perio surgical considerations Flashcards
The essentials of a smile involve:
- The teeth
- The gingival scaffold
- The lip framework
“Esthetic Smile”
gingival exposure?
Display of % of the crowns and all?
Symmetric display and harmony between the?
Lower lip parallel to? and in?
Minimal gingival exposure
Display of 75-100% of the crowns and all interproximal tissue
Symmetric display and harmony between the maxillary gingival line and the upper lip
Lower lip parallel to the incisal edges of the maxillary teeth and in close
approximation
Ideal gingival contours: zenith positions
Centrals: 1 mm distal to midline
Laterals: 0.3 mm distal to midline, 1 mm coronal to centrals and canines
Canines: centered M-D
SUPRACRESTAL ATTACHMENT
(BIOLOGIC WIDTH) diagram
Crown lengthening definition
Indications for Crown Lengthening: esthetic crown lengthening
- Excessive gingival display
- Gingival overgrowth
- Altered passive eruption
Indications for Crown Lengthening: functional crown lengthening
- Subgingival restorative margins
- Tooth fracture
- Endo perforations
- Cervical root resoprtion
perio exam considerations
Width and thickness of keratinized tissue
Location of CEJ in relation to attachment level
Gingival health
active eruption
eruption of tooth through bone and
soft tissue into occlusion with opposing tooth
passive eruption
apical migration of dentogingival
complex following the completion of active eruption
Normally concludes when sulcus depth is at the level of the CEJ, placing the gingival margin 1-2 mm coronal to the CEJ
Contraindications
for Crown Lengthening
- Removal of ?
- Furcation?
- Aesthetic?
- Anatomic?
- Poor?
- Medical?
- Removal of supporting bone
- Furcation exposure
- Aesthetic concerns
- Anatomic landmarks
- Poor oral hygiene
- Medical considerations
GINGIVECTOMY
Definition:
Definition: The excision of a portion of the gingiva; usually performed to reduce the soft tissue wall of a periodontal pocket.
Gingivectomy INDICATIONS
- Elimination of suprabony pockets
- Elimination of gingival enlargements
gingevetomy contraindications
- The need for bone surgery.
- Bottom of the pocket is apical to the mucogingival junction
- Esthetic considerations
Prior to consultation:
Step 1: Most important thing?
Step 2: When an inadequate restoration exists and/or decay is present, they should be?
Step 3: Take another ? after Step 2 is completed
Step 1: Most important thing: Make sure tooth is RESTORABLE.
Step 2: When an inadequate restoration exists and/or decay is present, they should be removed before consultation.
Step 3: Take another PA after Step 2 is completed
Prior to surgery:
If endodontic treatment is indicated?
A proper what is needed?
Prior to surgery:
If endodontic treatment is indicated and tooth can be properly isolated, root
canal therapy should be completed prior to the surgery.
A proper provisional restoration should be fabricated.
HEALING
- Surface epithelization is complete in?
- Vascularity appears normal after?
- Complete epithelial repair takes about?
- Complete repair of CT takes about?
- Surface epithelization is complete in 5 to 14 days
- Vascularity appears normal after 15 days
- Complete epithelial repair takes about 1 month
- Complete repair of CT takes about 6 weeks.
HEALING
- More bone density loss ? weeks post surgically,
- After 1 year, marginal tissue can grow?
-Tissue rebound following CL is stable after?
- More bone density loss 4 to 6 weeks post surgically,
- After 1 year, marginal tissue can grow coronally
-Tissue rebound following CL is stable after 6 months
ELECTROSURGERY
Division of tissue by high-frequency electrical current applied locally with a metal instrument or needle.
electrosurgery uses?
alternating current at high frequency.
electrosurgery actions
- Electrocutting :
- Electrocoagulation:
-Electrofulguration:
-Electrodessication:
- Electrocutting : Minimun energy used
- Electrocoagulation: Greater energy used
-Electrofulguration: Considerable energy used
-Electrodessication: Uncontrolled action
Electrosurgery vs scalpel
- Healing was delayed
- ES wound had more inflammatory response and more tissue destruction
