Periodontal Surgical Concepts Flashcards
(37 cards)
what is resective?
removing the tissues
what is the primary outcome of periodontal therapy?
long junctional epithelium and resolution of inflammation
what is the way we want the tissues to heal?
shrinkage of the tissues
is it possible to grow new PDL fibers and a new alveolar bone?
yes
what is the fundamental goal of periodontal surgery
provide an environment in the periodontium that can be maintained in health and comfort throughout the life of the patient
when is surgery necessary
when the periodontium is unhealthy and cannot be repaired with nonsurgical treatment
what are some indications for perio surgery
- remove tissues
- reduce pocket depth
- regenerate periodontium
- enhance prosthetic dental care
- improve appearance of periodontium
what does relative contraindications mean?
each patient is different from all others
what are some relative contraindications for perio surgery
- high risk for dental caries
- unrealistic expectations
- systemic diseases/conditions
- non compliant with home care
systemic disease and conditions that would contraindicate perio surgery
- uncontrolled hypertension and diabetes
- kidney dialysis
- HIV infection
- recent history of heart attack
why can’t someone who has a high caries risk get perio surgery?
perio surgery can expose portions of tooth roots
what are terms to describe healing?
healing by:
- repair
- reattachment
- new attachment
- regeneration
define healing by repair? what procedure would result in healing by repair?
healing is complete, tissue is not completely the same in appearance or function though
- results in long junctional epithelium
- example is healing that takes place after instrumentation (root debridement or scaling)
define healing by reattachment? what procedure would result in healing by reattachment?
- reunion of connective tissue and root that was separated by incision or injury NOT disease
- moving healthy tissue on a tooth may be necessary to access damaged tissue on an adjacent tooth
- example would be surgical extraction of a tooth
define healing by new attachment? what procedure would result in this?
- new attachment describes union of pathologically exposed root with connective tissue or epithelium
- occurs when epithelium and connective tissues are newly attached to root where periodontitis previously destroyed the attachment
- example would be mucogingival surgery or soft tissue grafts
difference between reattachment and new attachment
reattachment does not involve disease while new attachment is from disease
define healing by regeneration? what procedure would result in this?
- biologic process by which architecture and function of lost tissue are completely restored
- tissues look exactly the same as before
- reformed alveolar bone, PDL, and cementum that were lost
- example would be guided tissue regeneration
define healing of a wound by primary intention
- wound margins are closely adapted to each other
- IDEALLY all periodontal surgery wounds heal this way, but not possible
define healing of a wound by secondary intention
- margins or edges of the wound are not in close contact with each other
- many wounds in perio surgery involve healing this way
define healing of a wound by tertiary intention
- healing of a wound that is temporarily left open with the specific intent of surgically closing that wound at a later date
- not common in dentistry
common types of periodontal surgery
- periodontal flap
- bone replacement graft
- crown lengthening
- guided tissue regeneration
- gingivectomy
- dental implant placement
what is the most common periodontal surgery?
periodontal flap
what is a periodontal flap surgery?
incisions are made in the gingiva to allow separation of the epithelium and connective tissues from the underlying tooth roots and underlying alveolar bone
indications for perio flap surgery
- provide access for treatment of tooth roots or bone
- flip can be elevated for periodontal instrumentation to access bone to reshape or fill defects
