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Perio Final SP2018 > Management of the aberrant frenum and laser applications > Flashcards

Management of the aberrant frenum and laser applications Flashcards

1
Q

an … … is an abnormale insertion of labial, buccal or lingual frenula capable of retracting gingival margins, creating diastemas, and limiting lip and tongue movements

A

aberrant frenum

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2
Q

What is the etiology of an aberrant frenum?

A

after centrals erupt, the labial frenum will gradually transposition in an apical direction. inability of frenum to migrate apically during alveolar growth and tooth development will cause a persistent aberrant frenum

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3
Q

4 classifications of labial frenums

A

mucosal
gingival
papillary
papillary penetrating

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4
Q

a …. labial frenum is when the insertion of frenum ends in mucosa or at most at the mucogingival junction

A

mucosal

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5
Q

a … labial frenum is when insertion of frenum ends in gingiva, between mucogingival junction and the base of the interdental papilla

A

gingival

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6
Q

a … labial frenum is when insertion of the frenum ends at the interdental papilla but does not penetrate to the palatal aspect of tissues

A

papillary

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7
Q

a …. labial frenum is when insertions of the frenum ends at the interdental papilla and penetrates to the palatal aspect of tissues

A

papillary penetrating

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8
Q

2 genetic syndromes associated with an aberrant max. frenum

A

Ellis-van Creveld syndrome

Orofacial-digital syndrome

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9
Q

2 genetic syndromes that are associated with absence of maxillary labial frenum

A

Ehlers-Danlos syndrome

Holoprosencephaly

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10
Q

which labial frenum is most common

A

gingival

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11
Q

a … labial frenum is more prevalent in children younger than 8 and is associated with a midline diastema

A

papillary penetrating

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12
Q

what is present histologically in a frena?

A

both orthokeratinized and parakeratinized epithelium

collagen fibers

chronic inflammatory infiltrate

presence of muscle fibers is inconsistent

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13
Q

4 issues that are associated with an aberrant labial frenum

A

frenal tension
interference with OH
gingival recession
midline diastema

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14
Q

4 indications for a frenectomy

A

1) recession
2) interference with OH (trauma, plaque reten)
3) diastema
4) denture fabrication

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15
Q

A … is the cutting of a frenulum especially the release of ankyloglossia (but not removing frenum)

A

frenotomy

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16
Q

A … is the excision (total removal) of a frenulum

A

frenulectomy (frenectomy)

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17
Q

4 surgical options for a frenectomy

A

V-shaped (simple)

Z-plasty (more demanding, less relapse, less scar tissue)

Lasers- better pt outcomes

Electrosurgery

18
Q

frenectomy can result in scar tissue between central incisors leading to resistance to … but if the frenum is wide and thick you may need to still prior to closure

A

ortho movement

19
Q

… is a congenital oral anomaly characterized by an abnormally short lingual frenulum. M:F 3:1

A

Ankyloglossia (tongue tie)

20
Q

Ankyloglossia does not always need correction but there are 4 anatomic indications

A
  • notching of protruding tongue tip
  • inability of tip of tongue to contact maxillary alveolar risge
  • restriction of lateral movement
  • restriction of tongue protrusion beyond mandibular alveolus
21
Q

what does LASER stand for

A

Light Amplification by Stimulated Emission of Radiation

22
Q

3 characteristics of laser light

A

monochromatic
directional
coherent

23
Q

active medium of lasers

A

solid crystals (ruby or Nd:YAG)

liquid dyes (CO2 or helium/neon)

semiconductors such as GaAs

24
Q

Lasers: excitation mechanisms pump energy into the active medium by one or more of these 3 basic methods:

A

optical, electrical, chemical

25
Q

the … … mirror reflects essentually 100% of the laser light

A

high reflectance

26
Q

the … … mirror reflects less than 100% of the laser light and transmits the remainder

A

partially transmissive

27
Q

6 factors that dictate laser interaction with oral tissues

A 
wavelength
energy level
waveform
focused/defocused beam
duration of exposure
tissue characteristics
28
Q

6 advantages of using a laser

A

1) hemostasis
2) accuracy
3) rapid healing
4) reduced inflammation
5) lack of scar tissue
6) low level of discomfort

29
Q

5 disadvantages of LASER use

A

1) technical difficulties
2) lack of precision of depth of cut
3) tissue not avail. for histopath.
4) hazardous
5) dispersal of viable virus particles in the plume

30
Q

soft tissue surgery where you can use a laser

A

gingivectomy

implant recovery

frenectomy

uncovering soft tissue impactions

31
Q

treatments of perio disease where you can use a laser

A

LANAP

PDT

32
Q

advantages of a laser frenectomy

A

painless
anesthetic free
bloodless

33
Q

disadvantages of laser frenectomy

A

recurrence

unpredictable healing

34
Q

what does LANAP stand for and what is the basic concept of it?

A

Laser Assisted New Attachment Procedure

  • remove sulcular epithelium
  • modify root surface
  • new attachment will occur
35
Q

for LANAP protocol, what does the first pass of the laser do?

A

bactericidal

affect calculus

denature pathologic proteins

removes sulcular lining

leaves CT intact

release tissue tension

36
Q

After first pass of Laser in LANAP what do you do ?

A

3 rounds of scaling with Piezo scaler

37
Q

What does the 2nd pass of the laser do in LANAP?

A
  • finishes debriding the pocket
  • kills gram neg bacteria
  • initiates stable fibrin clot
  • creates closed system
  • release stem cells from PDL and bone
38
Q

for LANAP, … must be done one week before and at least 3 months after

A

periostat

39
Q

LANAP … the mouth at a time and then systemic antibiotics for … days and 1/2 mouth ….

A

1/2

7

occlusal adjustment

40
Q

for LANAP, occlusal adjustments must continue post op and patient must wear … and you need to splint mobile teeth and patient should have …. one month after and throughout the year

A

nightguard

perio prophies

41
Q

3 advantages of photo dynamic therapy (PDT)

A

useful for hard to reach areas

tissue specific

no antibiotic resistance

42
Q

3 disadvantages of photo dynamic therapy (PDT)

A
  1. wavelength is narrow so big tumors or deep pockets cannot be penetrated
  2. light configuration is cumbersome
  3. photosensitivity can cause severe burn injuries

Perio Final SP2018 (13 decks)

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