perio exam 3

Question 1

causes of tooth impaction (several local factors that may become an obstacle to the normal eruption process)

Answer 1

• 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

Question 2

systemic factors that may also affect the normal eruption process

Answer 2

childhood diseases
hereditary factors
genetic syndromes

Question 3

studies have shown a _____ toward canine impaction

Answer 3

genetic predisposition

Question 4

sequelae of canine impaction

Answer 4

• 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

Question 5

surgical techniques for exposing impacted tooth

Answer 5

open eruption- window technique and apically positioned flap technique
closed eruption- flap elevated, ortho appliance applied, flap closed

Question 6

advantage of open eruption technique

Answer 6

if bonding of bracket/chain fails, no additional surgery needed

Question 7

disadvantages of open eruption approach

Answer 7

• greater discomfort (pain, bad taste)
• interference with function (eating)
• delayed healing (secondary intention)
• bone exposure

Question 8

advantages of closed eruption technique

Answer 8

• rapid healing
• less discomfort
• less interference with function

Question 9

disadvantage of closed eruption

Answer 9

if bonding of bracket/chain fails, additional surgery needed

Question 10

4 different types of abscesses

Answer 10

gingival, pericoronal, periodontal, periapical

Question 11

treatment of gingival abscess

Answer 11

removal of noxious agent(s)
incision and drainage (if necessary)
antibiotics contraindicated
home care: rinse with warm NaCl water

Question 12

pericoronal abscess treatment

Answer 12

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

Question 13

periapical abscess treatment

Answer 13

removal of tooth

root canal therapy

Question 14

treatment of periodontal abscesses

Answer 14

drainage thru pocket retraction or incision
SRP
periodontal surgery
systemic complications- antibiotics (amox for 3 days)
extraction

Question 15

mechanic etiologies of gingival recession

Answer 15

traumatic brushing/flossing
ortho tx
trauma
parafunctional habit

Question 16

biologic etiologies of recession

Answer 16

generalized: tissue biotype and oral hygiene
localized: anatomy (tooth position) and defective restoration

Question 17

miller class I

Answer 17

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

Question 18

miller class II

Answer 18

no interproximal bone loss and the recession extends to or beyond the MGJ; 100% root coverage can be anticipated

Question 19

miller class III

Answer 19

interproximal bone loss and recession may or may not extend to MGJ; partial root coverage up to level of interproximal bone can be anticipated

Question 20

miller class IV

Answer 20

interproximal bone loss beyond level of recession; no root coverage can be anticipated

Question 21

flap options for treatment of recession

Answer 21

coronally advanced flap (CAF)
tunnel
lateral sliding flap
double papilla flap
semilunar flap

Question 22

grafting options for recession

Answer 22

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)

Question 23

____ provides the best outcome for root coverage

Answer 23

Coronally advanced flap (CAF) and subepithelial CT graft (SGCT)

Question 24

free gingival graft indications

Answer 24

• to increase KG/attached gingiva
• increase vestibular depth
• achieve root coverage

Question 25

disadvantages of free gingival grafts

Answer 25

• not predictable to achieve root coverage
• esthetic concern: color discrepancy at recipient site
• complications at donor site

Question 26

healing of free gingival graft

Answer 26

initial phase (0-3 days)- "plasmatic circulation"
revascularization phase (2-11 days)
tissue maturation phase (11-42 days)

Question 27

classifications of labial frenum

Answer 27

mucosal, gingival, papillary, and papillary penetrating

Question 28

genetic syndromes associated with prominent/aberrant maxillary frenum

Answer 28

ellis-van Creveld syndrome

orofacial-digital syndrome