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Perio II > EXAM 2 Intro to Barrier Technology and Osseous Grafts > Flashcards

EXAM 2 Intro to Barrier Technology and Osseous Grafts Flashcards

1
Q

what are the 4 possible outcomes of osseous therapy?

A
  • new attachment
  • long junctional epithelium
  • root resorption/ankylosis
  • recurrence of pocket
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2
Q

describe “new attachment”

A
  • the union of connective tissue or epithelium with a root surface that has been deprived of its original attachment apparatus
  • this new attachment may be epithelial adhesion and/or connective tissue adaptation or attachment and may include new cementum
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3
Q

what is described by the healing of a wound by tissue that does not fully restore the architecture or the function of the part?

A

repair

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4
Q

what is described by procedures attempting to regenerate lost periodontal structures through differential tissue responses?

A

guided tissue regeneration (GTR)

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5
Q

GTR involves the exclusion of ___ and ___ from the root surface during healing

A

epithelium and connective tissue

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6
Q

GTR involves repopulation of the area by cells from ___ and ___

A

the periodontal ligament and bone

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7
Q

in 1976, melcher suggested that there were 4 separate compartments of connective tissue in the periodontium. what are they?

A
  • the gingival corium (CT)
  • periodontal ligament
  • cementum
  • bone
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8
Q

cells that would repopulate the periodontal defect could arise from which 4 major structures?

A
  • gingival epithelium
  • gingival connective tissue
  • bone
  • periodontal ligament
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9
Q

in 1982, nyman and coworders demonstrated the first human histologic evidence of ___ in response to guided tissue regeneration

A

periodontal regeneration

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10
Q

a certain degree of success has been seen with GTR, but there are some cases wherein the potential for regeneration is not maximized. this is associated with the fact that the development of the periodontal tissues requires a complex cascade of interactions between various ___ and ___

A

cells and matrix elements

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11
Q

although regeneration has been demonstrated to be achievable, it still hasn’t been demonstrated to be 100% predictable clinically. predictable regeneration is greatly influenced by what?

A

the type of osseous defect present

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12
Q

what are the 3 classifications of osseous defects?

A
  • 3-wall infrabony defects
  • 2-wall infrabony defects
  • 1-wall infrabony defects
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13
Q

what is the function of the placement of a barrier in GTR?

A

ensures repopulation of cells from the periodontal ligament

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14
Q

ideal properties of barrier membranes include what 5 things?

A
  • bio-compatibility
  • space maintenance
  • cell occlusiveness
  • good handling properties
  • resorbability
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15
Q

barriers can be divided into what two major categories?

A

non-absorbable and absorbable

aka non-resorbable and resorbable

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16
Q

what type of barrier is described by the following:

polytetrafluoroethylene (PTFE)

expanded PTFE (ex. gore-tex, titanium reinforced gore-tex)

non-porous polytetrafluoroethylene (ex. tefgen-fd)

A

non-resorbable barrier membrane

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17
Q

were absorbable or non-resorbable barrier membranes the first approved for clinical use?

A

non-resorbable

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18
Q

what are the advantages of non-resorbable barriers?

A
  • they maintain their structural integrity and their essential features for as long as they are left in the tissues
  • maintain separation of tissues over an extended period, if unexposed
  • have more “body” (thickness) and rigidity compared to the resorbable barriers
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19
Q

what are the disadvantages of non-resorbable barriers?

A
  • it requires a second surgical procedure for its removal
  • in the event that the barrier is exposed, the non-resorbable barrier is very susceptible to bacterial contamination and accumulation
  • premature removal results in less regeneration
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20
Q

what are 4 complications of the use of non-resorbable barriers?

A

pain, purulence, swelling, tissue sloughing

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21
Q

which non-resorbable barrier is described by the following:

this barrier features two structural designs to address specific needs

  1. an open microstructure collar corresponding to the coronal aspect of the device
  2. partially occlusive, structurally relatively stable membrane
A

gore-tex

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22
Q

the ___ aspect of the barrier serves to promote connective tissue ingrowth, support wound stability, and to inhibit epithelial migration

A

coronal

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23
Q

what are 3 other non-resorbable materials that have been investigated and considered as barriers?

A
  • rubber dams
  • resin-ionomer barrier
  • composite device made out of knitted nylon fabric mechanically bonded onto a semi-permeable silicone membrane and coated with collagen peptides
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24
Q

what is the function of the apical aspect of barriers?

A
  • provide a space for regeneration and as a barrier towards gingival flap tissue invasion or collapse onto the root surface
  • this part has higher density and is less porous
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25
Q

___-reinfoced nonresorbable membranes maintain space better

A

titanium

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26
Q

what are the two main types of resorbable barrier membranes?

A
  • natural - collagen
  • synthetic (organic aliphatic thermoplastic materials)
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27
Q

describe synthetic resorbable barrier membranes

A
  • organic aliphatic thermoplastic materials
  • poly (alpha-hydroxy acids)
    • polylactide
    • polyglycolic
    • copolymer poly (glycolide-lactide)
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28
Q

what is an advantage of resorbable barrier membranes?

A

elimination of a second surgical procedure for the membrane removal

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29
Q

what are disadvantages of resorbable barrier membranes?

