Osseous Surgery Flashcards
what are the types of osseous surgeries
- resective procedures ( subtractive)
- regeneration procedures (additive)
what is an osteoplasty
the reshaping of bone to achieve a more physiologic form without removal of alveolar bone proper
what is an ostectomy
the removal of alveolar bone proper (supporting bone)
where is an infrabony defect
apical to the alveolar crest
what are the types of infrabony defects
- one wall: can be a hemiseptum
- two wall: crater
- three wall: true infrabony defect
- combination: any of the above
what is the most common type of infrabony defect
two wall
what is the difference between suprabony and infrabony
if the distance between the roots of the teeth is greater than or equal to 2.5mm then the defects will be a vertical defect (amount of cancellous bone present)
- if the distance is less than 2.5mm then horizontal bone loss will occur
what are inconsistent margins
the interdental crestal bone is located apical to the level of the radicular bone
what are the osseous defect classifications
- infrabony
- suprabony
- interradicular defects
- dehiscences
- fenestrations
- inconsistent margins
- horizontal bone loss
what are the types of bone morphology and describe each
- positive architecture: physiologic architecture
- negative architecture: reverse architecture, or inconsistent margins
- flat architecture
what are the determinants of gingival contour
- not necessarily the underlying bone
- interdental space
- position of tooth in the arch- facial or lingual position in the alveolus
- root shape
- crown shape
what is the rationale of osseous surgery
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
what are the indications for osseous surgery
- shallow infrabony defects
- osseous ledges and tori
- furcations invasions - class I or shallow class II
- inconsistent margins
what are the contraindications for osseous surgery
- maxillary anteriors (esthetics)
- three wall defects (regeneration)
- isolated deep defects
- generalized advanced bone loss
- local anatomic factors
- high caries rate
- dentinal sensitivity
what are the local anatomic factors that are contraindications to osseous surgery
- sinus
- ascending ramus
- flat palate
- external oblique ridge
what are the advantages to osseous surgery
- predictable
- one-stage
- single surgical site
- minimal healing time
- ease of post operative maintenance
what are the disadvantages of osseous surgery
- root sensitivity and esthetics (especially in the maxillary anterior)
- defect dependent
- loss of attachment ( by ostectomy)
what are the alternative treatment for osseous surgery
- regenerative procedures
- root amputation or hemisection
- non surgical therapy
- extraction
what is the interrelationship of factors for osseous surgery
- gingival contours
- bone thickness and contour
- anatomic factors
- dentition
- adjacent teeth
- position in the arch
- root and crown anatomy
what is the surgical technique in osseous surgery
- bone sounding
- intra sulcular incisions on facial and lingual of mandible and facial of maxilla
- mucoperiosteal flap reflection
- root and defect debridement
- vertical interproximal grooving
- reduction of marginal radicular bone
- elimination of lips of craters
- removal of widow’s peaks
- removal of marginal radicular bone
what is involved in closure in osseous surgery
tissue placement
what is closure at the alveolar crest for
pocket elimination
what is closure coronal to alveolar crest for
pocket reduction
what are the considerations in the palatal approach in osseous surgery
- wider embrasures
- more cancellous bone
- defect location
- all keratinized tissue
- one root vs two roots
- furcations more apical
what is the lingual approach in osseous surgery
- furcations more apical
- defect location
- axial inclination of molars
- wider embrasures
- avoids external oblique ridge
