Perio Midterm 2023 Flashcards
SRP in pockets greater than 6mm result in what percentage of plaque & calculus reduction?
32%
OFD in pockets greater than 6mm result in what percentage of plaque & calculus reduction?
50%
SRP in pockets 4-6mm can result in what percentage of plaque & calculus reduction?
43%
OFD in pockets 4-6mm can result in what percentage of plaque & calculus reduction?
76%
SRP in pockets 1-3mm can result in what percentage of plaque & calculus reduction?
86%
OFD in pockets 1-3mm can result in what percentage of plaque & calculus reduction?
86%
The CEJ should be approximately ____ from the alveolar crest
2 mm
The gingival margin should be _____ coronal to the CEJ (covering the anatomic crown)
0.5 - 2 mm
Stages of normal tooth eruption according to crown lengthening lecture:
2 or 4?????
Minimum healing time before taking impressions after crown lengthening is ____ weeks
6 weeks
T/F: In pockets greater than 5mm, plaque and calculus is left 85% of the time
True
Contraindications for a bone graft include:
Poor oral hygiene/plaque control
Nonsurgical-treated areas have a greater percentage of defects that convert from nondiseased to diseased for:
Single & multi-rooted teeth
What do you use the end-cutting bur for?
Ostectomy
What do you use the large round bur (#6 or #8) for?
Osteoplasty
What files are used interproximally?
9/10 Schluger
#3S/#4S Sugarman
What is the BEST graft material?
Autograft???
What incidence do palatal exostosis occur?
40% incidence
Why might flap necrosis occur?
Palatal flap too thin
The union of connective tissue with root surface that has been deprived of its original attachment apparatus:
New attachment
The healing of a wound that does not fully restore the architecture in function (healing of long junctional epithelium):
Repair
The reunion of connective tissue with root surface on which viable PDL tissue is present (biologic width regrowing when flap reattached):
Reattachment
Most common type of flap:
Mucoperiosteal (full thickness)
Split thickness flap leave:
periosteum on bone
What type of defect is most common?
Crater
What is the therapeutic goal of periodontal therapy?
functional, comfortable, healthy dentition & stable probing
T/F: Periodontal osseous defects are classified by bone missing
False- defects are classified by bone remaining
How many incisons does a palatal flap have?
4
Gingivectomy is mot often done for:
Elimination of gingival enlargement
Position of flap margin on osseous/alveolar crest leads to:
pocket elimination
Keeping epithelium out:
Guided tissue regeneration
What would you perform to get interproximal bone loss/defects but no facial defects?
Anterior curtain
What is the histological difference of palatal flaps?
Thick connective tissue
What is the second incision of palatal flap?
Undermine
(Trace, undermine, contact bone, intrasulcular)
Where does healing potential come from?
PDL
Contributing anatomy to perio defect in retromolar pad areas except:
mylohyoid ridge
Disadvantages of surgical approach to tuberosity area:
???
Distal wedge:
Preserves keratinized tissue
You have a patient with lots of bleeding and subgingival calculus. You are doing scaling in the presence of inflammation. What do you do?
Use local anesthetic per quadrant
Ostectomy is:
Removal of alveolar bone proper
T/F: The space between the roots matters (2.5mm)
True
Hemiseptum =
1 wall
True intrabony =
3 wall
Three things you need before crown lengthening include:
How do you know where to start for crown lengthening?
Bone sounding
Autograft:
Using ones own bone for boen graft
When you can see a window in the bone, this is called:
Fenestration
Type of defect that has a most successful outcome to surgery:
3-wall defect
Picture of intrammarow penetration - the purpose of this is to:
increase blood flow
The CEJ should be ____ mm from the osseous crest
2mm
Which of the following is not a distal wedge flap
Trapezoidal
Factors affecting retromolar area: (4)
- external oblique ridge
- lingual bony ridge
- ascending ramus proximity to terminal tooth
- impacted third molars
Factors affecting tuberosity area: (3)
- palatal exostosis
- buccal exostosis
- impacted third molars
Distal wedge advantages/indications:
- management of pockets and keratinized tissue
- access to osseous defects
- access for exostosis removal
- less post-op discomfort due to primary closure
Types of distal wedge flaps:
- square
- triangular
- O & R (trap door)
Excessive force on a normal system is:
Primary occlusal trauma
Which side of trauma from occlusion is associated with resorption of the alveolar bone proper?
Compression
Trauma from occlusion in the absence of inflammation does NOT cause:
- gingivitis
- periodontitis
- pocket formation
- mucogingival defects
Periodontitis superimposed with occlusal trauma produces an ____ in bone loss
increase
Which of the following is considered pathologic?
Traumatic occlusion
What is associated with an increased density in the lamina dura?
Hyperfunction
What is associated with capillary hemorrhage into the PDL spaces?
Traumatic occlusion
The principle of excluding epithelium and connective tissue from surgical site is termed:
Guided tissue regeneration
What does pocket elimination do?
