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SP18: Perio MT2 > Gingivectomy and Flap Design > Flashcards

Gingivectomy and Flap Design Flashcards

1
Q

What are some indications for gingivectomy?

A
  1. Hyperplastic tissue

2. Suprabony pockets

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2
Q

What are some contraindications to gingivectomy?

A
  1. Osseous involvement
  2. Mucogingival involvement
  3. Furcation involvement
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3
Q

T/F: Gingivectomy is indicated when you have a pocket below the crest of bone.

A

False

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4
Q

Gingivectomy is often done in conjunction with ____________.

A

Gingivoplasty - recontour tissue to look more normal

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5
Q

What is the first step in gingivectomy after LA has been administered?

A

Mark pocket depths with bleeding points

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6
Q

You start the incision ___________ to the bleeding point.

A

Apical

Allows for a beveled incision

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7
Q

T/F: You would typically work distal to mesial for a gingivectomy procedure.

A

True

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8
Q

What is the general purpose of the gingivectomy?

A

Makes it easier for patient to clean and removes the anaerobic environment

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9
Q

What is imperative in order for the tissue to regrow and heal after a gingivectomy?

A

That there is adequate keratinized tissue before and after surgery

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10
Q

T/F: Lasers and electrosurgery can be used for gingivectomy.

A

True

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11
Q

T/F: Tissues are exposed during healing after flap surgery.

A

False

Tissues exposed during gingivectomy, not flap surgery

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12
Q

T/F: Flaps are externally beveled.

A

False

Internal bevel

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13
Q

T/F: Flaps preserve keratinized gingiva and can be closed by suturing.

A

True

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14
Q

What are some contexts for using a flap?

A
  1. Resective surgery
  2. Conservative (access only)
  3. Regeneration
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15
Q

T/F: Using a flap is much more versatile than gingivectomy.

A

True

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16
Q

What is the difference between a full thickness flap and a partial thickness flap?

A

Full: includes epithelium, connective tissue, and periosteum (peeled off bone surface)

Partial: includes epithelium and a portion of connective tissue

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17
Q

What is the advantage to a partial thickness flap?

A

Leaves the periosteum on the bone - protecting it from resporption

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18
Q

T/F: Full thickness flaps are more commonly used.

A

True

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19
Q

What is the most common blade used for a flap?

A

15 or 15c (smaller)

20
Q

What instrument is used to elevate a full thickness flap?

A

Periosteal elevator

21
Q

T/F: You cut from distal to mesial, elevate from mesial to distal.

A

True

22
Q

T/F: The primary incision for a full thickness flap should hit bone.

A

True

23
Q

T/F: All soft tissue should be removed from the flapped bony area.

A

True (debridement)

24
Q

T/F: Full thickness flaps facilitate an increase in width of keratinized tissue.

A

False

Partial-thickness flaps

25
Q

T/F: Partial thickness flaps are reflected with blunt instruments.

A

False

Sharp scalpel

26
Q

What would be three indications for partial thickness flap?

A
  1. Thin bone
  2. Not much keratinized tissue
  3. Tissue grafting
27
Q

T/F: Vertical incisions should be placed mid facial of a tooth.

A

False

Over bone, at the line angles of teeth

28
Q

When would you position the flap coronally to heal?

A

Regeneration or root coverage

29
Q

When would you simply put the flap back where it was to heal?

A

Conservative flaps

30
Q

When would you position the flap apically to heal?

A

For pocket elimination of crown lengthening (resective)

31
Q

T/F: The entire palatal gingival tissue is adhered to bone.

A

True

32
Q

How would you reduce pocket size with a palatal flap?

A

You must thin the flap

33
Q

A _____________ is a perio sx procedure for removing excessive soft tissue distal to a terminal tooth.

A

Distal wedge

34
Q

What are some typical sites for wedges?

A

Maxillary tuberosity, mandibular retromolar area, edentulous ridges

35
Q

T/F: It is possible to obtain primary closure of the wound after bulky tissue reduction with a distal wedge.

A

True

36
Q

Which distal wedge design is the least difficult and least invasive?

A

Triangular wedge

37
Q

Which distal wedge design provides the best access?

A

Square wedge

38
Q

Which distal wedge design is best at preserving keratinized tissue?

A

Linear wedge

39
Q

T/F: When you have limited keratinized tissue, scalloped incisions are indicated for flap design.

A

False

Stay sulcular to preserve keratinized tissue

40
Q

What can allow you to get primary closure in flaps and distal wedges?

A

Thinning of the flap

41
Q

T/F: Triangular distal wedges often heal with secondary closure.

A

True

42
Q

______________ is a conservative flap design intended to _____________.

A

Modified Widman flap; minimize recession

43
Q

In order to have minimal recession, where should the flap be placed for closure?

A

It should be replaced back where it was

Minimal flap elevation allows for this

44
Q

T/F: A modified Widman flap is good for anterior teeth.

A

True

45
Q

T/F: A modified Widman flap involves 5 mm of scalloping.

A

False

Minimal scalloping - allows for replaced primary closure

SP18: Perio MT2 (7 decks)

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