misc from Davidson

Question 1

Name any and all surgical methods for root coverage

Answer 1

Laterally positioned flap, free gingival graft (most predictable in a narrow defect), connective tissue
graft, coronally positioned graft with or without connective tissue or acellular dermal matrix, guided tissue regeneration

Question 2

6-According to the Position Paper, “Oral Reconstructive and Corrective Considerations in Periodontal Therapy, what is the most predictable method for soft tissue coverage of 90% of the exposed root surface?

Answer 2

Use of an acellular dermal matrix graft covered by a coronally positioned flap. “Mean defect coverage
for all studies was 86%….predictability data indicated that 90% or greater defect coverage was
achieved 74% of the time”

Question 3

What factors affect the predictability of root overage

Answer 3

Malocclusion, loss of interproximal supporting bone, width and extent (above or below the mucogingival
junction), thickness of the residual keratinized tissue, adequate vascular supply, flap tension,
8-Your patient presents with the chief complaint of a black triangle (loss of proximal papilla between the
upper central incisors. What treatment choices do you have to restore the papilla.

Restoration with or without orthodontic therapy…..presently there are no techniques in periodontics
that will predictably restore a black triangle.

Question 4

9- According to Becker, Becker and Berg (1979 and 1984) what is the numerical difference in teeth lost
per year for individuals without periodontal treatment and those who have had treatment and are being
maintained.

Answer 4

Becker, Berg and Becker 1979-untreated- .36 teeth/year

Becker, Becker and Berg: treated and maintained .11 teeth/year

Question 5

Is BOP a good predictor of future attachment loss? Explain.

Answer 5

Lang et al JCP 1986 -Patients who had been treated for severe chronic periodontitis were evaluated at
recall (3-5 months) for at least four years. Four sites on every tooth were evaluated for BOP at each
recall. Pockets with BOP in 4/4 recall visits had only a 30% chance of loss of attachment. Therefore,
BOP is a poor prognosticator of future periodontal disease.

Lang et al 1990-Absence of BOP was a reliable predictor for the maintenance of periodontal health.

Question 6

How to differentiate btwn pemphigoid and pemphigus

Answer 6

Histologically, mucous membrane pemphigoid demonstrates a subbasilar separation of the epithelium
from the underlying connective tissue. Vessicle formation occurs below intact epithelium. Pemphigus is
characterized by acantholysis and suprabasilar bullae formation with intraepithelial clefting. The basal
cells lining the floor of the bullae are in a tombstone pattern and Tzank cells float in the blister fliud. In
mucous membrane pemphigoid the inflammatory pattern is non-specific (lymphocytes, plasma cells and
neutrophils) while in pemphigus the inflammation is primarily plasma cells.