Osseous Surgery

Question 1

Describe physiologic architecture of alveolar bone.

Answer 1

When the crest of interdental gingiva/bone is located coronal to its midfacial/midlingual margins

U shape around tooth

Question 2

Describe reverse architecture of alveolar bone.

Answer 2

When the crest of interdental bone/gingiva is located apical to midfacial/midlingual margins

Reverse U around the teeth or straight line

Question 3

T/F: In physiologic architecture, the bone should meet the tooth at a knife edge.

Answer 3

True

Otherwise it would be buttressing bone

Question 4

___________ is the removal of bone that is attached to the tooth.

Answer 4

Ostectomy

Question 5

What is a major goal of ostectomy?

Answer 5

Turn reverse architecture into physiologic architecture

Question 6

T/F: Reverse architecture as a result of horizontal bone loss is an indication for ostectomy.

Answer 6

True

Question 7

T/F: A three walled vertical defect is an indication for ostectomy.

Answer 7

False

Would try regeneration on 3 and some 2 walled vertical defects

Question 8

T/F: Shallow vertical defects are great for regeneration.

Answer 8

False

Must have enough vertical room to pack bone — if less than 2mm deep do ostectomy

Question 9

T/F: Esthetic limitations are not a concern when performing ostectomy.

Answer 9

False

Want to avoid esthetic areas — teeth will look long

Question 10

T/F: It is okay to perform ostectomy even if the attachment will be compromised.

Answer 10

False

Question 11

What are three major advantages to ostectomy?

Answer 11

1. Pocket elimination
2. Physiologic architecture
3. Favorable prosthetic environment

Question 12

What are three major disadvantages of ostectomy?

Answer 12

1. Loss of attachment
2. Esthetic compromise
3. Increased root sensitivity

Question 13

How is osteoplasty different from ostectomy?

Answer 13

Osteoplasty does not remove alveolar bone proper (bone attached to tooth/PDL)

Question 14

If only outer cortical plate of alveolar bone is removed, the procedure is termed ____________.

Answer 14

Osteoplasty

Question 15

What is the most common osteoplasty procedure?

Answer 15

Tori reduction

Question 16

Other than tori reduction, what are some other indications for osteoplasty?

Answer 16

1. Intrabony defects adjacent to edentulous ridge
2. Incipient furcations
3. Reduction of thick/heavy ledges
4. Shallow Osseous craters

Question 17

What types of instruments will be used for Osseous surgery?

Answer 17

Chisels, files, burs

Question 18

What are the basic three steps in Osseous resective surgery?

Answer 18

1. Vertical grooving — removes the crater by making a ramp to it
2. Radicular blending — blend bone into the create grooves
3. Gradualizing marginal bone — creating physiologic architecture

• Vertical grooving and radicular blending = osteoplasty
• Gradualizing = ostectomy

Question 19

What are the benefits of approaching Osseous surgery for craters from the palatal side?

Answer 19

1. More keratinized gingiva
2. Larger embrasure for access
3. More cancellous bone = less post surgical resorption

Question 20

T/F: You want to avoid shorter root trunks when doing Osseous surgery.

Answer 20

True

One reason for taking a lingual approach on mandibular molars

Question 21

T/F: Removing exostoses is an osteoplasty procedure.

Answer 21

True

Question 22

T/F: There will be recession with Osseous surgery.

Answer 22

True

Question 23

T/F: The best surgery for the long term stability of a tooth is Osseous surgery.

Answer 23

True