Mucogingival Surgery Parts 5 and 6 Flashcards
is it possible to maintain periodontal health without keratinized gingiva
yes
all surfaces with less than ____ of keratinized gingiva exhibit clinical inflammation even in the absence of plaque
2mm
when a _____ band of keratinized gingiva is present, sites with a _____ phenotype have a greater tendency to progress
narrow; thinner
what is looked at in mucogingival deformities and conditions
- periodontal phenotype
- gingival/soft tissue recession
- lack of keratinized gingiva
- decreased vestibular depth
- aberrant frenum/muscle position
- gingival excess
- abnormal color
what are the types of periodontal phenotype
- thin scalloped
- thick scalloped
- thick flat
what is the etiology of periodontal phenotype
tooth position
what is gingival recession
the apical migration of the gingival margin with concomitant exposure of the root surface
gingival recession affects a large population ____ of oral hygiene
irrespective
what is the estimated prevalence of gingival recession
- 54.5% of young adults
- 100% of middle aged elderly adults suffer from gingival recessions with an average prevalence of 78.6%
what are the categories of gingival excess
- pseudo pocket
- inconsistent gingival margin
- excessive gingival display
- gingival enlargement
what are the most common mucogingival defects in daily practice
- gingival recessions
- inadequate zone of keratinized gingiva
what are the predisposing factors to mucogingival deformities
- periodontal phenotype and attached gingiva
- the impact of tooth brushing
- the impact of cervical restorative margins
- the impact of orthodontics
- other conditions
what are the diagnostic considerations for recession
- recession depth and gingival thickness
- modern recession classification
what is recession type 1 (RT)
gingival recession with no loss of interproximal attachment. interproximal CEJ was not detected either on the mesial or distal aspect of the tooth
what is recession type 2
gingival recession associated with loss of interproximal attachment
- the amount of interproximal attachment loss was less or equal to the buccal attachment loss
what is recession type 3
gingival recession with the loss of interproximal attachment
- interproximal attachment loss is greater than the buccal attachment loss
what is the cairo classification results for gingival recession
- 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
what is the comparison between treated and untreated sites of recession
- 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
what are the treatment options for recession
- free autogenous soft tissue graft
- connective tissue auto or allograft with tunneling or vestibular approach
- coronally positioned flap
- semilunar flap
- GTR
what is the gold standard surgical approach in treating recession
Connective tissue grafts
describe the tunnelling technique and what it is effective in
- flap elevation that does not dissect the papilla or require vertical releasing incisions
- effective in treating localized and multiple recession defects
what is the acellular dermal matrix allograft made of and what is it used for
- 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
free gingival grafts is one of the most common approaches for _____
gingival augmentation
what do gingival augmentation procedures utilizing free gingival grafts do
they provide an increased amount of keratinized gingiva along with a reduction of recession over a long period of time
describe the wound healing stages and their duration of the free gingival graft
- plasmatic circulation (2-4 days)
- revascularization (2-8 days)
- organic union (4-10 days)
- epithelialization (10-14 days)
- keratinization (21-28 days)
what gets converted in the free gingival graft
phenotype
what are the factors affecting treatment
- extent of the recession
- root prominence
- quantity of keratinized gingiva
- tooth location
- concomitant presence of non carious cervical lesions
what are the anatomical challenges in mucogingival deformity treatment
- vascular supply
- muscle pull
- shallow vestibule
- location and extent of the recession
what are the most treated mucogingival deformities in order
- maxillary canines
- maxillary first premolars
- manidbular incisors
what are the least treated in mucogingival deformities
maxillary right laterals and second pre molars
