Indications for Periodontal Surgery Flashcards
what are the goals of non surgical therapy
- removal of plaque and calculus
- microflora alteration
- endotoxin removal
- smooth surface
- tissue shrinkage
what is the scaling and root planing efficiency and open flap debridement for a 1-3mm pocket
- 86% calculus free for SRP
- 86% calculus free with open flap debridement
what is the scaling and root planing efficiency and open flap debridement for a 4-6mm pocket
- 43% calculus free for SRP
-76% calculus free for open flap debridement
what is the scaling and root planing efficiency and open flap debridement for a greater than 6mm pocket
-32% calculus free for SRP
- 50% for open flap debridement
what is the chance of leaving residual calculus or biofilm in pockets greater than 5mm
85%
what are the disadvantages of non surgical therapy
- depth of pockets- determines efficiency
- loss of CT by scaling and root planing in healthy tissues
- thin versus thick tissue
- instrumentation of furcations
- size of instruments
- size of furcation entrances
what is the endpoint of scaling and root planing
- eliminate inflammation, bleeding on probing, suppuration, disease progression
what are the indications for surgery
- root and defect access
- regeneration: the gold standard
- pocket elimination
- removal of bacteria
- mucogingival surgery/periodontal plastic surgery
- retreatment of case
- pre-prosthetic surgery
- drug induced gingival overgrowth
- abscess debridement
- implants
what are the indications for surgery with root and defect access
- plaque and calculus removal (non surgical more difficult to accomplish in deeper pockets)
- difficulty for furcation instrumentation without surgical access
- granulation tissue removal
- access to osseous defects
what is regenerated in surgery
- new PDL
- new cementum
- new bone
what is the definition of regeneration in periodontics
reconstitution of a lost or missing part
what procedures is regeneration in surgery done through
- autografts
- allografts
- alloplasts/xenografts
- guided tissue regeneration
- non resorbable vs resorbable membranes
guided tissue regeneration will provide:
epithelial exclusion
where is the calculus left behind most often
at the CEJ and the line angle
what is pocket elimination used for in periodontal surgery
- osseous contouring with placement of the flap margin at the alveolar crest
- creation of shallow sulci
- ease of maintenance by therapist