EIT Skills Flashcards
Perio Staging
Perio Grading
Miller Classification of Mobility
Class 0:
* Normal physiologic mobility
Class 1:
* Slightly more than normal
Class 2:
* moderately more than normal (</= 1mm)
Class 3:
* severely more than normal (> 1mm) & Vertically depressable
Hamp Furcation Classification
Class 0:
* No furcation involvement
Class 1:
* Horizontal furcation involvement < 3mm
Class 2:
* Horizontal furcation involvement > 3mm
Class 3:
Through-and-through furcation invovlement
What are some factors that predispose a tooth to furcation involvement?
- Short root trunk
- Short Roots
- Narrow interradicular dimensions (B/w roots)
- Cervical enamel projections
Gingival Recession Classification
Type 1:
* recession w/no interproximal attachment loss
* Interproximal CEJ not detected clinically
Type 2:
* recession w/loss of interproximal attachment
* interproximal attachment loss </= buccal attachment
Type 3:
* recession w/interproximal attachment loss
* interproximal attachment loss > Buccal attachment
Prognosis: McGuire & Nunn
Good:
* Good control of hygiene
* High likelihood to maintain tooth w/proper maintenance
Fair:
* 25% CAL
* Class 1 Furcation-cleansable
Poor:
* 50% CAL
* Class 2 Furcation
* Maintenance possible but difficult
Questionable:
* >50% CAL
* poor clinical crown:root ratio
* Class 2/3 Furcation
* Class 2/3 mobility
Hopeless:
* Severe CAL
* ext suggested
Seibert’s Classification of Ridge Defects
Class 1=Horizontal
Class 2: Vertical
Class 3: Combination
Perio Tx Planning: Long Term Goal
Arrest CAL
Reduce Tooth Loss
Eliminate Pain
Stabilize Occlusal Function
Prevent recurrence
Phase 0 Tx planning
Tx emergencies
Ext hopeless teeth
Phase 1 Tx planning
Non-surgical
* Diet & Caries control
* OHI
* Pt education
Prophy/SRP + EIT
Local/Systemic Antibiotics
Phase 2 Tx planning
Surgical
Regenerate periodontal tissue & eliminate pockets
* includes implants and ends
Phase 3 tx planning
Restorative
Phase 4 tx planning
Maintenance
* Ongoing evaluation
* every 3 months for 1st year
Risk Factor
Causal Association
* Smoking causes perio
Risk Determinant
Unchangeable characteristic
* Genetics, Gender
Risk Indicator
Does not casual but still associated
* Stress
Flap Design
- Wider base-adequate blood supply
- Incisions over intact bone– NOT over bondy defects or eminences
- Rounded Corners
- Vertical Releases at Line angles
- Avoid Vital Structures
Partial Thickness Flap
Gingiva/mucosa, submucosa
* mucogingival surgery
* does not expose bone
* leaves vascular bed intact for grafting
Full thickness Flap
Gingiva/mucosa, submucoa, periosteum
osseous surgery & periodontal regeneration
exposes bone
* expect 1 mm of resorption
* bad for thin bone where dehiscence/fenestraction likely
If no response to SRP, whats next?
Open Flap Debridement
Osseous Surgery
Open Flap Debridement
Increased access for SRP
3 incisions (Modified Widman)
1. Internal/Reverse Bevel- 1mm from margin
2. Sulcular-horizontal across crest
3. interproximal-removes tissue collar
Apically-repositioned Flap
* attain pocket reduction
Distal wedge
* Pocket reduction
* after 3rd molar ext
* max- parallel
* mand- V
Osseous Surgery
Same as OFD, but recontours bone to resemble healthy periodontist
positive architecture
* interproximal bone is above radicular bone (normal)
Ostectomy vs osteotomy
Ostectomy
* remove supporting bone
Osteotomy:
* remove non-supporting bone
