Osseous Surgery: Resection- Review

Question 1

Osseous surgery may be ____ or ___.

Answer 1

Resective or regenerative

Question 2

Osseous surgery in which we are subtracting or taking away bone:

Answer 2

Resective procedure

Question 3

Osseous surgery in which we are adding bone:

Answer 3

Regenerative procedure

Question 4

What is the rationale behind osseous surgeries?

Answer 4

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

Question 5

Indications of osseous surgery include:

Answer 5

1. shallow infra bony defects
2. osseous ledges and tori
3. furcation invasions (class I or shallow class II)
4. cutting multi-rooted teeth to be single rooted
5. inconsistent margins

Question 6

Contraindications of osseous surgery:

Answer 6

1. maxillary anteriors (esthetics)
2. three walled defects (want to regenerate these areas if possible)
3. isolated deep defects
4. generalized advanced bone loss
5. high caries rate
6. dentinal sensitivity
7. local anatomic factors
8. poor plaque control

Question 7

Advantages of osseous surgery:

Answer 7

1. predictable
2. one-step
3. single site
4. minimal healing time
5. ease of post-op maintenance
6. improved contours for better flap adaptation

Question 8

Disadvantages of osseous surgery:

Answer 8

1. root sensitivity
2. esthetics
3. defect dependent
4. loss of attachment (by osteotomy but usually limited)

Question 9

Alternative treatments to osseous surgery include:

Answer 9

1. regenerative procedures
2. root amputation or hemisection
3. non-surgical therapy
4. extraction

Question 10

Resective surgery technique depends on:

Answer 10

1. anatomic factors
2. gingival contours
3. bone thickness & contour
4. dentition

Question 11

Steps of resective surgery:

Answer 11

1. bone sounding
2. instrsulcular incisions
3. mucoperiosteal flap reflection
4. root and defect debridement

Question 12

What are some differing techniques with resection?

Answer 12

1. vertical interproximal grooving
2. reduction of marginal radicular bone
3. elimination of lips of craters
4. removal of “widows peaks”
5. removal of marginal radicular bone

Question 13

With closure during resection, the tissue placement can be done at the ____ or ____.

Answer 13

AT THE alveolar crest or CORONAL to the alveolar crest

Question 14

If the soft tissue is placed AT the alveolar crest during closure:

Answer 14

pocket elimination

Question 15

If soft tissue is place CORONAL to the alveolar crest during closure:

Answer 15

pocket reduction

Question 16

Between the palatal and lingual approach of osseous surgery, the ____ approach is more common:

Answer 16

palatal

Question 17

The palatal approach of osseous surgery is used for:

Answer 17

maxillary surgery

Question 18

The palatial approach of osseous surgery is used for maxillary surgery due to:

Answer 18

1. furcations more apical
2. wider embrasures
3. defects commonly seen on palatal
4. more cancellous bone
5. all keratinized tissue
6. one root on palatal (vs. two on buccal)

Question 19

The lingual approach of osseous surgery is used for:

Answer 19

mandibular surgery

Question 20

The lingual approach of osseous surgery is used for mandibular surgery due to:

Answer 20

1. furcations more apical
2. wider embrasures
3. defects commonly seen on lingual
4. axial inclination of molars
5. avoids external oblique ridge

Question 21

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

Answer 21

osteoPLASTY

Question 22

The removal of alveolar bone proper (supporting bone)

Answer 22

ostectomy

Question 23

Osseous defect classifications include:

Answer 23

1. infrabony
2. supra bony
3. inconsistent margins
4. other

Question 24

Osseous defect that is apical to the, within the bone, and considered more severe. Characterized by one, two or three-walled

Answer 24

infrabony

Question 25

Osseous defect that is CORONAL to the alveolar crest, may be vertical or horizontal:

Answer 25

suprabony

Question 26

Infrabony osseous defects are classified as: Suprabony osseous defects are classified as:

Answer 26

Infra= one, two, or three-walled Supra= horizontal or vertical

Question 27

In a supra bony defect, if the distance between the roots of the teeth is GREATER or EQUAL TO 2.5mm, then the defect will be a ____ defect

Answer 27

vertical

Question 28

In as supra bony defect, if the distance between the roots of the teeth is LESS THAN 2.5mm, then the defect will be a ____ defect

Answer 28

horizontal

Question 29

Defect in which the interdental crestal bone is located apical to the level of the radicular bone resulting in a NEGATIVE architecture:

Answer 29

Inconsistent margins

Question 30

Other osseous defect not categorized as infra bony, supra bony, or inconsistent margins include:

Answer 30

1. interradibular defects (furcations) 2. dehiscence (missing bone, most commonly MB root of max 1st molar) 3. fenestrations (windowing of bone)

Question 31

Dehiscence are _____ and they most commonly occur ____.

Answer 31

missing bone, MB root of maxillary 1st molar

Question 32

Windowing of bone=

Answer 32

fenestrations

Question 33

Interradicular defects =

Answer 33

furcations

Question 34

Defects classified by the number of walls remaining:

Answer 34

infra bony osseous defect

Question 35

Infrabony osseous defects are categorized by the number of walls:

Answer 35

remianing

Question 36

One wall defect:

Answer 36

hemiseptum

Question 37

Defect in which there is only one wall remaining:

Answer 37

one wall defect (aka hemiseptum)

Question 38

Disease starts inter proximally underneath the contact point (leads to this type of defect):

Answer 38

two wall defect

Question 39

What is the most common type of infra bony defect?

Answer 39

two wall defect

Question 40

A "true" infra bony defect, "hole" that osseous graft material goes into:

Answer 40

Three wall defect

Question 41

A two wall defect is also called a:

Answer 41

crater

Question 42

Type of defect In which we have the best chance of success for regeneration/graft:

Answer 42

three wall

Question 43

What type of defect is a contraindication for resection?

Answer 43

3 wall

Question 44

Considrered both an INFRAbony and INTRAbony defect:

Answer 44

three wall

Question 45

A _____ is considered a four-walled defect

Answer 45

implant (circumferential defect)

Question 46

Physiologic architecture of bone:

Answer 46

positive architecture

Question 47

Reversed architecture or inconsistent margins (interdental crestal bone located apical to the level of radicular bone)

Answer 47

negative architecture

Question 48

Interdental crestal bone located APICAL to the level of radicular bone

Answer 48

negative architecture

Question 49

Type of architecture that tends to be done by dental providers to maintain various factors:

Answer 49

flat architecture

Question 50

List the determinants of gingival contour:

Answer 50

1. Interdental space 2. Position of tooth in arch 3. Root shape 4. Crown shape

Question 51

T/F: The determinant of gingival contour is NOT necessarily underlying bone

Answer 51

true