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Flashcards in week 8 Deck (11)
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1

Osseous surgery

procedure which changes are made to the alveolar bone to rid it of deformities induced by periodontal disease or other related factors (exostosis, tooth supraeruption)

2

Additive osseous surgery

procedures that attempt to restore alveolar bone
to its original level
• Implies regeneration of lost bone and reestablishment of periodontal attachment
apparatus

3

Subtractive osseous surgery

procedures that restore preexisting alveolar bone to the level present at the time of surgery or slightly more apical
• Used when additive surgery is not possible

4

wall defect morpholgy and txt

* One-wall angular: recontoured surgically (subtractive)
• Three-wall: can be treated to obtained new attachment and bone (additive)
• Two-wall angular: additive or subtractive depending on depth, width and
configuration

5

RATIONALE/GOAL OF OSSEOUS SX

• Most predictable pocket reduction technique, performed at expense of bony tissue and attachment level.
• Rationale: discrepancies in level and shape of bone/gingiva predispose the patient to a recurrence of pocket depths post-SRP
• Goal: to reshape the marginal bone to resemble that of the alveolar process
undamaged by periodontal disease

6

NORMAL ALVEOLAR MORPHOLOGY

• Interproximal bone is more coronal in position than the labial or lingual/palatal
bone
• IP bone is pyramidal in form
• Form of IP bone is a function of tooth form and embrasure width
•-- The more tapered the tooth, the more pyramidal the bony form
•-- The wider the embrasure, the more flattened the IP bone is mesiodistally and buccolingually
• Position of bony margin mimics the contours of the CEJ
--molar teeth have less scalloping

7

Osteoplasty vs Ostectomy

Osteoplasty: reshaping the bone without removing tooth-supporting bone

Ostectomy: includes the removal of tooth-supporting bone

8

positive vs negative vs flat vs ideal architecture

Positive Architecture: radicular bone is apical to the interdental bone

Negative Architecture: interdental bone is apical to the radicular bone

Flat Architecture: the reduction of the interdental bone to the same height as the radicular bone

Ideal: bone is consistently more coronal on the IP surfaces than on the facial and lingual surfaces

9

Definitive osseous reshaping vs Compromised osseous reshaping

Definitive osseous reshaping: further osseous reshaping would not improve the overall result

Compromised osseous reshaping: a bone pattern that cannot be improved without significant osseous removal that would be detrimental to the overall result

10

correction of craters

Therapeutic result is less pocket depth and increased ease of maintenance
• Results in attachment loss at proximal line angles and facial/lingual aspects
• Mean attachment loss is 0.6 mm, therefore technique is best indicated for
interproximal craters of 1-3 mm
• Consider regeneration for craters with 4+ mm bone loss

11

how do you do osseous sx

1) vertical grooving
2) radicular blending
3) gradualizing and preserving bone at furcation