Osseous Resective Surgery

Question 1

What are the goals of resective surgery

Answer 1

Eliminate Pocket
Develop positive architecture
Enable pt and dentist to maintain tooth

Question 2

What are the indications for resective surgery

Answer 2

Access
Remove Calculus
Reduce or eliminate persistent infection
Alter periodontium for aesthetics

Question 3

What are the contra indications of resective surgery

Answer 3

Ineffective plaque control
Non compliant pt
Shallow PD
Defects that can be regenerated
Severely advanced diseased
Uncosmetic result
Uncontrolled systemic illness

Question 4

What are the goals of gingivectomy

Answer 4

Soft tissue resection
Eliminate soft tissue pocket
Gingival Enlargement
Remove supra bony pockets

Question 5

Indication of gingivectomy

Answer 5

Suprabony gingival pockets
Tissue crater
Unaesthetic gingiva in altered passive eruption
reduce gingival enlargement
Crown lengthen

Question 6

Contra Indications of gingivectomy

Answer 6

Poor OH
PD apical to MGJ
Lack of KT
Infrabony defect
Osseous Ledge
Exostosis
Shallow vestibular depth
Cosmetic compromise
Increase caries risk

Question 7

What are the types of gingivectomy

Answer 7

Ext Bevel: Incision at base of pocket, painful, cannot suture. Needs perio dressing

Int Bevel: Less painful. Can suture. Heal by primary intention. Does not expose root surface.

Question 8

What are the advantages of MWF

Answer 8

Intimate post op adaption of healthy collagen to tooth
New Cementum for apical aspect of lesion
Optimum root coverage

Question 9

How does MWF heal

Answer 9

CAL Gain
PD decrease
BUT NO NEW ATTACHMENT

Question 10

Discuss palatal osseous technique

Answer 10

Max posterior IP crater
Goal physiologic architecture
Avoid buccal furcation
Poor posterior access bucally

Question 11

Discuss lingual osseous technique

Answer 11

Man posterior interproximal crater
Prominent ext oblique ridge can complicate
Lingual crown inclination aids
Base of crate usually to lingual due to force
Lingual buccal plate thicker

Question 12

What is the wound healing after osseous surgery

Answer 12

Depends on incision, thinning, elevation and closure
Resorption increased with thin plates

Flap Reflection: 0.2 mm
Osteoplasty: 0.6 mm
Ostectomy: Immediate CAL, with further loss during remodelling

Question 13

What are the indications for clinical crown lengthening

Answer 13

Caries
Wear
Fracture
Delayed passive eruption

Question 14

What distance is needed from the alveolar crest to restoration margin

Answer 14

3-5 mm