Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Classic Lit Fall 2021 > Perio Plastics I > Flashcards

Perio Plastics I Flashcards

1
Q

What ways can you distinguish gingiva from alveolar mucosa?

A

Visual assessment
Schiller’s iodine (detects glycogen in oral mucosa)
Roll test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is the location of the MGJ determined

A

Genetically pre-determined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens with KG as we age? Citation

A

Increases due to continuous eruption of the teeth (Ainamo & Ainamo 1978)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Facial Attached Gingiva measurements/locations of widest/narrowest - citation

A

Bowers 1963

Ranges from 1-9mm
Widest: Maxillary Lateral Incisor
Narrowest: Mandibular 1st premolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lingual KG

A

Widest: 2PM, 1M
Narrowest: Anteriors

Voigt et al. 1978

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gingival thickness

A

Claffey & Shanley 1986

Thick: >2mm
Thin: <1.5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How thick is thin GT on average? Citation

A

0.8mm

Zweers et al. 2014

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What makes up periodontal biotype?

A

Purposed by Zweers et al. 2014

Gingival Thickness
Keratinized Tissue Width
Bone morphotype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What types of periodontal biotypes were proposed?

A

Thin scalloped
Thick Flat
Thick Scalloped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe a thin scalloped phenotype
Prevalnce?

A

Zweers 2014

Slender triangular crowns
Thin delicate tissue with narrow KT
Thin alveolar bone
42.3% (Female > Male)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe a Thick Scalloped phenotype

A

Slender teeth
Clear thick fibrotic gingiva with narrow KT
Pronounced gingival scalloping

51.9% (Thick)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe thick flat phenotype

A

Square shaped crowns with pronounced cervical convexity
Thick fibrotic gingiva with broad KT
Thick alveolar bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name studies that say we need 2mm of KG

A

Lang and Loe 1972
Stetler and Bissada 1987 (subG Restorations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name studies that say we do NOT need 2mm of KG

A

Miyasato et al. 1977
Wennstrom & Lindhe 1983
Kennedy et al. 1985
Cortellini & Bissada 2018

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What did they do in Miyasato et al. 1977? Results?

A

16 dental students - No OH for 25days
No difference in plaque induced inflammation in <1mm KG and >2mm KG groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What did they do in Wennstrom and Lindhe 1983? Results?

A

Beagle dogs - excised KG then FGG in 50% of sites
Plaque control
NO clinical or histological inflammation in either group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What was the Stetler and Bissada 1987 Study?

A

Higher gingival scores in teeth with SubG restorations and narrow KG (<2mm)

NSSD when restorations were SupraG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the current view on KG around teeth?

A

In the presence of adequate OH, minimum KT is not needed to prevent CALoss
In the presence of inadequate OH, KG (2mm KG, 1mm AG) is crucial for maintenance of gingival health.

Kennedy et al. 1985
Cortellini & Bissada 2018

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 1 study that says 2mm KG is needed around implants. Describe it

A

Thoma et al. 2018
Systematic Review
Autogenous grafts result in more favorable peri-implant health
Increased KTW improves BOP and marginal bone levels
Increase MT reduces likelihood of MBL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name 1 study that says we do NOT need KG around implants. Describe it

A

Wennstrom & Derks 2012
Systematic Review
With goodOH, peri-implant soft tissue health can be maintained in absence of adequate amount of KG`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name a RECENT study on KG around implants. What did it find?

A

Ravida et al. 2022
Systematic review, Meta analysis, and Trial Sequential Analysis

NSSD and Low power evidence for KMW impact on PD, recession, MBL

SSD mean Plaque Index for implants with 2mm+ KG

Strength of evidence of KMW as a risk factor for Pi remains low - need more control studies with larger samples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the INCIDENCE of recessions? Citation

A

O’Leary 1967

27.7% in at least 1 segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the PREVALENCE of GR? Citation

A

Varies by size of recession

Albander & Rams 2002 (1999 NHANES Data)
_>_1mm: ~60%
_>_3mm: 23%

Rios et al. 2014 (Brazil)
_>_1mm: ~70%
_>_3mm 28%
_>_5mm: 23%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who classified Mucogingival Deformities in the current AAP/EFP Classification?