- creates shallow sulci
- ease of maintenance by therapist & patient
The most common type of flap design:
mucoperiosteal (full thickness flap)
Histologic difference that separates te palatal flap from other flaps:
Thickness of connective tissue
The second incision of a palatal flap is also known as:
Undermining
The third incision of a palatal flap is also known as:
contact with bone
All of the following are factors exaggerating the periodontal bony lesion n the retromolar area except:
a) external oblique ridge
b) mylohoid ridge
c) promiximity of ascending ramus to the terminal tooth
d) impacted third molars
b
Disadvantages of surgical approach to tuberosity area include:
- presence of exostosis on the palatal aspect
- presence of exostosis on the buccal aspect
- presence of impacted third molars
Disadvantages of surgical approach to the tuberosity area include:
- can’t gain access to osseous defects
- incisions end in mucosa
- extremely broad wound
- exposed exostosis
Know the advantages/indications of the distal wedge flap procedure:
- management of pockets and keratinized tissue
- access to osseous defects
- access for exostosis removal
- less post-op discomfort due to primary closure
Lit the contraindications fo a distal wedge flap:
- flat palate
- limited distal space
- when no osseous defect exists
List the types of distal wedge flaps:
- triangular
- linear
- square
Gingivectomies are typically started with a ____ bevel
External
List the contraindications of gingivectomies:
- anterior maxilla region
- base of pocket is apical to MG junction without attached tissue
- infrabony defects
T/F: you can perform a gingivectomy for the exposure of interrupted teeth
True
The modified widman flap requires:
3 separate incisions
Purpose of the modified widman flap:
to allow access to root surfaces
Which type of flap is used in the maxillary anterior region where there are interproximal defects but not facial defects?
anterior curtain
Hemiseptum is another name for which type of defect?
1 wall
Which is the most common osseous defect:
2 wall (crater defect)
Which is a true intrabony defect?
3 wall
Which type of defect has the greatest predictability of success:
3 wall
Interdental crestal bone located APICAL to the level of the radicular bone is termed:
Negative architecture
Which of the following is NOT a determinant of gingival contour?
Bone
(interdental space, position of tooth in arch & root/crown shape are all determinants of gingival contours)
Contraindications of osseous surgery include:
- 3-walled defects
- maxillary anteriors
- isolated deep defects
(Ledges and tori are NOT a contraindication of osseous surgery)
Which of the following materials is osteoconductive?
Freeze dry bone allograft
Vertical defects occur when the distance between the roots of the teeth are greater than:
2.5 mm
Which of the following does NOT have an effect on bone grafts?
Use of antibiotics
(intrammarow penetrations, endo, smoking do have an effect on bone grafts)
PRP is used to induced the formation of:
Platelet-derived growth factors
Attachment loss =
Probing depth + GM (enlargment)
Gingival enlargement is a ____ value
negative
Gingival recession is a _____ value
positive
Trauma from occlusion does NOT cause:
recession
Aggressive periodontitis is now termed:
Periodontitis
Studies show that single rooted teeth are better than molars for:
Both surgical & non-surgical perio therapy
Gingivectomies are performed to eliminate:
- gingival enlargements
- SUPRAbony pockets
Primary goal of periodontal surgical procedures is:
ACCESS
The only advantage of a gingivectomy is:
Easier & quicker
(cannot gain access to osseous defects, broad wound may be created, and incision often ends in mucosa are all disadvantages)
-flat palate
-limited distal space
-when no osseous defect is present
These are all contraindications of:
Distal wedge
What is both an INFRAbony and INTRAbony defect?
3 wall defect
Give an example of an indication for osseous surgery:
Osseous ledges & tori
Root sensitivity is a disadvantage of:
osseous surgery
If placement of flap margin is done at the alveolar crest, the goal is:
elimination of pocket depth
What is a contraindication for osseous grafting?
Poor plaque control
A graft with 25% hydroxyapatite and 75% freeze dried bone is an:
composite graft
What is a disadvantage of an osseous graft?
Expensive
T/F: Osseous surgery success is defect dependent
True
Residual calculus is often found at:
CEJ & line angles
If a patient has #1 missing and defect on #2 what is the best choice of flap?
Distal triangular wedge
Where does the incision start for a palatal flap?
2/3 probing depth
An ideal bone graft releases:
BMP slowly to form bone
Trauma from occlusion in the absence of inflammation may be responsible for causing:
Bone density loss
The main tissue that guided tissue regeneration excludes is:
epithelium
Open flap curettage uses a ____ bevel incision
Intrasulcular- modified widman, palatal flap
Which of the following will NOT increase the width of keratinized tissue?
Modified widman flap
Crown lengthening usually only requires:
OstECTOMY on the FACIAL
The second step in the healing sequence of a bone graft is:
Revascularization
Free gingival grafts will end up:
Revascularizing with underlying CT
The coding to determine the type of tissue you obtain from a graft is in the:
CT
Epithelium gets its blood supply and nutrients from:
underlying CT
What is hard to accomplish with a bone augmention?
Bone height
