perio exam 3 Flashcards
causes of tooth impaction (several local factors that may become an obstacle to the normal eruption process)
- failure of deciduous tooth roots to resorb
- abnormal position (eruptive path)
- supernumerary tooth
- tooth crowding
- dentigerous cyst (enlarged dental follicle)
- thickened oral soft tissues (genetics, trauma)
- oral soft tissue pathology
- hard tissue pathology (odontoma)
- premature extraction of deciduous teeth
systemic factors that may also affect the normal eruption process
childhood diseases
hereditary factors
genetic syndromes
studies have shown a _____ toward canine impaction
genetic predisposition
sequelae of canine impaction
- palatal or labial malposition of impacted tooth
- migration of neighboring teeth
- internal resorption
- external root resorption
- dentigerous cyst formation
- referred pain
- combinations of the above
surgical techniques for exposing impacted tooth
open eruption- window technique and apically positioned flap technique
closed eruption- flap elevated, ortho appliance applied, flap closed
advantage of open eruption technique
if bonding of bracket/chain fails, no additional surgery needed
disadvantages of open eruption approach
- greater discomfort (pain, bad taste)
- interference with function (eating)
- delayed healing (secondary intention)
- bone exposure
advantages of closed eruption technique
- rapid healing
- less discomfort
- less interference with function
disadvantage of closed eruption
if bonding of bracket/chain fails, additional surgery needed
4 different types of abscesses
gingival, pericoronal, periodontal, periapical
treatment of gingival abscess
removal of noxious agent(s)
incision and drainage (if necessary)
antibiotics contraindicated
home care: rinse with warm NaCl water
pericoronal abscess treatment
removal of noxious agent(s) irrigation under soft tissue operculum systemic complications- antibiotics home care: rinse with warm NaCl water extraction/operculectomy when infection under control
periapical abscess treatment
removal of tooth
root canal therapy
treatment of periodontal abscesses
drainage thru pocket retraction or incision
SRP
periodontal surgery
systemic complications- antibiotics (amox for 3 days)
extraction
mechanic etiologies of gingival recession
traumatic brushing/flossing
ortho tx
trauma
parafunctional habit
biologic etiologies of recession
generalized: tissue biotype and oral hygiene
localized: anatomy (tooth position) and defective restoration
miller class I
when there is no interproximal bone loss and the recession does not extend to the MGJ; 100% root coverage can be anticipated in miller class I recession defects
miller class II
no interproximal bone loss and the recession extends to or beyond the MGJ; 100% root coverage can be anticipated
miller class III
interproximal bone loss and recession may or may not extend to MGJ; partial root coverage up to level of interproximal bone can be anticipated
miller class IV
interproximal bone loss beyond level of recession; no root coverage can be anticipated
flap options for treatment of recession
coronally advanced flap (CAF) tunnel lateral sliding flap double papilla flap semilunar flap
grafting options for recession
subepithelial CT graft (SGCT)
allograft (human donor skin)
mucograft- xenograft porcine collagen type I and III
emdogain (extract of enamel matrix and contains amelogenins)
bone graft + membrane (GTR)
free gingival graft (FGG)
____ provides the best outcome for root coverage
Coronally advanced flap (CAF) and subepithelial CT graft (SGCT)
free gingival graft indications
- to increase KG/attached gingiva
- increase vestibular depth
- achieve root coverage
disadvantages of free gingival grafts
- not predictable to achieve root coverage
- esthetic concern: color discrepancy at recipient site
- complications at donor site
healing of free gingival graft
initial phase (0-3 days)- "plasmatic circulation" revascularization phase (2-11 days) tissue maturation phase (11-42 days)
classifications of labial frenum
mucosal, gingival, papillary, and papillary penetrating
genetic syndromes associated with prominent/aberrant maxillary frenum
ellis-van Creveld syndrome
orofacial-digital syndrome
