Osseous Surgery

Question 1

Osseous Surgery
(2)

Answer 1

 Resective procedures
(subtractive)
 Regeneration procedures
(additive)

Question 2

Osteoplasty:

Answer 2

The reshaping of bone
to achieve a more physiologic form
without removal of alveolar bone
proper.

Question 3

 Ostectomy:

Answer 3

The removal of alveolar
bone proper (supporting bone).

Question 4

infrabony:

Answer 4

apical to the alveolar crest

Question 5

Infrabony
 One-wall:
 Two-wall:
 Three-wall:
 Combination:

Answer 5

(can be a hemiseptum)
(crater-the most common
defect)
(true intrabony defect)
(of any of the above)

Question 6

Osseous Defects
 Suprabony versus Infrabony defects
 If the distance between the roots of the
teeth is ≥—mm then the defects will be a
vertical defect (amount of cancellous bone
present).
 If the distance is less than — mm then
horizontal bone loss will occur.

Answer 6

2.5
2.5

Question 7

Osseous Defect
Classification
(5)

Answer 7

 Inconsistent margins
 Interradicular defects (furcation defects)
 Dehiscences
 Fenestratons
 Horizontal bone loss

Question 8

 Inconsistent margins –

Answer 8

the interdental
crestal bone is located apical to the level of
the radicular bone

Question 9

Bone Morphology
(3)

Answer 9

 Positive architecture (physiologic
architecture)
 Negative architecture (reverse
architecture, or inconsistent margins)
 Flat architecture ?

Question 10

Osseous Surgery
 Determinants of Gingival Contour-
(Not necessarily the underlying
bone)
(4)

Answer 10

 Interdental space
 Position of tooth in the arch (facial or
lingual position in the alveolus)
 Root shape
 Crown shape

Question 11

Rationale of osseous surgery:

Answer 11

A
reduced probing depth will both
increase the effectiveness of oral
hygiene by the patient and also
facilitate the ease of maintenance by
the therapist

Question 12

Indications for osseous surgery
(4)

Answer 12

 Shallow infrabony defects
 Osseous ledges and tori
 Furcation invasions-Class I or
shallow Class II
 Inconsistent margins

Question 13

Osseous Surgery
 Contraindications for osseous
surgery
(4)

Answer 13

 Maxillary anteriors (esthetics)
 Three-wall defects (regeneration)
 Isolated deep defects
 Generalized advanced bone loss

Question 14

Contraindications to osseous
surgery
(3)

Answer 14

 Local anatomic factors
 High caries rate
 Dentinal sensitivity

Question 15

 Local anatomic factors
(4)

Answer 15

 Sinus
 Ascending ramus
 Flat palate
 External oblique ridge

Question 16

Osseous Surgery
 Advantages to osseous surgery
(5)

Answer 16

 Predictable
 One-stage
 Single surgical site
 Minimal healing time
 Ease of post-operative maintenance

Question 17

Osseous Surgery
 Disadvantages of osseous surgery
(3)

Answer 17

 Root sensitivity and esthetics
(especially in the maxillary anterior)
 Defect dependent
 Loss of attachment (by ostectomy)
 (However, ostectomy is usually limited)

Question 18

Osseous Surgery
 Alternative Treatments
(4)

Answer 18

 Regenerative procedures
 Root amputation or hemisection
 Non-surgical therapy
 Extraction

Question 19

Osseous Surgery
 Interrelationship of factors
(4)

Answer 19

 Gingival contours
 Bone thickness and contour
 Anatomic factors
 Dentition

Question 20

 Dentition
(3)

Answer 20

 Adjacent teeth
 Position in the arch
 Root and crown anatomy

Question 21

Osseous Surgery
 Surgical Technique
(4)

Answer 21

 Bone sounding
 Intra-sulcular incisions on facial and
lingual of mandible and facial of
maxilla
 Mucoperiosteal flap reflection
 Root and defect debridement

Question 22

Osseous Surgery
 Osseous surgery technique
(5)

Answer 22

 Vertical interproximal grooving
 Reduction of marginal radicular
bone
 Elimination of lips of craters
 Removal of “widow’s peaks”
 Removal of marginal radicular bone

Question 23

Osseous Surgery
 Closure
 Tissue placement
 At the alveolar crest =
 Coronal to alveolar crest =

Answer 23

pocket
elimination
pocket
reduction

Question 24

Osseous Surgery
 Palatal Approach
(6)

Answer 24

 Wider embrasures
 More cancellous bone
 Defect location
 All keratinized tissue
 One root vs. two roots
 Furcations more apical

Question 25

Osseous Surgery
 Lingual Approach
(5)

Answer 25

 Furcations more apical
 Defect location
 Axial inclination of molars
 Wider embrasures
 Avoids external oblique ridge