Osseous Surgery Flashcards
Describe physiologic architecture of alveolar bone.
When the crest of interdental gingiva/bone is located coronal to its midfacial/midlingual margins
U shape around tooth
Describe reverse architecture of alveolar bone.
When the crest of interdental bone/gingiva is located apical to midfacial/midlingual margins
Reverse U around the teeth or straight line
T/F: In physiologic architecture, the bone should meet the tooth at a knife edge.
True
Otherwise it would be buttressing bone
___________ is the removal of bone that is attached to the tooth.
Ostectomy
What is a major goal of ostectomy?
Turn reverse architecture into physiologic architecture
T/F: Reverse architecture as a result of horizontal bone loss is an indication for ostectomy.
True
T/F: A three walled vertical defect is an indication for ostectomy.
False
Would try regeneration on 3 and some 2 walled vertical defects
T/F: Shallow vertical defects are great for regeneration.
False
Must have enough vertical room to pack bone — if less than 2mm deep do ostectomy
T/F: Esthetic limitations are not a concern when performing ostectomy.
False
Want to avoid esthetic areas — teeth will look long
T/F: It is okay to perform ostectomy even if the attachment will be compromised.
False
What are three major advantages to ostectomy?
- Pocket elimination
- Physiologic architecture
- Favorable prosthetic environment
What are three major disadvantages of ostectomy?
- Loss of attachment
- Esthetic compromise
- Increased root sensitivity
How is osteoplasty different from ostectomy?
Osteoplasty does not remove alveolar bone proper (bone attached to tooth/PDL)
If only outer cortical plate of alveolar bone is removed, the procedure is termed ____________.
Osteoplasty
What is the most common osteoplasty procedure?
Tori reduction
Other than tori reduction, what are some other indications for osteoplasty?
- Intrabony defects adjacent to edentulous ridge
- Incipient furcations
- Reduction of thick/heavy ledges
- Shallow Osseous craters
What types of instruments will be used for Osseous surgery?
Chisels, files, burs
What are the basic three steps in Osseous resective surgery?
- Vertical grooving — removes the crater by making a ramp to it
- Radicular blending — blend bone into the create grooves
- Gradualizing marginal bone — creating physiologic architecture
- Vertical grooving and radicular blending = osteoplasty
- Gradualizing = ostectomy
What are the benefits of approaching Osseous surgery for craters from the palatal side?
- More keratinized gingiva
- Larger embrasure for access
- More cancellous bone = less post surgical resorption
T/F: You want to avoid shorter root trunks when doing Osseous surgery.
True
One reason for taking a lingual approach on mandibular molars
T/F: Removing exostoses is an osteoplasty procedure.
True
T/F: There will be recession with Osseous surgery.
True
T/F: The best surgery for the long term stability of a tooth is Osseous surgery.
True