What publication provided evidence to support it?

A

Jepsen et al. 2018

Cortellini & Bissada 2018

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the difference between Periodontal Phenotype and Periodontal Biotype?

A

Biotype is genetically predetermined

Phenotype is determined by genetics & environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is included in periodontal phenotype?

A

Gingival Phenotype(KTW, MT)

Bone Morphotype (buccal bone thickness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the underlying etiology of all gingival recession?

Citation

A

Localized inflammatory process causing CT breakdown and Epi proliferation in its place

Baker & Seymour 1976

28
Q

What etiological factors are there for recession?

A

According to Zucchelli

  • *Traumatically induced** (Brushing, Flossing, Piercings, Prosthodontics (restorative margin), Occlusion (impinging bite), Orthodontics
  • *Bacteria induced** (Plaque)
  • *Virus induced** (Herpes Simplex)
  • *Unknown** (Children/Teens)
  • *Mixed** (Trauma/Bacteria)
29
Q

What are Predisposing and Precipitating factors?

Citation

A

Hall 1977

Predisposing factorsL pre-determined/non-modifiable (periodontal Biotype)

Precipitating: Environmentally acquired/modifiable (trauma, plaque buildup, restorations)

30
Q

What are examples of Predisposing factors?

A 
Thin Periodontal Biotype
Root prominence (dehisence)
Shallow Vestibule
Frenula insertion in gingival margin
31
Q

How does Frenum impact recession?

A

Impedes patient’s oral hygiene

Breaks marginal seal favoring plaque accumulation

32
Q

What are examples of Precipitating factors?

A

Traumatic factors (improper brushing, piercings)

Iatrogeneic factors (Ortho wires/brackets, SubG Restos)

Pathologic factors (periodontal disease/other bacteria/viruses)

33
Q

Why is there increased CALoss with age? Citation

A

Billings et al. 2018

More recession with age - NOT deepening pocket

34
Q

Is there an association between TFO and Recession?

A

No - Fan & Caton 2018

Bernimoulin 1977

35
Q

What are the different classifications of Recessions?

A

Sullivan & Atkins 1968

Miller 1985

Cairo et al. 2011

36
Q

What classifications are there for local factors effecting recession coverage?

A

Pini-Prato et al. 2010 (Identifiable CEJ: A or B, + or -)

Rasperini et al. 2018 (NCCL)

37
Q

Sullivan & Atkins (year?)
How much coverage can be expected for each?

A

1968

3mm cutoff for deep/shallow and wide/narrow

Deep/Wide

Shallow/Wide

Deep/Narrow

Shallow/Narrow

  • *Wide = 1-2mm coverage can be expected**
  • *Narrow = 100% coverage (deep) or maintain (shallow)**
38
Q

Miller 1985

A
39
Q

Cairo et al. 2011

A

RT1: GR - no interproximal CAL (Miller 1-2)

RT2: GR with interproximal CAL < facial CAL (Miller 3)

RT3: GR with interproximal CAL > facial CAL

40
Q

Pini-Prato 2010

A

A: CEJ detectable

B: CEJ non-detectable

+: Step

-: No step

41
Q

Prevalence of different Pini-Prato classifications

A

A+: 45%

A-: 15%

B+: 25%

B-: 25%

42
Q

What methods are there for measuring gingival thickness?

A

Transgingival probing

Ultrasonic measurement

Probe visibility

43
Q

How accurate is transgingival probing and how do you do it?

A

accurate within 0.5mm (Studer et al. 1997)

Anesthetize

Pierce w/ perio probe

Use endo stopper

44
Q

Who used ultrasonic measurement? Pros/cons

A

Eger et al. 1996

Highly reproducable

Intra-examiner error more pronounced in 2nd and 3rd molar region

45
Q

What can be done to use probe visibility for gingival thickness?

