Mucogingival Surgery

Question 1

what patient factors are important for surgery

Answer 1

oral hygiene
quality of maintenance available and patient access
ability of patient to tolerate procedure
compliance
aesthetics

Question 2

what are the tooth factors important for surgery

Answer 2

access to non-responding sites
shape of defect
prosthodontic/endo
tooth position/anatomy

Question 3

what medical factors are important for surgery

Answer 3

smoking
cardiac issues
poorly controlled diabetes
immunosuppressed
anticoagulants

Question 4

what are the 3 surgical approaches

Answer 4

conservative (access)
resective
reconstructive

Question 5

what factors determine which surgery approach you get

Answer 5

anatomy of residual pocket
anatomy of tooth
position of tooth
complexity and predictability

Question 6

what is regenerative surgery

Answer 6

promote regeneration of periodontal tissues that have been lost
uses membranes/grafts

Question 7

what are the indications for mucogingival surgery

Answer 7

periodontitis lesions
mucogingival deformities
short clinical crowns
removal or aberrant frena
pre-implant surgery

Question 8

what are the 3 most common mucogingival surgery procedures (grafts)

Answer 8

free gingival graft
pedicle graft
connective tissue graft

Question 9

what is the difference between a split and full thickness flap

Answer 9

full thickness raises the periosteum as well but split does not

Question 10

what is a free gingival graft

Answer 10

raise a split thickness flap and place graft onto the exposed connective tissue allowing healing

Question 11

what is a connective tissue graft

Answer 11

open up a window and remove connective tissue and then close over the epithelium so no open wound

Question 12

what are the 3 classifications of infrabony defects

Answer 12

one wall defects
two wall defects
three wall defects

Question 13

what biomaterials can be used in surgery

Answer 13

barrier membrane
DBBM
EMD

Question 14

how do access and resective surgeries heal

Answer 14

long junctional epithelium

Question 15

how do graft surgeries heal

Answer 15

new connective tissue attachments

Question 16

what is gingival recession

Answer 16

apical migration of gingival margin from CEJ

Question 17

what are the indications for treatment with gingival recession

Answer 17

poor aesthetics
difficult plaque control
sensitivity

Question 18

what is the aetiology of localised recession

Answer 18

excessive toothbrushing
traumatic incisor relationship
habits
anatomical

Question 19

what is the aetiology of generalised recession

Answer 19

ongoing periodontal disease or following resolution of inflammation after successful treatment

Question 20

what classification is used for gingival recession

Answer 20

cairo

Question 21

what is the cairo classification

Answer 21

1. no interproximal tissue loss
2. interproximal loss but not as bad as mid-buccal
3. interproximal loss worse than mid-buccal

Question 22

what are the treatment options for gingival recession

Answer 22

record magnitude
eliminate aetiological factors
oral hygiene instruction
topical desensitising agents
gingival veneer
crowns
mucogingival surgery

Question 23

what does crown lengthening aim to do

Answer 23

apically reposition the entire periodontal attachment including alveolar bone

Question 24

what are the indications for crown lengthening

Answer 24

retention for restorations
for ferrule
subgingival pathology
correct uneven gingival contour

Question 25

when do you consider referral

Answer 25

after non-surgical treatment
highly motivated/engaged patients
non-smoker
reasonable prognosis of tooth