Indications for Periodontal Surgery Flashcards

1
Q

what are the goals of non surgical therapy

A
  • removal of plaque and calculus
  • microflora alteration
  • endotoxin removal
  • smooth surface
  • tissue shrinkage
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2
Q

what is the scaling and root planing efficiency and open flap debridement for a 1-3mm pocket

A
  • 86% calculus free for SRP
  • 86% calculus free with open flap debridement
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3
Q

what is the scaling and root planing efficiency and open flap debridement for a 4-6mm pocket

A
  • 43% calculus free for SRP
    -76% calculus free for open flap debridement
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4
Q

what is the scaling and root planing efficiency and open flap debridement for a greater than 6mm pocket

A

-32% calculus free for SRP
- 50% for open flap debridement

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5
Q

what is the chance of leaving residual calculus or biofilm in pockets greater than 5mm

A

85%

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6
Q

what are the disadvantages of non surgical therapy

A
  • 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
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7
Q

what is the endpoint of scaling and root planing

A
  • eliminate inflammation, bleeding on probing, suppuration, disease progression
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8
Q

what are the indications for surgery

A
  • 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
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9
Q

what are the indications for surgery with root and defect access

A
  • 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
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10
Q

what is regenerated in surgery

A
  • new PDL
  • new cementum
  • new bone
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11
Q

what is the definition of regeneration in periodontics

A

reconstitution of a lost or missing part

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12
Q

what procedures is regeneration in surgery done through

A
  • autografts
  • allografts
  • alloplasts/xenografts
  • guided tissue regeneration
  • non resorbable vs resorbable membranes
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13
Q

guided tissue regeneration will provide:

A

epithelial exclusion

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14
Q

where is the calculus left behind most often

A

at the CEJ and the line angle

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15
Q

what is pocket elimination used for in periodontal surgery

A
  • osseous contouring with placement of the flap margin at the alveolar crest
  • creation of shallow sulci
  • ease of maintenance by therapist
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16
Q

surgery to remove bacterial penetration is seen in:

A

aggressive periodontitis

17
Q

what bacteria is removed in periodontitis

A

A.a

18
Q

what is mucogingival surgery/periodontal plastic surgery used for

A
  • regain periodontium
  • remove frena
  • root coverage or increase keratinized tissue
  • restore gingival topography
  • pre-prosthetics and pre-orthodontics
19
Q

when is periodontal surgery for retreatment of a case done

A
  • non surgical therapy has failed
  • surgical therapy has failed
  • new techniques or materials are available
20
Q

what procedures are done in periodontal surgery for pre-prosthetic surgery

A
  • crown lengthening
  • ridge augmentation
  • palatal recontouring
  • gingivectomy/gingivoplasty
  • ridge or tuberosity reduction
21
Q

what drugs cause drug induced gingival overgrowth

A
  • dilantin
  • cyclosporin
  • calcium channel blockers (nifedipine)
22
Q

what is abscess debridement used for

A
  • undiagnosed periodontitis
  • maintenance patients
  • recurrent abscesses
  • undiagnosed diabetes
23
Q

non surgically treated areas have a greater percentage of defects that convert from:

A

non diseased to diseased sites than surgically treated sites

24
Q

what type of teeth are better for both non surgical and surgical modalities

A

single rooted teeth

25
Q

implants are indicated after:

A

periodontal disease has been controlled and all other dental needs are addressed in a comprehensive treatment plan

26
Q
A