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Perio II > EXAM 2 Principles of Osseous Resective Surgery > Flashcards

EXAM 2 Principles of Osseous Resective Surgery Flashcards

1
Q

what is described by the following definition:

bony deformities are not uniform: often a combination of horizontal and vertical loss

concavity or deformity in alveolar bone involving one or more teeth

A

osseous defect

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2
Q

T or F

the presence of osseous defect is a sign of active disease

A

false

it is not a sign of active disease

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3
Q

an osseous defect is an osseous deformity resulting from ___

A

periodontal disease

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4
Q

what two things can be used in the diagnosis and evaluation of an osseous defect?

A

radiographs and probing

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5
Q

radiographs can reveal the existence of ___ in the interproximal space, but only provides ___ information

A
  • angular bone loss
  • 2-dimensional
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6
Q

probing supplies only ___ measurements of the soft tissue pocket

A

linear

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7
Q

what is transgingival probing?

A
  • “bone sounding”
  • indicates the topography of the bony defect in two directions
    • vertical and horizontal
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8
Q

what are the three classifications of osseous defects?

A
  • 3-wall infrabony defects
  • 2-wall infrabony defects
  • 1-wall infrabony defects
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9
Q

___-wall infrabony defects are usually located in the interdental region

A

3-wall

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10
Q

3-wall defects consist of which 3 walls?

A

facial, proximal, and lingual

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11
Q

what is the name for 3-wall defects that wrap around the tooth involving two or more contiguous root surfaces?

A

circumferential defects (a type of 3-wall infrabony defect)

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12
Q

what are the 4 additional designations for 3-wall infrabony defects?

A

narrow, wide-mouth, shallow, and deep

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13
Q

what is another word for infrabony?

A

intrabony

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14
Q

what are the two types of two-wall infrabony defects?

A

interdental craters and two-wall hemiseptum

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15
Q

what are the most common bony defects?

A

interdental craters (2-wall)

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16
Q

interdental craters are located ___

A

interdentally

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17
Q

interdental craters consist of what 3 things?

A

facial bony wall, lingual bony wall, two adjacent roots

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18
Q

what infrabony defect is described as 1/2 of an interdental septum, and a lingual and proximal wall or a facial and proximal wall?

A

2-wall hemiseptum (2-wall infrabony defect)

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19
Q

what infrabony defect is described by the following:

remaining one wall usually located interdentally (hemiseptum); may also be located on facial or lingual aspect

A

1-wall infrabony defect

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20
Q

what is described by the following:

the general term for procedures which modify and shape bone defects and deformities

may be defined as a procedure which aims to eliminate deformities induced by periodontal disease process or other related factors, such as exostosis and tooth supraeruption

A

osseous surgery

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21
Q

what are the 2 types of osseous surgery

A
  • additive osseous surgery (regenerative)
  • subtractive osseous surgery (resective)
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22
Q

what are the 5 therapeutic choices for osseous defects

A
  • osseous recontouring (osteoplasty vs. ostectomy)
  • induce regeneration of bone
  • root resection with osseous resection
  • maintenance of the pockets associated with osseous defects
  • tooth extraction
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23
Q

what procedure is described by the reshaping of bone without removing tooth supporting bone?

A

osteoplasty

24
Q

what procedure is described by the reshaping of the bone, including the removal of tooth structure?

