Exam 3 -ch 14 Flashcards by Tosha Boyd

what are examples of access flap procedures?

the modified widman flap, the excisional new attachment procedure and open flap curettage

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why is thorough phase 1 therapy, including scaling, root planing and oral hygiene instruction, completed at least 4 weeks prior to periodontal surgery

for enough time to heal

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window like openings in alveolar bone over a root surface

fenestration

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this is the sliding of the gingival tissue from an adjacent tooth or papilla

lateral pedicle graft

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this technique uses three incisions to separate the pocket lining from the tooth in a controlled manner

modified widman flap

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produced by bone loss of interdental bone… facial and lingual plates without concomitant loss of tadicular bone

reversed architecture

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what type of pockets are often best treated by flap surgery?

suprabony pockets

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The primary reason to perform excisional periodontal surgery is to provide access to root surfaces for debridement. Debridement during surgery is necessary because it is very difficult to remove all the calculus and plaque on root surfaces during the pre surgical phase

both are TRUE

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if bony ledges or non supporting bone is removed, the procedure is called….

osteoplasty

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this flap technique does not involve elevating the flap past the mucogingival junction

new attachment procedure

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what is the major benefit of periodontal surgery?

to gain access to the root surfaces for scaling and root planing

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root is denuded of bone and portions of root surface covered by soft tissue

dehiscence

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this type of procedure is to provide access to the root surfaces for the debridement and to create conditions for reattachment of the gingival tissues to the root

access flap procedure

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The most important clinical measure of bone loss is

attachment loss

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this includes a variety of periodontal plastic surgery procedure to augment the thickness of keratinized gingival tissues, increase the zone of the attached gingiva or augment endentulous spaces

mucogingival surgery

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regenerative periodontal surgical procedures….

selectively encourage the growth of cells of the attachment apparatus

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this is a deepened gingival sulcus with an infected root surfaces covered by an ulcerated epithelial surface with underlying inflamed connective tissue

periodontal pocket

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this includes a variety of surgical techniques that attempt to restore the periodontal tissues lost through disease

regeneration surgery

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what cells are the first to heal?

epithelial

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what does regeneration surgery include?

a variety of surgical techniques that attempt to restore the periodontal tissues lost through disease

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this is placed over sutures to hold the flaps tightly to the teeth and underlying bone when pocket reduction surgery has been performed.

periodontal dressing

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what are the contraindications to periodontal surgery?

health statues or age of patient.

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sever abscess containing multiple boils

carbuncle

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surgical sites should not be probed for at least one week after surgery because the collagen fibers have not had sufficient time to heal to be able to resist the penetration force of the probe

the statement is NOT correct, but the reason is correct

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what is the most often quoted ideal width of attached gingival tissue?

3 mm

what is the most successful material used in alloplasts?

porous hydroxyapatite

list the general factors that must be considered before periodontal surgery

general health pocket depths attachment loss patient compliance

the types of periodontal surgery in which the periodontist shapes the alveolar bone with chisels or burs to remove bony defects are called procedures for...

treatment of osseous defects

these are created from donor bone from the patients own body... may be taken from i gra oral sites such as tori, maxillary tuberosity or bone removed during osteoplasty

Autograft

what are indications of access flap procedure?

to treat periodontal pockets aesthetically sensitive areas or where pocket reduction is not destined or indicated

this is a type of bone loss in which the interproximal bone is apical to the facial and lingual bone

reverse alveolar bony architecture

what is the most predictable method for regenerating lost periodontal tissues??

guided tissue regeneration

what types of surgeries do pocket reduction include??

excisional (gingivectomy and gingivoplasty) incisional (periodontal flap procedures)

these extend epically beyond the crest of the bone

infrabony pockets

the most common oral site for donor tissue for free gingival graft procedure is the

palate

these are created from bone taken from another species such as bovine or cow, porcine or pig bone.

xenografts

what has been suggested as the best technique to attempt to cover exposed root surfaces?

lateral pedicle graft

if alveolar bone that contains periodontal fibers that support the tooth is removed, this procedure is called...

