Osseous Sx & Reattach_Magda_02072022 Flashcards
Reattachment Vs New attachment
Reattachment: To attach again. Reunion of epith. & CT to root surface following incision orn physical injury (Not disease).
New attachment: Union of epith and CT to root surface that has been deprived of its original attachment (by disease). This new attachment may be:
- Epith adhesion
- CT adaptation or attachment
- May include new cementum
Repair Vs Regeneration
Repair: reproduction of lost structure by a tissue that does not fully restore the architecture and function (LJE)
Regeneration: reproduction of lost structure by a tissue that fully restores the architecture and function (GTR or use of EMD)
Gingival curettage
Removal of inflamed soft tissue lateral to the pocket wall
What is the goal of osseous resective Sx?
1: Establish minimal or physiologic PD
Barrington 1981: 2 goals –>
What are the periodontal new attachment procedures?
1- Ging. curettage
2- ENAP
3- Modified ENAP
4- MWF
5- LANAP
Gingival curettage
Removal of soft tissue lining of Perio pocket leaving only CT lining.
Provide no additional benefit in the treatment of periodontitis compared to SRP alone
Echeveirra & Caffesse 1981:
MM: 4Quad SRP, wait 4 weeks then currettage split mouth using SC 13-14.
Results: Ging. currettage didn’t improve PD beyond intial improvement obtained initially by SRP alone.
In 1987, Ramfjord compared 4 ttt modalities (SRP, curettage, Pocket elimination Sx and MWF) and assessed Plaque/calc., gingivitis, PD, CAL and mobility at 5 years. What did he find?
No additional benefit from curettage over SRP.
1-3 mm PD: SRP & curettage –> less CAL loss than MWF and pocket elimination Sx. No PD reduction
4-6 mm PD: SRP & curettage –> better CAL than pocket reduction Sx, with PD reduction from baseline (greatest reduction following Sx)
7-12 mm PD: Sig. PD reduction following intial hygienic phase.
1 year: greatest PD reduction was in the pocket reduction Sx grp.
5 years: No SSD betw all ttt modalities.