A

Kan et al. 2010
Thin (_<_1mm) - Probe visible
Thick (>1mm) - Probe not visible

Rasperini et al. 2015
Color coded probe
Thin, Medium, Thick, Very thick

White < Green < Blue < None

46
Q

What are the indications for perio-plastic surgery?

A

Esthetics
Hypersensitivity
Root expsure/Abrasion/Caries
Inconsistent gingival margin

47
Q

What are the aims of Soft Tissue Autmentation?

A

Increased MT
Increase KMW
Root coverage
Deepen vestibule

48
Q

What important studies have been done on Gingival Thickness?

A

Hwang & Wang 2006

Baldi et al. 1999

Tavelli et al. 2019a

Barootchi et al. 2022

Cairo et al. 2016 (RCT)

Zuhr et al. 2021

49
Q

How does thick tissue help CAF? Citation

A

Hwang & Wang 2006

Resists: Inflammation/Trauma/Recession

Enables: Manipulation/Creeping Attachment/Predictable surgery

50
Q

How thick does tissue need to be for predictable complete coverage in a CAF?

A

0.8mm (Baldi et al. 1999)

51
Q

How can gingival margin/thickness be effected by ortho movement? Citation

A

Wennstrom 1996

Facial movement results in thinning and apical migration

Lingual movement results in thickening and coronal movement

52
Q

What factors predict gingival margin stability after root coverage with ADM? Citation

A

Tavelli et al. 2019

12-yr follow up of RCT

GT of 1.2mm at 6mo predicted stability after multiple recession coverage w/ ADM

53
Q

What factors predict gingival margin stability after root coverage with CTG? Citation

A

Barootchi et al 2022

When GT was 1.46mm or more at 6mo, REC change was <0.5mm at 10yrs

54
Q

Aguido et al. 2016

A

18-35yr follow up study

84% of treated recessions exhibited recession reduction

48% of untreated recessions exhibited an increase

55
Q

Who proposed vestibular extension? Why?

A

Nabers 1966

Shallow vestibule promotes food impaction

Oral hygiene more challenging

56
Q

Who proposed FGGs? Why?

A

Nabers 1977

High morbidity of APF

Concurrent increasing of KT

57
Q

How do we evaluate outcomes of root coverage procedures?

A

mRC (mean root coverage)

cRC (complete root coverage)

Both are percentages

58
Q

What factors could have a negative impact when attempting complete root coverage according to Miller?

A

Inadequate Classification of gingival tissue recession
Inadequate root planing
Inadequate size of interdental papilla
Inadequate graft size/thickness
Graft dehydration
Inadequate adaptation of the graft
Inadequate adaptation of the graft to root or periosteal bet
Graft instability
Excess pressure in coaptation of sutured graft
Trauma during healing
Smoking

Miller 1987

59
Q

What factors play a role in root coverage according to Cairo?

A

Interproximal bone height/CAL

60
Q

What factors can influence root coverage according to Zucchelli?

A

papilla loss
tooth extrusion/rotation

Zuchelli et al. 2006

61
Q

What are some long term studies/systematic reviews on root coverage?

A

Tavelli et al. 2019 (LT)

Chambrone & Tatakis 2015 (SR)

62
Q

What is 1 systematic review comparing FGG with Soft tissue substitutes?

A

Bertl et al. 2017 (Stravropoulos)

63
Q

Tavelli et al. 2019

A

CTG more stable over time

Recession defects tend to relapse over time

64
Q

Chambrone et al. 2015

A

CAF+CTG, CAF+ADM, CAF+EMD, CAF+CMX

2015 AAP Regeneration Workshop

CTG had better mRC and cRC as well as increased KT

65
Q

Bertl et al. 2017

A

With Stravropoulos

FGG vs ADM for KT increase

Larger, more predictable increase in KT width w/ FGG

ADM more aesthetic

Classic Lit Fall 2021 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions