Perio Flaps

Question 1

The union of
connective tissue with a root surface
that has been deprived of its original
attachment apparatus. i.e. Reunion of
connective tissue with a root surface which
has been pathologically exposed.

Answer 1

New Attachment:

Question 2

The reunion of connective
tissue with a root surface on which viable
periodontal ligament tissue is present.

Answer 2

Reattachment:

Question 3

The healing of a wound that does
not fully restore the architecture or
function of the part.

Answer 3

Repair:

Question 4

all soft tissue
including the periosteum is reflected
exposing the underlying bone. (Most
commonly used flap, and also called a
mucoperiosteal flap.)

Answer 4

Full thickness flap:

Question 5

epithelium
and some connective tissue is reflected,
leaving periosteum and some connective
tissue overlying the bone.

Answer 5

Partial (split) thickness flap:

Question 6

Removal of the
connective and epithelial
attachment circumferentially
with a curette

Answer 6

Curettage:

Question 7

Removal
of the connective
and epithelial
attachment
circumferentially
with a scalpel

Answer 7

ENAP:

Question 8

The excision of the soft
tissue wall of the periodontal pocket. The
incision forms an external bevel or surface
that is exposed to the oral cavity.

Answer 8

Gingivectomy:

Question 9

Gingival deformities are
reshaped and reduced to create a normal
and functional form. The incision creates an
external bevel.

Answer 9

Gingivoplasty:

Question 10

Indications for _____
 Elimination of suprabony pockets which
can’t be adequately debrided without tissue
removal.
 Elimination of suprabony pockets if the
pocket wall is fibrous and firm and therefore
will not shrink after non-surgical therapy.
 Access for restorative with suprabony
pockets.
 These three indications are usually
corrected by flap surgery for access
. Elimination of gingival enlargements (most
common indication for gingivectomy).**
 Elimination of asymmetrical or unesthetic
gingival topography (gingivectomy and/or
gingivoplasty).
 Exposure of unerupted teeth when
adequate keratinized tissue is present.

Answer 10

Gingivectomy

Question 11

_____ contraindications
 Access is needed to infrabony defects.
 Base of pocket is apical to MG junction, or
when keratinized tissue is inadequate so
that a gingivectomy would remove all of the
keratinized tissue.
 Severely inflamed tissue (needs scaling
and root planing)
 Esthetics (anterior maxilla)
 Anatomical preclusion (lack of keratinized
tissue)

Answer 11

Gingvectomy

Question 12

_______ Advantages and
Disadvantages
 Advantages
 Relatively simple and fast.
 Disadvantages
 Limited applicability (suprabony defects)
 Longer healing period (4-5 weeks)
 More post-operative discomfort
 Less effective than flap surgery (no
access to osseous defects)

Answer 12

Gingivectomy

Question 13

 Surgical debridement of the root surface
and removal of granulation tissue from
osseous defects following reflection of a
mucoperiosteal flap.
 Modifications:
 Modified Widman

Answer 13

open flap debridement

Question 14

____ is a modification of an open flap debridement where only the root is accessed thru a flap where no bone is exposed

Answer 14

Modified widman

Question 15

_____ indications
 Advanced disease where access is needed
to root surfaces and osseous defects.
 Where regeneration may be possible.
 To preserve tissue for esthetics.
 As an exploratory procedure or as part of
the non-surgical phase of treatment for
fibrous tissue.
 Less post-operative discomfort.

Answer 15

Open flap indications

Question 16

_____ contraindications
 Patient is unable to tolerate a surgical
procedure.
 Increased tissue recession may result in
esthetic compromise.
 Potential of root caries and root sensitivity
due to greater root exposure post-
surgically.

Answer 16

Open flap debridement

Question 17

_____ can occur due to compromised
blood supply due to over-thinning
of flap or vascular compromise
Source of healing is the PDL,
flap margin, and underlying bone

Answer 17

Flap necrosis

Question 18

______ is a modification of
subgingival curettage with flap reflection.
 Objectives
 Minimal tissue recession by not reflecting
past the alveolar crest.
 Conservation of alveolar bone - no
osteoplasty or ostectomy
 New Attachment ???? (long J.E. actually
is the result)

Answer 18

Modified Widman

Question 19

 Indications
 Moderate disease
 Infrabony defects
 Patient with high caries rate or root
sensitivity
 Anterior esthetic areas
 Contraindications
 Severe disease and greater access
needed.

Answer 19

Modified Widman

Question 20

 Advantages
 Access to root surfaces
 Esthetics??
 Minimal recession
 Primary closure???
 Disadvantages
 Flat or concave post-operative tissue
contours

Answer 20

Modified widman

Question 21

 Objective is to gain access to interproximal
defects in the maxillary anterior region
with minimal recession.
 Technique
 Palatal flap
 Incisions only in the facial interproximal
areas, with no direct facial incisions
 Debridement and then closure

Answer 21

Anterior curtain

Question 22

 Indications
 Maxillary anterior region with
interproximal or palatal osseous defects
and no facial bone loss.
 Esthetic concern.
 Contraindication
 Facial bone loss.

Answer 22

Anterior curtain