Efficacy of Surgical Periodontal Therapy

Question 1

What is the purpose of surgical treatment

Answer 1

Retention of the tooth in health and comfort

• Create accessibility for proper professional debridement of the tooth surface
• Establish a gingival morphology that facilitates the patient’s self-performed plaque control

Question 2

What are the indications for Periodontal Surgery

Answer 2

Failure to resolve periodontal inflammation by meticulous SRP due to inability to instrument tortuous pockets or furcation areas
Regeneration of periodontium
Cosmetic improvements

Question 3

What are the two different types of perio surgery?

Answer 3

Access

Regeneration

Question 4

What are the ways to do Access perio surgery

Answer 4

Replaced flap
Apically positioned flap
Resective

Question 5

What are the ways to do regenerative perio surgery

Answer 5

Autograph/allograph
Guided Tissue Regeneration
Biologics

Question 6

What is a meta-analysis?

Answer 6

‘An analysis of analyses’
An evaluation that uses statistical methods to combine and summarize the results of several primary studies for the purpose of integrating the findings

Question 7

Why is a meta-anaylsis better than a literature review

Answer 7

A literature review is a qualitative, somewhat subjective, manipulation of published information
Whereas a Meta-analysis is a more objective and accurate evaluation using a statistical basis

Question 8

Describe a Forest Plot

Answer 8

A graphical representation of data
Horizontal line - Point estimate and a 95% confidence interval containing the true underlying effect in 95% of occasions in the study
Vertical line - 0 corresponds to no effect in treatment

Question 9

Based on meta-analyses, what is the difference in results of Open Flap Debridement v Scaling and Root Planing

Answer 9

Greater probing depth reduction and clinical attachment gain with Open Flap debridement
Less incidence of future breakdown with Open Flap Debridement

Question 10

Gingival recession in the different perio treatments

Answer 10

Long term, everything remains stable

But if you touch bone during treatment (osseous resective), you get more INITIAL recession

Question 11

What are the different types of healing

Answer 11

Repair
Regeneration
New Attachment

Question 12

Repair

Answer 12

Healing of wound by tissue that does not fully restore the architecture or function of the part
ie Long Junctional Epithelium

Question 13

New Attachment

Answer 13

Union of CT and root surface that has been deprived of its original attachment apparatus due to pathology

Question 14

Regeneration

Answer 14

Production of new cementum, PDL, and bone to reconstitute lost part

Question 15

What does success or failure of a perio surgeyr depend on?

Answer 15

Patient cooperation (maintenance)
Uncontrolled systemic disease (diabetes)
Patient behavior (smoking)
Ability of operator to throughly debride root surfaces or manipulate materials
Type of surgery
Definition of success or failure

Question 16

Surgical treatment is necessary to arrest what?

Answer 16

Inflammatory progress of disease

Question 17

What is the most common surgical treatment to arrest perio disease?

Answer 17

Surgical access

Question 18

T/F - Regnerative surgery is rapidly changing the way perio disease is managed

Answer 18

True

Question 19

Surgical treatment and consistent perio maintenance are required for what?

Answer 19

Retention of tooth in health and comfort