Ostectomy/Osteoplasty

Question 1

Purpose of resective osseous surgery:

Answer 1

1) Eliminate osseous defects from periodontitis with pronounced, irregular bone loss.
2) Correct anatomic defects like exostoses or bony architecture that prevents good plaque control.

Question 2

Most common walled defect associated with chronic periodontitis.

Answer 2

2 -walled

Question 3

In healthy teeth, how far away should the alveolar bone be from from CEJ?

Answer 3

1-2 mm

Question 4

Another name for a 2-walled defect.

Answer 4

Osseous crater bc just the buccal and lingual walls are present, and there’s a loss of bone between those two walls.

Question 5

T/F:

Poor oral hygiene is a contraindication for osseous surgery.

Answer 5

TRUE!

Poor oral hygiene is a contraindication for any surgery bc you don’t want oral pathogens entering the systemic circulation.

Question 6

If there’s severe alveolar bone loss, should we do ressective osseous surgery?

Answer 6

NO!

Doesn’t make sense to take away more bone if there’s already bone loss.

Question 7

Ressective osseous surgery increases ______ sensitivity.

Answer 7

root

Question 8

Treatment for root sensitivity.

Answer 8

Sensodyne or Topical Fluoride treatment,

Question 9

In what location in the arch is ressective osseous surgery contraindicated?

Answer 9

Anterior bc it compromises esthetics by creating black triangles.

Question 10

Typical tx for patients that have so much bone loss that an ostectomy is contraindicated.

Answer 10

Splinting.

If lower anteriors have B mobility and a ton of bone loss, splint from canine to canine (canines are more stable).

Question 11

Osseous surgery where:

1) Osseous defects are corrected.
2) Achieve positive or at least neutral architecture.
3) Used for shallow to moderate bony defects (2-3 mm).
4) For one or two-walled defects.

Answer 11

Definitive Osseous Surgery

Question 12

Two types of osseous surgery.

Answer 12

Definitive or Compromised.

Question 13

Definitive osseous surgery is used for what kinds of osseous defects?

Answer 13

Shallow (2-3 mm)

Question 14

Osseous surgery in which the osseous defects can be improved, but cannot be completely corrected without removing so much bone that teeth would be jeopardized.

Answer 14

Compromised osseous surgery.

Question 15

Can’t get positive osseous architecture with this kind of osseous surgery.

Answer 15

Compromised osseous surgery.

Question 16

When interdental bone is CORONAL to the radicular bone.

Answer 16

Positive architecture

Question 17

The alveolar crest is parallel to the ______.

Answer 17

A line drawn between adjacent CEJ’s.

Question 18

Important for food to roll off the labial surfaces and gingiva.

Answer 18

Interproximal sluiceways.

Question 19

Scalloping of the alveolar bone increases or decreases as we go from anterior to posterior?

Answer 19

Decreases

Question 20

Shape of the interdental bone in the anterior?

Answer 20

Pyramidal

and flattens as you go posterior.

Question 21

Osseous recontouring is most predictable in people with what kind of periodontitis?

Answer 21

Mild to moderate

Question 22

Reduces both attachment and alveolar bone.

Answer 22

Osseous surgery.

Question 23

Is short-term pocket depth reduction better with or without osseous surgery?

Answer 23

WITH!

Question 24

Are subgingival pathogens eliminated better with or without osseous surgery?

Answer 24

WITH!

Question 25

Types of osseous architecture.

Answer 25

1) Positive
2) Flat
3) Negative

Question 26

Flat osseous architecture.

Answer 26

Interdental bone is at the same level as radicular bone.

Question 27

Negative osseous architecture.

Answer 27

Interdental bone is apical to the radicular bone.

Question 28

Most common osseous defect for chronic periodontitis.

Answer 28

2-walled/ interproximal osseous crater.

Question 29

Most common osseous defect for localized aggressive periodontitis.

Answer 29

Circumferential defect

Question 30

Grafts work best in what kind of osseous defects?

Answer 30

3-walled

Question 31

1-walled osseous defects are missing these walls.

Answer 31

B and Lingual

Question 32

How are osseous defects classified?

Answer 32

By the number of walls that are PRESENT.

Question 33

Tx for 1-walled osseous defects.

Answer 33

Ostectomy/plasty.

Have only 1 wall present, so they’re not good for grafts bc there aren’t enough walls to contain the graft.

Question 34

Tx for 2-walled osseous defects.

Answer 34

• Ostectomy/plasty
• Bone graft
• Guided Tissue Regeneration

Seen in chronic periodontitis.

Question 35

Walls present in a 3-walled osseous defect.

Answer 35

Buccal
Lingual
Interproximal

Question 36

Tx for 3-walled osseous defects.

Answer 36

Bone graft and maybe GTR.

Question 37

Can get new CT attachment and bone fill in this osseous defect.

Answer 37

3-walled

Question 38

Circumferential defect is AKA.

Answer 38

Circumferential GUTTER.

Question 39

Causes of a circumferential gutter defect.

Answer 39

1) LAP

2) Occlusal trauma + Plaque

Question 40

T/F: Occlusal trauma alone can cause a circumferential defect.

Answer 40

FALSE.

Need PLAQUE in addition to occlusal trauma in order to get a circumferential defect.

Question 41

Occlusal trauma only causes periodontal pockets in the presence of ______.

Answer 41

Plaque

Question 42

Reshaping bone without removing tooth supporting bone.

Answer 42

Osteoplasty

Question 43

Removing tooth-supporting bone.

Answer 43

Ostectomy.

Question 44

Used to remove thin layers of bone on the root surface where you don’t want to use the bur.

Answer 44

Chisel

Question 45

Used to remove pedunculated exostoses.

Answer 45

Rongeur

Question 46

How are interproximal osseous craters corrected?

Answer 46

RAMPING to the buccal or lingual.

Question 47

Is it more esthetic to ramp to the buccal or the lingual for an interproximal osseous crater?

Answer 47

Lingual.

Question 48

LAP affects which teeth?

Answer 48

Incisors and first molars.