Mucogingival Surgery Parts 5 and 6 Flashcards

1
Q

is it possible to maintain periodontal health without keratinized gingiva

A

yes

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2
Q

all surfaces with less than ____ of keratinized gingiva exhibit clinical inflammation even in the absence of plaque

A

2mm

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3
Q

when a _____ band of keratinized gingiva is present, sites with a _____ phenotype have a greater tendency to progress

A

narrow; thinner

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4
Q

what is looked at in mucogingival deformities and conditions

A
  • periodontal phenotype
  • gingival/soft tissue recession
  • lack of keratinized gingiva
  • decreased vestibular depth
  • aberrant frenum/muscle position
  • gingival excess
  • abnormal color
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5
Q

what are the types of periodontal phenotype

A
  • thin scalloped
  • thick scalloped
  • thick flat
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6
Q

what is the etiology of periodontal phenotype

A

tooth position

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7
Q

what is gingival recession

A

the apical migration of the gingival margin with concomitant exposure of the root surface

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8
Q

gingival recession affects a large population ____ of oral hygiene

A

irrespective

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9
Q

what is the estimated prevalence of gingival recession

A
  • 54.5% of young adults
  • 100% of middle aged elderly adults suffer from gingival recessions with an average prevalence of 78.6%
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10
Q

what are the categories of gingival excess

A
  • pseudo pocket
  • inconsistent gingival margin
  • excessive gingival display
  • gingival enlargement
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11
Q

what are the most common mucogingival defects in daily practice

A
  • gingival recessions
  • inadequate zone of keratinized gingiva
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12
Q

what are the predisposing factors to mucogingival deformities

A
  • periodontal phenotype and attached gingiva
  • the impact of tooth brushing
  • the impact of cervical restorative margins
  • the impact of orthodontics
  • other conditions
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13
Q

what are the diagnostic considerations for recession

A
  • recession depth and gingival thickness
  • modern recession classification
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14
Q

what is recession type 1 (RT)

A

gingival recession with no loss of interproximal attachment. interproximal CEJ was not detected either on the mesial or distal aspect of the tooth

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15
Q

what is recession type 2

A

gingival recession associated with loss of interproximal attachment
- the amount of interproximal attachment loss was less or equal to the buccal attachment loss

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16
Q

what is recession type 3

A

gingival recession with the loss of interproximal attachment
- interproximal attachment loss is greater than the buccal attachment loss

17
Q

what is the cairo classification for gingival recession

A
  • RT 1: (miller class I and II): 100% root coverage can be predicted
  • Cairo RT 2: (overlapping Miller class III): mixed results
  • Cairo RT 3 (overlapping Miller class IV): full root coverage is not achievable
18
Q

what is the comparison between treated and untreated sites of recession

A
  • treated sites showed recession reduction and untreated sites experienced increased recession
  • amount of increases in recession was limited
  • thin gingival biotypes augmented by grafting remained stable over time compared to untreated areas with thin biotypes
  • untreated areas showed a tendency to develop new recession
19
Q

what are the treatment options for recession

A
  • free autogenous soft tissue graft
  • connective tissue auto or allograft with tunneling or vestibular approach
  • coronally positioned flap
  • semilunar flap
  • GTR
20
Q

what is the gold standard surgical approach in treating recession

A

Connective tissue grafts

21
Q

describe the tunnelling technique and what it is effective in

A
  • flap elevation that does not dissect the papilla or require vertical releasing incisions
  • effective in treating localized and multiple recession defects
22
Q

what is the acellular dermal matrix allograft made of and what is it used for

A
  • cell free dermal matrix comprised of a structurally integrated basement membrane complex and extracellular matrix
  • ADMAs have been applied as a substitute for CTGS in various periodontal procedures including root coverage cell free
23
Q

free gingival grafts is one of the most common approaches for _____

A

gingival augmentation

24
Q

what do gingival augmentation procedures utilizing free gingival grafts do

A

they provide an increased amount of keratinized gingiva along with a reduction of recession over a long period of time

25
Q

describe the wound healing stages and their duration of the free gingival graft

A
  • plasmatic circulation (2-4 days)
  • revascularization (2-8 days)
  • organic union (4-10 days)
  • epithelialization (10-14 days)
  • keratinization (21-28 days)
26
Q

what gets converted in the free gingival graft

A

phenotype

27
Q

what are the factors affecting treatment

A
  • extent of the recession
  • root prominence
  • quantity of keratinized gingiva
  • tooth location
  • concomitant presence of non carious cervical lesions
28
Q

what are the anatomical challenges in mucogingival deformity treatment

A
  • vascular supply
  • muscle pull
  • shallow vestibule
  • location and extent of the recession
29
Q

what are the most treated mucogingival deformities in order

A
  • maxillary canines
  • maxillary first premolars
  • manidbular incisors
30
Q

what are the least treated in mucogingival deformities

A

maxillary right laterals and second pre molars

31
Q
A