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Flashcards in week 11 and 9 Deck (20)
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1

Laser stands for?
absored vs not

Light Amplification by Stimulated Emission of Radiation

absorbed= ablation
not well absored= scattered and charring/melting

2

common dental lasers

CO2, Nd:YAG, Er:YAG, GaAs (diode)

3

Regeneration

healing occurs through reconstitution of a new periodontium (alveolar bone, PDL, cementum) *THE GOAL*

4

repair

healing by replacement with epithelial and/or connective tissue that matures into nonfunctional types of scar tissue (new attachment)

5

reconstructive surgical techniques

1) non-graft
2) graft associated/combined therapy (GTR +bone graft)
3) biologic mediator

6

non-graft reconstructive surgical technique

* GTR – guided tissue regeneration, originally a non-graft-associated procedure but now mostly used with graft (USA)
• LANAP – laser-assisted new attachment procedure (controversial and need bootcamp)

7

graft associated/combined therapy (GTR +bone graft) reconstructive surgical technique

• autografts
• allografts – FDBA, DFDBA
• xenografts - BioOss

8

biologic mediator reconstructive surgical technique

Tissue engineering: wound healing process is manipulated so that tissue
regeneration occurs

two options:
* Enamel Matrix Derivative (EMD) (Emdogain)
• Platelet-derived growth factor (rhPDGF)

9

GTR – guided tissue regeneration

objectives: 1) prevent epithelial migration into site, 2) maintain
space for clot stabilization

*Favors repopulation of area by
PDL and bone cells (which develop more slowly than epithelium)

10

Osteogenic vs Osteoconductive vs Osteoinductive

Osteogenic: formation or development of new bone by cells contained in the graft

Osteoconductive: material that functions as physical scaffold that favors outside
cells to penetrate and form new bone

Osteoinductive: material that allows a chemical process to occur that converts
neighboring cells into osteoblasts

11

autografts

1) intraoral sites with osseous coagulum or bone blend
2) bone marrow transplants from MX tuberosity or healing extraction sites
3) bone swaging- edentulous area is pushed into defect without fracturing bone
4) extraoral sites are tibia and iliac crest

12

Osseous coagulum vs Bone blend

Osseous coagulum – “bone dust” and blood, uses small particles ground from cortical bone, small particle size yields increased surface area for cellular/vascular interaction

Bone blend – autoclaved plastic capsule and pestle, bone triturated in capsule to packable mass

13

allografts: FDBA vs DFBA

FDBA: freeze-dried bone allograft
• osteoconductive
* hot magnet for bacteria, must take out if graft is exposed


DFDBA: demineralized freeze-dried bone allograft, preferred over FDBA (PREFERRED- doesn’t need taking out if exposed)
• Osteoinductive
• Demineralization in hydrochloric acid exposes molecules called bone morphogenic proteins
(BMPs)
• Cannot see on radiographs immediately postop (problem for direct/indirect sinus lifts)

14

EMD – enamel matrix derivative (Emdogain)

comparable to GTR

Concern remains about whether commercial batches of EMD will be consistent and comparable- conflicting studies

15

what is OFD?

Open flap debrivment
* everything better than this*

16

PDGF

• Commercially available, requires no barrier membranes
• Effectiveness in furcation defects and implant sites remains unstudied

17

Xenografts

BioOss with resorbable membrane BioGide
** permits clot stabilization and revascularization

18

Use allograft or xenografts for implants?

Allografts Bc it recruits your own cells

(Bovine lasts forever tho)

19

Infraboney pockets

Base of the pocket is apical to the crest of the alveolar bone, pocket wall lines between the tooth and the bone

VERTICAL BONE LOSS

Aka intraboney

20

Supraboney pcokets

Base of the pocket is coronal to the crest of alveolar bone and pocket wall lies coronal to the bone as well

HORIZONTAL BONE LOSS

Aka Supracrestal or Supra-alveolar