ostectomy

the types of periodontal surgery that increase the predictability for growth of new tissues of the periodontal apparatus are called procedures for

guided tissue regeneration

what is root sensitivity following perio surgery caused by?

exposed root surfaces apically positioned perio flaps gingival shrinkage during healing root planing with cementum removal

when is periodontal surgery indicated?

to control the progress of periodontal destruction and attachment loss when more conservative non surgical treatment is not successful

this includes a variety of periodontal plastic surgery procedures to augment the thickness of keratinized gingival tissues, increase the zone of attached gingiva, improve gingival aesthetics by covering recessed root surfaces, or augment edentulous spaces.

mucogingival surgery

periodontal surgery is most successful when pocket depths are between 5 and 9 mm. Indications for periodontal surgery are more effected by measurements of clinical attachment loss than those by pocket depths

both statements are TRUE

what are relative contraindications to periodontal surgery?

patient with certain systemic diseases uncontrolled hypertension recent history of heart attack uncontrolled diabetes certain bleeding disorders kidney dialysis patients non complaint patients with high risk for caries patients with unrealistic expectations history of radiation to the jaws HIV infections

pockets coronal to the horizontal bone loss are called

suprabony pockets

what is periodontal regeneration??

the formation of new alveolar bone, new cementum and new periodontal ligament on a tooth root surfaces that was previously diseased

what does guided tissue regeneration permit??

the healing cells to proliferate from bone and periodontal ligament rather than epithelium to and from bone and periodontal ligament rather than epithelium to more reliably gain new attachment to the tooth more reliably

this is measured from the cej to the base of the pocket

attachment loss

these types of grafts have donor sites located somewhere in the mouth away from the site that requires grafting

free gingival graft

what are the most common mucogingival procedures?

lateral pedicle gingival graft free autogenous gingival graft subgingival connective tissue graft

this is 1-2 mm of connective tissue attachment covered by epithelium between the probing depth and the alveolar bone

biologic width

fissure in gingival tissues caused by abnormal frena, trauma from occlusion or pierce related trauma

gingival cleft

what are the goals of periodontal surgery?

pocket reduction abscess drainage correction of mucogingival defects aesthetic improvements access for restorative procedures regeneration of lost tissue placement of dental implants

what are the four healing categories

repair reattach new attachment regeneration

what is an advantage of periodontal surgery?

better access to furcations, complex root surfaces and infrabony pockets.

these type of grafts has a variety of synthetic bone minerals... they may be made of hydroxyapatite mineral or ceramics, such as plaster of paris and tricalcium phosphate

alloplasts

what are some post operative instructions the hygienist must review with a patient after periodontal surgery??

limiting physical activity controlling bleeding with finger pressure if needed consuming a soft diet filling and takin prescriptions for analgesics and antibiotics if needed being aware of swelling that may occur avoid smoking follow plaque and biofilm instructions

this is created from bone that comes from another person...

allograft

this has become the procedure of choice when root coverage is the objective of mucogingival surgery

subgingival connective tissue graft

when prescribing periodontal surgery, what factors are considered?

probing pocket depth amount of bone loss importance of the tooth to function and aesthetics patients level of plaque biofilm control patients general health

what are some specific considerations in deciding to perform periodontal surgery?

pocket depth bone loss value of the tooth plaque and biofilm control health of the patient patient preference

dome shaped lesion known as boil

furncle

this is the measurement from the crest of the gingival margin to the base of the pocket

probing depth

what pocket depths are most successfully treated by periodontal surgery procedures?

5-9 mm

when is the surgical wound well epitheliaized?

7-10 days

what does a blood clot act as?

matrix and scaffolding for healing cells to migrate into the wound area

how should a blood clot be? thick or thin

thin as possible because the inflammatory cells associated with wound healing are also required to remove the fibrin clot to complete healing

in studies of the healing of periodontal surgical wounds, the junctional epithelium returned to its pre surgical appearance in...

10-12 days

maturation of newly formed bone can continunuo to...

6 months

what type of healing intention is gingvectomy?

secondary

post op care of the hygienist may include:

suture removal, dressing removal, post surgical biofilm removal, follow up wound care and home care instructions