25
what are the 5 therapeutic determinants for osseous surgery?
* depth of the defect * width of the defect mouth * defect topography * number of remaining bony walls * number and configuration of the adjacent root surfaces
26
an objective of osseous resection is to reshape the ___ bone to resemble the alveolar process undamaged by \_\_\_
* marginal * periodontal disease * \*positive architecture vs. negative architecture
27
an objective of osseous resection is to create ___ contours that will be parallel to ___ contours with shallow crevice depths after healing
* bony * gingival
28
an objective of osseous resection is to create ___ gingival contours
cleansable
29
an objective of osseous resection is to permit easier primary wound closure by ___ bone and allowing better \_\_\_
* thinning * flap approximation
30
an objective of osseous resection is to expose additional ___ for proper restoration
clinical crown (for crown lengthening)
31
what are 4 considerations of gingival behavior?
* the biologic width * normal gingival contours * bone - hard tissues * gingival tissues - tend to follow more fluid form
32
in normal gingival contours, there are ___ and ___ scalloping of marginal gingiva to the tips of the interdental papilla
facial and lingual
33
the degree of scalloping is determined by what 3 things?
* cemento-enamel junctions * the convexity of the teeth * tooth position in alveolar bone
34
gingival behavior after surgery: gingiva will heal according to what?
the same anatomic concepts as in health (follow contours of tooth or contours of CEJ)
35
gingival behavior after surgery: the gingiva will attempt to re-establish the ___ with shallow sulci
biologic width
36
what are the 5 indications for osseous resection?
* shallow infrabony defects (1-2mm deep) * incipient and shallow definites furcation invasions * flat or reverse architecture, tori, exostoses and ledges * bone contouring in conjunction with root resection * to achieve primary closure of flaps by thinning bone (osteoplasty), not removing attached bone (ostectomy)
37
what are the 6 contraindications for osseous resection?
* esthetic areas * isolated deep pockets * advanced periodontitis * the presence of certain local anatomic factors * a patient with a high caries index * a patient with a serious systemic condition
38
one contraindication for osseous resection is the presence of certain local anatomic factors. what are the 4 factors?
* near the ascending ramus * near the external oblique ridge * in close proximity to the maxillary sinus * adjacent to a flat palate
39
what are two types of instruments used for osseous resective surgery?
hand instruments and rotary instruments
40
for osseous resective surgery, a basic flap approach should be used, with what 3 things?
* local anesthesia * full thickness, apically positioned flaps * thorough tissue debridement
41
what are the 4 steps of the osseous resection phase?
1. vertical grooving 2. radicular blending 3. flattening interproximal bone 4. gradualizing marginal bone
42
describe the vertical grooving step of the osseous resection phase
* reduces the thickness of the alveolar housing and provides relative prominence to the radicular aspect of the teeth * also provides continuity from the interproximal surface onto the radicular surface
43
describe the radicular blending step of the osseous resective phase
* it attempts to gradualize the bone over the entire radicular surface * provides a smooth surface for good flap adaption
44
describe the flattening interproximal bone step of the osseous resection phase
* requires removal of very small amounts of supporting bone * indicated when interproximal bone levels vary horizontally
45
describe the gradualizing marginal bone step of the osseous resection phase
* minimal bone removal * necessary to provide a sound, regular base for gingival tissue to follow
46
in osseous resection, failure to remove small bone discrepancies on the gingival line angles ("widow's peaks") can cause what?
allows the tissue to rise to a higher level than the base of the bone loss in the interdental area
47
what are the advantages for the lingual approach for osseous resection?
* maxilla: defects are ramped towards the palate * mandible: defects are ramped towards the lingual
48
describe how it is advantageous for maxilla defects to be ramped towards the palate in the lingual approach to osseous resection
* avoids removing bone from facial, exposing molar furcations * the palatal aspect has wider interdental embrasures for access during surgery and for post surgical maintenance * a better esthetic result is achieved
49
describe how it is advantageous for mandibular defects to be ramped towards the lingual in the lingual approach to osseous resection
* less removal of supporting bone due to a lingual inclination (approx. 20\*) in posterior teeth * the deepest point of most interdental osseous defects is usually positioned lingually * less chance to expose lingual furcation (positioned more apically)
50
what are the disadvantages of the lingual approach to osseous resection from the mandibular aspect?
* the lingual bone is often thick * a considerable amount of osteoplasty is required to achieve proper architecture
51
in osseous resection, the flap is positioned ___ to cover the marginal bone crests with flap-tooth contact ___ mm supracrestally and sutured
* apically * 1-2mm
52
what are the 3 advantages of osseous resection?
* more predictable than osseous regeneration * a minimal waiting period for healing * plaque control is easier with shallower probing depths than deeper probing depth
53
what are the disadvantages of osseous resection?
* greater loss of attachment than other surgeries * esthetics compromised, especially in the maxillary anterior region * root hypersensitivity * root caries
54
what is positive architecture?
the radicular bone is apical to the interdental bone
55
what is negative architecture?
the interdental bone is more apical than the radicular bone
56
what is flat architecture?
interdental and radicular bone are at the same height
57
what is ideal osseous form?
when the bone is consistently more coronal on the interproximal surfaces than on the facial and lingual surfaces

Perio II (5 decks)

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