Osseous Surgery-Regeneration Flashcards
Osseous Regeneration
Objectives of Bone Replacement
Grafting
(2)
Regeneration* of lost periodontium
new bone, cementum and
periodontal ligament
Reduce or eliminate the periodontal
pocket
Autograft:
tissue transferred from one site
to another in the same individual
Allograft:
tissue transferred between
individuals of same species
Alloplast:
inert material used for graft
Xenograft:
tissue transferred between
individuals of differing species
Composite:
combination of grafts
Bone Replacement Grafts
Indications for grafting
(5)
Deep vertical defects
Esthetic considerations
Teeth critical to prosthesis
When anatomy precludes other
procedures
Guided Tissue Regeneration (GTR)
Contraindications
for grafting
(3)
Poor plaque
control
Medically
compromised
Poor
maintenance
compliance
Bone Replacement Grafts
Advantages of grafting
(3)
Restores lost periodontal tissue
Maintains teeth in healthy functional
state
Enhances long term prognosis of
teeth
Disadvantages of grafting
(2) sensitive
— (?)
May require — (?)
Predictability?
Requires —
Longer, more frequent — needed
— sometimes required
Success decreases significantly in — and is —dependent
Technique and material
Expensive
two surgeries
Unpredictable
ideal wound closure
post-op care
Second surgical site
furcations, defect
Osteogenic-
viable osteoblasts are
transplanted
Osteoconductive-
scaffold for bone
formation
Osteoinductive-
release of material to
induce bone formation
Osteoproductive-
production of bone by
a biologic mechanism?
Bone Replacement Grafts
Healing Sequence
(5)
Incorporation (clot formation)
Revascularization
Resorption of graft material with release
of factors (BMP) to induce bone
formation
Bone formation
Bone remodeling and maturation
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
2.5
2.5
Osseous Defect
Classification-Review
Infrabony: apical to the alveolar crest
(4)
One wall-(can be a hemiseptum)
Two wall-(crater-the most common
defect)
Three wall-(true intrabony defect)
Combination-(of any of the above)