A
  • the clinician has no control over the length of time that the barrier is in place
  • premature degradation
  • degradation associated with mild inflammation
  • materials may elicit tissues reactions that may influence wound healing
  • lack stiffness - may collapse into defect
30
Q

ideally, the membrane should maintain their in vivo structure for how long?

A

at least 4 weeks

31
Q

synthetic absorbable devides are degraded by ___, which results into decomposition products that are mostly metabolized to carbon dioxide and water through the CAC

A

hydrolysis

32
Q

what are 4 factors that can affect the rate of degradation of the material?

A
  • pH
  • the presence of mechanical strain
  • enzymes
  • bacteria, in the case of infections
33
Q

in resorbable barrier membranes, collagen from different ___ and different ___ have been used

A

different species and different anatomical sites

34
Q

___ is a commercially available collagen barrier

A

biomend

35
Q

what type of collagen is the biomend barrier made of?

A

type I collagen derived from bovine deep flexor (achilles) tendon

36
Q

biomend is semi-occlusive and is completely absorbed in how long?

A

4-8 weeks

37
Q

T or F

the effectiveness of biomend is consistent among treatment types

A

false

the effectiveness appears to vary depending on the type of defect being treated

38
Q

___ is a composite consisting of an occlusive membrane of glycolide and lactide copolymer and a porous web structure of bonded polyglycolide fiber

A

resolut regenerative material

39
Q

histologic studies of resolut regenerative material have indicated that it is as effective as non-absorbable barriers and is able to retain its structure for ___ weeks and absorb completely after ___ months

A
  • 4
  • 5-6
40
Q

vicryl periodontal mesh is a copolymer of ___ and ___

A

glycolide and lactide

41
Q

what device can lose integrity within 2 weeks and resorb within 4 or more weeks, but is still as effective as other regenerative membranes?

A

vicryl periodontal mesh

42
Q

___ is a poly lactide polymer supplied in a flowable formulation

A

atrisorb

43
Q

how is atrisorb applied?

A
  • the polymer can be supplied with a solvent
  • after mixing, it will harden or solidify upon contact with saline within 4-6 minutes
  • it can then be cut and shaped according to the area where it will be placed
44
Q

___ has been used with the “flow technique”

A

atrisorb

the flow technique is…

45
Q

histologic studies have documented that atrisorb is completely absorbed by ___ months

A

6-12

46
Q

what is defined as any tissue or substance with the potential to induce growth or repair of bone?

A

osteogenic

47
Q

what are the 3 biologic mechanisms of osseous grafts?

A

osteoconduction, osteoinduction, osteogenesis

48
Q

what are 4 types of bone grafts?

A

autografts, allografts, xenografts, alloplasts

49
Q

what type of graft is described as tissue transferred from one position to another within the same individual?

A

autograft

50
Q

what type of graft is described as a graft between genetically dissimilar members of the same species?

A

allograft

51
Q

what type of graft is described as a synthetic graft or inert foreign body implanted into tissue?

A

alloplast

52
Q

what type of graft is described as a graft taken from a donor of another species?

A

xenograft (heterograft)

53
Q

what are 6 common intraoral sites of autogenous bone grafts?

A
  • maxillary tuberosity
  • healing sockets
  • edentulous ridges
  • surgically created defects
  • exostoses and tori
  • mandibular symphysis and ramus
54
Q

what are 4 common intraoral sites where bone grafting material is collected?

A
  • osseous coagulum
  • bone blend
  • intraoral cancellous bone marrow
  • bone swaging
55
Q

___ can be used as donor sites for autogenous bone grafting

A

bony exostoses

56
Q

what is a common extraoral site for bone grafting material?

A

iliac marrow

57
Q

___ are obtained within hours of death

A

allografts

58
Q

are viral infections a risk of allografts?

A

yes, but several steps are taken to eliminate viral infection

59
Q

what type of graft is described by the following:

eliminates second surgical site

safe to use

large quantities can be used

A

allografts

60
Q

what type of allograft bone material is considered to be osteoconductive, and bone fills up to 67%?

A

undecalcified freeze-dried bone (FDBA)

61
Q

what type of allograft bone material is described by the following?

considered to be osteoinductive

demineralization exposes bone morphogenetic proteins

similar osteogenic potential as autografts

A

decalcified freeze-dried bone (DFDBA)

62
Q

___ are fabricated from inorganic portion of animals other than man (bovine bone)

A

xenografts

63
Q

are xenografts osteoinductive or osteoconductive?

A

osteoconductive

64
Q

xenografts are an alternative to what two other types of grafts?

A

allografts and autografts

65
Q

what are common alloplast materials?

A
  • coral derived materials
  • bioactive glass
  • calcium phosphate
  • others
    • plastic materials, plaster of paris, cartilage, sclera
66
Q

sinus grafting is indicated when insufficient ___ dimension exists

A

vertical

67
Q

sinus grafting can be performed through a “lateral window” or ___

A

osteotomy

68
Q

sinus grafts should be allowed ___ months of healing prior to placing implants

A

6-9 months

69
Q

sinus grafting is highly ___ sensitive

A

technique

70
Q

what are some complications of sinus grafting?

A
  • tearing of the sinus membrane
  • infection
71
Q

describe the survival of implants in sinus grafted sites?

A

survival of implants in grafted sites is similar to those placed in areas without sinus elevation procedure

Perio II (5 decks)

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