Lecture 9

Question 1

REPAIR

Answer 1

REPLACEMENT BY EPITHELIUM OR OTHER CONNECTIVE TISSUE => SCAR TISSUE (I.E. LONG JUNCTION EPITHELIUM, ANKYLOSIS, AND/OR OTHER NEW ATTACHMENT
DOES NOT GUARANTEE LONG-TERM STABILITY

Question 2

REGENERATION

Answer 2

GOLD STANDARD - RECONSTITUTION OF PERIODONTIUM (3 COMPONENTS)

1. ) ALVEOLAR BONE
2. ) CEMENTUM
3. ) PDL

Question 3

HORIZONTAL BONE LOSS

Answer 3

NOTHING TO HOLD REGENERATIVE MATERIAL IN PLACE AND EFFECTS 2 OR MORE TEETH - REGENERATION IS NOT POSSIBLE

Question 4

VERTICAL BONE LOSS

Answer 4

LEAVES MORE WALLS PRESENT (FOR REGENERATIVE PURPOSES, THE MORE WALLS THE BETTER THE HEALTH OUTCOME)
MORE WALLS HOLD BONE IN PLACE, PROVIDE BETTER BLOOD SUPPLY (I.E. NUTRIENTS/GF)

Question 5

PERIODONTAL SX TECHNIQUES

Answer 5

MODIFIED WIDMAN FLAP (USED FOR ROOT FLAP DEBRIDMENT)
OCCLUSAL ADJUNCT (TO AVOID BRUXISM OR OTHER MALOCCLUSAL PROBLEMS FROM INTERFERING W/ REGENERATION)
SPLINTING (DON’T WANT ANY TOOTH MVMT)
SYSTEMIC ANTIBIOTICS

Question 6

NON-BONE GRAFT ASSOCIATED SX TECHNIQUES

Answer 6

GUIDED TISSUE REGENERATION

Question 7

BONE-GRAFT ASSOCIATED SX TECHNIQUES

Answer 7

ALLOPLASTS
AUTOGRAFTS
XENOGRAFTS
ALLOGRAFTS

Question 8

GUIDED TISSUE REGENERATION

Answer 8

USE OF A MEMBRANE AND BARRIER TO PREVENT EPITHELIAL MIGRATION AND AID IN SPACE MANAGEMENT
2 TYPES OF MEMBRANES -
1.) BIODEGRADABLE
2.) NON-RESORBABLE

Question 9

GTR BARRIERS

Answer 9

CELLULAR BARRIER
CLINICALLY MANAGABLE 
PROVIDES SPACE FOR A HEALING TISSUE
PERMITS TISSUE INTEGRATION
BIOCOMPATIBLE

Question 10

NONRESORBABLE GTR BONE MEMBRANE

Answer 10

MORE PREDICTABLE IN HOLDING SPACE, NO PROBING, SOFT TISSUE HEALING IN 4-6 WEEKS, BONE HEALING IN 6 MONTHS TO 1 YEAR, MORE OFTEN USED
I.E. TITANIUM REINFORCED ePTFE
MAJOR PROBLEMS W/ CONTAMINATION OF EXPOSED MEMBRANES

Question 11

BIODEGRADABLE GTR BONE MEMBRANE

Answer 11

MADE FROM...
1.) POLYGLYCOSIDE SYNTHETIC POLYMERS
2.) COLLAGEN
3.) CALCIUM SULFATE
CAN REGULATE RESORPTION TIME W/ MEMBRANE DEPENDING ON AMOUNT OF CROSSLINKING

Question 12

BIOLOGICAL REQUIREMENTS FOR REGENERATION

Answer 12

1. ) BLOOD SUPPLY (IF NOT, DO CORTICAL PERFORATION)
2. ) STABILIZATION (FIXATION SCREWS)
3. ) OSTEOBLASTS (AUTOGENEOUS BONE SUPPLY)
4. ) CONFINED SPACE - FUNCTIONAL MEMBRANE
5. ) SPACE MAINTENANCE (GRAFT MATERIAL
6. ) WOUND COVERAGE

Question 13

BONE GRAFT ASSOCIATED SX TECHNIQUES - ALLOPLASTS

Answer 13

OSTEOCONDUCTIVE
SYNTHETIC HAP
BETA-TRICALCIUM PHOSPHATE
BIOGLASS

Question 14

BONE GRAFT ASSOCIATED SX TECHNIQUES - AUTOGRAFTS

Answer 14

CORTICAL OR CANCELLOUS
INTRA- OR EXTRA-ORAL CONTAIN PLURIPOTENT CELLS FOR OSTEOGENESIS
ALREADY CONTAINS VIABLE OSTEOGENIC CELLS
OSTEO-CONDUCTIVE/-INDUCTIVE/-GENIC
SOURCE - EDENTULOUS RIDGES, EXTRACTION SITES, MAXILLARY TUBEROSITY, RAMUS, RETROMOLAR PAD

Question 15

BONE GRAFT ASSOCIATED SX TECHNIQUES - XENOGRAFTS

Answer 15

REQUIRE 6-18 MONTHS OF REGENERATION TIME FOR REPLACEMENT BY BONE (LONGER THAN ALLOGRAFTS)
BioOss, NuOss, OSTEOGRAFT

Question 16

BONE GRAFT ASSOCIATED SX TECHNIQUES - ALLOGRAFTS

Answer 16

DFDBA, FDBA, FREEZE-DRIED BONE MARROW, ILLIAC CREST
OSTEO-CONDUCTIVE/-INDUCTIVE FOR DFDBA/BMPs
DFDBA = DEMINERALIZED => RETAINS ORIGINAL BMP
THE YOUNGER THE CADAVER, THE MORE BMP IS AVAILABLE FOR USE IN REGENERATION

Question 17

BIOLOGICAL MECHANISMS

Answer 17

OSTEOGENIC - LIVING OSTEOBLASTS => NEW BONE FROM GRAFT
OSTEOCONDUCTIVE - ACTS AS A SCAFFOLD
OSTEOINDUCTIVE - NEW BONE THROUGH STIMULATION OF OSTEOPROGENITOR CELLS => BONE CELLS

Question 18

TRIANGLE OF TISSUE ENGINEERING

Answer 18

1.) VIABLE CELLS
2.) SCAFFOLD
3.) SIGNALING MOLECULES
ALL HAVE TO BE W/IN THE APPROPRIATE ENVIRONMENT