Mucogingival Surgery/Perio Plastic Surgery Flashcards
How can you consider the prognosis of a tooth for mucogingival surgery?
- access to non-responding sites
- shape of defect involved
- prosthodontic/endodontic status
- tooth position/anatomy
What tooth anatomy may make mucogingival surgery difficult?
- tilting
- overeruption
- proximity to adjacent roots
- enamel pearls
- ridges/root grooves
What patient factors are involved in deciding if mucogingival surgery is an appropriate periodontal treatment?
- good OH paramount
- ability of pt to tolerate surgical procedure
- likeliness of pt compliance after surgery
- cost
- aesthetics of site and potential for post-op recession
What systemic/medical aspects may mean a patient isn’t suitable for mucogingival periodontal surgery?
- smoking
- unstable angina, uncontrolled hypertension, MI/stroke within 6 months
- poorly controlled diabetes
- immunosuppressed pts
- anticoagulants
What general surgical approaches to periodontal treatment exist?
- conservative approach [eg access surgery]
- resective approach [removing tissue]
- reconstructive approach
What are some indications for mucogingival surgery?
- periodontitis lesions requiring reconstructive or regenerative treatment
- mucogingival deformities
- short clinical crowns where an increase is clinical crown height is required before restorations are contructed
- removal of aberrant frena
What are the most common mucogingival surgical procedures?
- free gingival graft
- pedicle graft
- connective tissue graft
Name these surgical flaps:
- full thickness flap
- split thickness flap
What biomaterials can be used for mucogingival surgery?
- barrier membrane (collagen)
- DBBM (deproteinised bovine bone matrix)
- EMD (enamel matrix derivative/amelogenins)
What is gingival recession?
the apical migration of the gingival margin from the cemento-enamel junction
What is the aetiology of localised gingival recession?
- excessive toothbrushing
- traumatic incisor relationship
- habits = nail biting/pen chewing
- misaligned teeth
- frenal pull
What is a free gingival graft?
- raise split thickness flap
- remove epithelium around area where gingival recession is
- place graft onto exposed connective tissue and allow healing
What is the aetiology of generalised gingival recession?
ongoing periodontal disease
For a connective tissue graft, where is the tissue grafted from?
from palate
Why do 3-walled defects respond better to periodontal surgery compared to 1-wall defects?
osteoblasts come through from all 3 sides of the defect which leads to better healing
What are the healing outcomes of gingiva that can happen after periodontal surgery ?
- long junctional epithelium due to quicker migration of epithelial cells (access/resective)
- new connective tissue attachments (grafting procedures)
How is gingival recession categorised?
