Osseous Regeneration Flashcards

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1
Q

What are the possible outcomes of therapy?

A

New attachment
Long Junctional Epithelium
Root resorption/ankylosis

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2
Q

New attachment

A

Ideal

New PDL, Cementum, and Alveolar Bone

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3
Q

Long Junctional Epithelium

A

Classic form of healing following SRP

Junctional epithelium forms

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4
Q

Root Resorption/Ankylosis

A

Bonne attaches to the tooth

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5
Q

Guided Tissue Regeneration Definition

A

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

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6
Q

“The Race to Repopulate”

A

If bone and PDL don’t grow back, you will get a clot, and epithelium will replace that clot, creating a pocket

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7
Q

Membranes

A

Can help with guided tissue regeneration

Prevents the epithelium from invading

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8
Q

How to place a membrane

A

We fill a site with bone, cover it with a membrane, and place a flap over it
It allows the CT to regenerate

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9
Q

What are the criteria for success of GTR?

A

Primary closure of soft tissue
Secluded space maintenance
Membrane stabilization
Adequate healing period

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10
Q

What are the qualities of an ideal membrane?

A
Absorbable
Biocompatability
Cell occlusive
Space maintenance
Tissue integration
Clinically manegable
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11
Q

What is an example of a non-resorbable membrane

A

ePTFE

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12
Q

What are the advantages of ePTFE?

A

We know it won’t resorb, so we don’t rely on anything

There are many different configurations we can use

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13
Q

What are the disadvantages of ePTFE?

A

They come pre-cut, so we can’t customize

We have to do a second surgery

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14
Q

PLA/PGA membranes

A

Resorbable membrane
Polyactic acid and Citric Acid Ether
Degradation takes 4-6 weeks
One-stage surgery

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15
Q

Collagen membrane

A

Cross-linked
Adding Zinc to the membrane prevents the breakdown of collagen
-Zn provides more crosslinks making it more stable, leading to a slower break down

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16
Q

What are the different layers of functionally graded membranes

A

CL - Core layer

SL - surface layer

17
Q

Core layer of functionally graded membrane

A

Made of protein

18
Q

What are the two different surfaces of the Surface Layer of a functionally graded membrane

A

Epithelial SL - metronidazole incorporated; faces epithelium

Bone SL - HA incorporated; faces bone

19
Q

How can we reinforce a membrane?

A

Creating a scaffold with screws and/or fillers

20
Q

What are the different types of graft integrations?

A

Osteogenesis
Osteoinfuciton
Osteoconduction

21
Q

Osteogeneis

A

Viable cells

22
Q

Osteoinduciton

A

Uncommited CT cells get induced

23
Q

Osteoconduction

A

Non-viable scaffold

Extremely passive

24
Q

Autogenous graft

A

Cells from the same pt

Osteoconductive, osteoinductive, and osteogenic

25
Q

What are the advantages of an autogenous graft?

A

‘Gold standard’ - predictable results

Osteogenic

26
Q

What are the disadvantages of an autogenous graft?

A

Second surgery required

There’s a limit as to how much material we can use

27
Q

Allograft

A

From a human source, but a different patient

Osteoconductive and can be osteoinductive

28
Q

Allograft advantages

A

Avaliable
No second surgery required
Reduced surgical time
Fewer complicaitons

29
Q

Allograft disadvantages

A

Anitigenicity
Longer healing
Les volume (only get about 70-80% of what we put in)

30
Q

Alloplasts and Xenografts

A

Only osetoconductive

Can be from cows or somethign completely genetic

31
Q

What type of incision is used in GTF?

A

Sulcular

32
Q

Enamel Matrix Derivative (Emdogain)

A

Useful as an osteoinductive agent

Significantly improves attachment levels and reduces pockets

33
Q

Emdogain Action (Enamel Matrix Derivative)

A

Forms a layer of ECM on the root surface that promotes selective cell colonization - it enhances the mesenchymal cell adhesion and inhibits epithelial cell adhesion

34
Q

Human Platelet-Derived Growth Factor in Tri-Calcium Phosphate Action

A

PDGF stimulates migration and proliferation of osteoblasts, fibroblasts, and cementoblasts - leads to formation of new bone PDL, and cementum
Increases bone but no effect on attachment gain

35
Q

Which sutures are used for GTR?

A

Have to be non-braided and non-resorbable:
PLA/PGA
Goretex