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Perio 2 Exam 2 > Osseous Regeneration > Flashcards

Osseous Regeneration Flashcards

1
Q

Procedures allowing the repop of a perio defect by cells capable of forming new CT attachment and alveolar bone

A

Guided Tissue Regeneration

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2
Q

Desirable/Undesirable: Bone Cells

A

Desirable

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3
Q

Desirable/Undesirable: Gingival Epithelial Cells

A

Undesirable

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4
Q

Desirable/Undesirable: Gingival CT

A

Undesirable

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5
Q

Desirable/Undesirable: PDL

A

Extremely Desirable

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6
Q

Criteria (4) for GTR Success

A
  • Primary soft tissue closure
  • Secluded space maintenance
  • Membrane stabilization
  • Adequate healing period
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7
Q

Qualities of an Ideal Membrane

A 
Absorbable
Bio Compatible
Cell Occlusive
Space Maintenance
Tissue Integration
Clinically Manageable
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8
Q

Non-Resorbable GTR Materials

A

ePTFE

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9
Q

Resorbable GTR Materials

A

Cross-linked collagen membranes
Calcium Sulfate
PLA/PGA
Doxycycline 4%

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10
Q

About ePTFE

A

2nd stage surgery required to remove (4-6 weeks) - use small incision, do not disturb tissue, cover new tissue with flap

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11
Q

PLA/PGA

A

Degrades 4-6 weeks, one stage surgery

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12
Q

Collagen, and what do you add to it

A

Cross-linked, adding zinc prevents breakdown, bovine of porcine source

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13
Q

Functionally Graded Membranes

A

Stem cells
3 layers- core layer: protein
SL to epithelium= metornidazole
SL to bone= hydroxyapatite

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14
Q

Space Maintenance Guidelines (2)

A
  • Reinforce the membrane

- Create a scaffold - using tenting screws and fillers

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15
Q

Bio Mechs of Graft Integration

A

Osteogenesis - viable cells
Osteoinduction - uncommitted CT cells induced
Osteoconduction- non viable scaffold

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16
Q

Osteogenesis

A

Osteoblasts from the graft material contribute to bone growth

17
Q

Osteoinduction

A

Graft induces osteoprogenitor cells in the bone to form into osteoblasts and start producing bone

18
Q

Osteoconduction

A

Graft serves as a scaffold for new growth that is perpetuated by the native bone

19
Q

Conductive/Inductive/Genic? Autograft

A

Yes, Yes, Yes

20
Q

Conductive/Inductive/Genic? Allograft

A

Conductive and Usually Inductive, but NOT Genic

21
Q

Conductive/Inductive/Genic? Alloplast/xenograft

A

Conductive, but NOT Inductive or Genic

22
Q

Autogenous Grafts - Advantages

A
  • Gold Standard- predictable

- Osteogenic

23
Q

Autogenous Grafts- Disadvantages

A
  • second surgical site in same human
  • insufficient material
  • membranous bone vascularizes faster than endochondral bone
  • membranous bone resorbs slower that endochondral bone
24
Q

Allografts - Advantages

A
  • Availability
  • No Donor Site
  • Reduced surgical time
  • Fewer complications
25
Q

Allografts - Disadvantages

A
  • antigenicity
  • longer healing
  • less volume
26
Q

Alloplasts and Xenografts

A
  • hydroxyapatite
  • bovine derived
  • tricalcium phosphate
  • synthetic bone material
  • coralline
  • hard tissue replacement polymer
  • bioactive glass
27
Q

Biological Mediators (2)

A
  • Enamel matrix proteins

- rhBMP

28
Q

Human BMP-2 (INFUSE)

A

Stimulates bone formation

mix w/ water and applied to collagen sponges

29
Q

Enamel Matrix Derivative (Emdogain)

A

Forms layer of extracellular matrix on the root surface that promotes selective cell colonization - enhances mesenchymal adhesion and inhibits epithelial adhesion

Use PrefGel to wipe smear layer off root

30
Q

Benefits of Emdogain (EMD)

A

Improved AL, pocket reduction

formation of new bone, PDL, and cementum in primates

31
Q

PDGF in Tri-Calcium Phosphate (GEM21S)

A

PDGF stimulates migration of proliferation of osteoblasts, fibroblasts, and cementolblasts–> form new bone, PDL, cementum

32
Q

Effects of GEM21S

A
  • greater radiographical bone fill
  • But, no AL gain
  • Good for furcations
33
Q

Furcation Defects Regeneration

A
  • predictable GTR with Class 2 furcas on mand molars

- Consider GTR in areas with isolated Class 2 furcas

34
Q

Predictability of Furca Regeneration

A
  • Most- Mand or Buccal Max class 2’s
  • Mes or Dist Max class 2’s
  • Least - Class 3’s

Perio 2 Exam 2 (7 decks)

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