43

continuous sling suturing technique

Answer 43

engages lingual or facial flap for several teeth for independent suturing

Question 44

root resection

Answer 44

surgical removal of all or a portion of the root before or after endodontic tx

Question 45

examples of root resection

Answer 45

1. root amputation (usually performed on maxillary teeth) | 2. hemisection (usually performed on mandibular teeth)

Question 46

subepithelia CT graft

Answer 46

autogenous graft of CT wit ha small collar of epithelium or no epithelium taken from the palate and usually placed between a flap and the root, bone or periosteum at the recipient site

Question 47

submarginal (scalloped) incisions

Answer 47

blade enters gingiva apical to gingival margin and is directed toward alveolar crest

Question 48

what do submarginal (scalloped) incisions accomplished?

Answer 48

surgical recession

Question 49

when should submarginal incisions be avoided?

Answer 49

when there is not a abundance of keratinized gingiva or when surgical recession is not a goal

Question 50

sulcular incisions

Answer 50

blade enters the gingival sulcus and is directed toward the alveolar crest without incision of marginal gingiva

Question 51

vertical incisions

Answer 51

generallly oblique incisions that diverge in an apical direction

Question 52

where are vertical incisions placed?

Answer 52

near line angles of teeth but not over root prominences to aid in flap elevation without extending flap to adjacent teeth

Question 53

when are vertical incisions avoided?

Answer 53

on palatal and lingual aspects

Question 54

which type of flap does not have vertical incisions?

Answer 54

envelope flap

Question 55

distraction osteogenesis

Answer 55

bone augmentation procedure where a portion of jaw is sectioned by osteotomy and progressively displaced by a mechanical device that is attached to the separated bone segment and the original bone

Question 56

decortication

Answer 56

deliberate removal or repeated puncturing of cortical bone to initiate bleeding or a regional accelerated phenomenon for bone repair or to enable incorporation of bone graft into host bone

Question 57

decortication is a method routinely used in what?

Answer 57

1. ostemyelitis 2. periodontal defects ...after removal of sequestrum, the surrounding vital bone is included in the removal to initiate bleeding to promote osseous healing

Question 58

how is decortication performed in periodontal defects?

Answer 58

done through intramarrow penetration

Question 59

lamina dura

Answer 59

sheet of compact bone that forms the tooth alveolar wall or tooth alveolus

Question 60

crestal lamina dura

Answer 60

layer of compact bone existing at alveolar crest