Regenerative periodontal therapy Flashcards
(24 cards)
What are the 4 types of periodontal surgery
- access therapy
- resective therapy
- regenerative therapy - GTR and GBR (guided tissue/bone regeneration)
- mucogingival surgery - perio plastic surgery
What is access therapy used for
gain more access to root surface in persisting pockets
What is resective therapy
- remove infected soft tissue of gingiva and infected bone
When is resective therapy used
- furcation resective tx e.g root resective / tunnel preparation
- gingivectomy - hyperplasia
- crown lengthening - before pros
When is GTR and GBR used
- infrabony defects
- augmentation of edentulous ridge prior to implant placement
What is mucogingival therapy used for
- gingival augmentation
- root coverage
- gingival preservation at ectopic tooth eruption
- preservation of ridge collapse associated with tooth extraction
What is the aetiology of gingival recession in regards to periodontal disease
- bone is lost from disease process
- gingiva is inflamed
- tx reverses gingival inflammation and inflammation dies down, resulting in recession
- sign of successful tx
What are mechanical/physical factors that can result in recession
- vigorous toothbrushing
- traumatic incisal relationship
- trauma from foreign bodies e.g lower lip piercings
- prominent teeth out of alignment of arch especially if thin gingival biotype
- aberrant frenal attachment - apical pull
- high frenal attachments
- iatrogenic damage - subgingival margins impinging on biological width
- ortho tx not respecting width of alveolus
What is type 1 recession
- no loss of interproximal attachment
- interproximal CEJ not clinically detectable at both mesial and distal aspects
- i.e buccal/lingual recession only
What is type 2 recession
- loss of interproximal attachment
- measured from interproximal CEJ to depth of interproximal sulcus is less than or equal to the buccal attachment loss
What is type 3 recession
- loss of IP attachment
- amount of IP attachment loss greater than buccal attachment loss
What types of recession are treatable
type 1
type 2 partially treatable
What are the symptoms of gingival recession
- dentine hypersensitivity
- cervical caries
- cervical abrasion and erosion
- poor aesthetics
- loss of vitality, tooth loss
What are the tx options for recession
- mointor
- use of desensitizing agents e.g vranishes and bonding agents
- composite restoration
- prosthetic crown with pink porcelain to mask - not recmomended
- removable pink gingival veneers - not good
- orthodontics - restricted cases but good result
- surgery (graft)
What are the types of grafts that can be used in mucogingival therapy
- free soft tissue graft
- pedicle gingival graft
- rotational flap
- advanced flap
What are the 2 types of rotational flaps
- laterally positioned
- double papilla
What are the 2 types of advanced flaps
- coronally advanced
- semilunar coronally respositioned
What is a split thickness flap and why is it used in mucogingival therapy
- cut through mucosa and leave periosteum and soft tissue on bone
- dont want to expose bone to OC permanently
When is gingival graft indicated
- ortho/prosthetic tx - transform biotype prior to recession forming
- root sensitivity
- difficulty cleaning root surface by px
- aesthetic concern
What is the advantage of a free gingival graft
increase keratinized tissue around the teeth implant or crown
What are the disadvantages of a free gingival graft
- not perfect aesthetics
- graft has no blood supplies through the vessels during the first week
What makes a free connective tissue graft different from a gingival one
associated with a coronally advanced flap
connective tissue graft makes biotype much thicker
What is a laterally repositioned flap
borrwing tissue from tooth next door
What is a double papilla rotational flap
using tissue from both sides
