More Periodontal Surgeries Flashcards
purpose of bone replacement graft surgery
surgery used to encourage the body to rebuild alveolar bone lost from perio disease
what is involved in bone replacement graft surgery
- elevation of a flap
- treating roots as needed
- placement of grafting material into defect
- flap returned to original position
what can cause challenged in bone grafts?
- subject to contamination from bacteria and saliva traveling along the roots adjacent to graft site
- healing of bone can be disrupted by growth of epithelium into the wound
define osteogenesis
potential for new bone cells to develop following bone graft
two types of osteogenesis and features; which is better?
- osteoconductive-grafting materials form a framework outside the graft during the formation of the new bone
- osteoinductive-cells within the grafting material are converted into the bone-forming cells to form the new bone
onsteoinductive is the best way
what materials are used for bone grafts and which are osteoinductive or osteoconductive
autograft-inductive
allograft-inductive
xenograft-conductive
alloplast-conductive
is it possible for the reformed bone to not actually be attached to cementum by PDL fibers?
yes
what is important for hygienist to know after bone grafts?
- do not probe until appropriate interval has lapsed
- plaque control is critical to maintain health in the area
what is a guided tissue regeneration surgery?
encourages regrowth of lost periodontal structures (lost cementum, alveolar bone, and PDL)
why is a barrier membrane placed on the graft material?
to keep the graft material in place and it keeps the epithelium from forming where we want graft to form
what happens if epithelium covers the wound?
it prevents the slower growing cells from growing
what is periodontal plastic surgery’s healing method?
new attachment
what are common plastic surgery procedures
- free gingival graft
- laterally positioned flap
- frenectomy
- crown lengthening surgery
purpose of free gingival graft
increase width of the attached gingiva and cover areas of recession of the gingival margin
two wounds associated with free gingival graft
- donor site
2. recipient site
where is the donor tissue usually obtained from?
patient’s palate
does the color match at the free gingiva?
no
what is different from the subepithelial CT graft and free gingival graft
there is an excellent tissue color match from subepithelial CT graft compared to the free gingiva graft
what is a semilunar flap?
used to repair minor recession and where there is adequate thickness of keratinized tissues
what is a frenectomy surgery?
-used to remove a renum including the attachment of frenum to bone
what can result if the frenum is attached too close to the gingival margin?
it can pull the gingival margin away from the tooth surface resulting in persistent inflammation to the tissues
what is a crown lengthening surgery?
surgery that creates a longer clinical crown for a tooth by removing gingival and alveolar bone from necks of teeth
difference between functional and esthetic crown lengthening
functional-existing tooth strucutre is inadequate to support necessary restoration
esthetic-improve appearance of teeth when there is excess gingiva in relation to clinical crown
what is a gingivectomy surgery?
removal of the gingival tissues
-allows better self-care in select sites
what surgery is hardest to perform?
gingivectomy
disadvantages of gingivectomy
- leaves large open CT wound
- slower healind
- more discomfort
- teeth appear larger
what is gingival curettage? is it used today?
removal of the lining of a periodontal pocket using a periodontal curet
-not used today
what is a dental implant?
artificial tooth root placed into the alveolar bone to hold a replacement tooth
what is biological enhancement?
attempts to enhance the outcome of perio surgery by using chemical or biological mediators to influence healing of alveolar bone, cementum, and PDL fibers
methods of biological enhancement?
- root surface modification
- enamel matrix derivative EMD
- growth factors
- platelet rich plasma PRP
example of a growth factor
platelet derivative growth factor
purpose of sutures
stabilize position of the soft tissues during early phases of healing
two types of materials used for sutures
- nonresorbable: must be taken out
2. resorbable: dissolves into body fluids
how do you remove a suture?
cut material near the knot and grasp the knot with pliers and gently pull through the tissue
count number of sutures placed and enter in treatment notes
what is the largest suture and the smallest
3-0 is largest
5-0 is smallest
