OE L34 Clinical Applications of Tissue Regeneration

Question 1

What is tooth auto transplantation?

Answer 1

The surgical movement of a tooth from one place in the mouth to another in the same individual.

• Can replace 7s with poor prognosis with 8s
• Currently used clinically

Question 2

What are the advantages of tooth auto transplantation?

Answer 2

• Maintains tissue at the recipient site and stimulates growth (bone)
• If roots are immature, they can continue to grow
• There is no risk of tissue rejection
• Natural tooth is always preferable over a prosthetic replacement

Question 3

What are the disadvantages of tooth auto transplantation?

Answer 3

• Requires donor teeth to move to new position
• Biological complications e.g. infection
• Highly complex procedure

Question 4

What regenerative technique can be used in periodontitis patients?

Answer 4

Guided tissue regeneration

Question 5

Describe periodontal guided tissue regeneration.

Answer 5

• Gingival flap raised and granulation tissue from infrabony defect removed
• Material placed e.g. enamel matrix derivative to promote regeneration
• Membrane placed over defect
• Flap replaced and sutured

Question 6

In what circumstances may GTR be recommended for periodontitis patients?

Answer 6

• Excellent OHI of patient
• Steps 1 and 2 of perio therapy successfully completed
• Remaining bone levels important
• Patient risk factors to be considered e.g. health, smoking status

Question 7

How is gingival recession classified and at which stages is complete regeneration possible?

Answer 7

Class 1 to 4.
Complete regeneration possible for class 1 and 2.

Question 8

Describe class 1 gingival recession.

Answer 8

• Recession does not extend to mucogingival junction

- 100% root coverage possible

Question 9

Describe class 2 gingival recession.

Answer 9

• Recession extends to or beyond the mucogingival junction

- 100% root coverage can be expected

Question 10

Describe class 3 gingival recession.

Answer 10

• Recession extends to or beyond the mucogingival junction with loss of interdental tissue, or malpositioning, meaning 100% root coverage is not possible

Question 11

Describe class 4 gingival recession.

Answer 11

• Recession extends to or beyond the mucogingival junction with advanced loss of interdental tissue
• Root coverage not anticipated

Question 12

What is an alternative treatment for gingival recession where OHI is excellent?

Answer 12

Prosthetic option