perio surgical considerations

Question 1

The essentials of a smile involve:

Answer 1

• The teeth
• The gingival scaffold
• The lip framework

Question 2

“Esthetic Smile”
gingival exposure?
 Display of % of the crowns and all?
 Symmetric display and harmony between the?
 Lower lip parallel to? and in?

Answer 2

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

Question 3

Ideal gingival contours: zenith positions

Answer 3

 Centrals: 1 mm distal to midline
 Laterals: 0.3 mm distal to midline, 1 mm coronal to centrals and canines
 Canines: centered M-D

Question 4

SUPRACRESTAL ATTACHMENT
(BIOLOGIC WIDTH) diagram

Answer 4

Question 5

Crown lengthening definition

Answer 5

Question 6

Indications for Crown Lengthening: esthetic crown lengthening

Answer 6

• Excessive gingival display
• Gingival overgrowth
• Altered passive eruption

Question 7

Indications for Crown Lengthening: functional crown lengthening

Answer 7

• Subgingival restorative margins
• Tooth fracture
• Endo perforations
• Cervical root resoprtion

Question 8

perio exam considerations

Answer 8

Width and thickness of keratinized tissue
Location of CEJ in relation to attachment level
Gingival health

Question 9

active eruption

Answer 9

eruption of tooth through bone and
soft tissue into occlusion with opposing tooth

Question 10

passive eruption

Answer 10

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

Question 11

Contraindications
for Crown Lengthening
- Removal of ?
- Furcation?
- Aesthetic?
- Anatomic?
- Poor?
- Medical?

Answer 11

• Removal of supporting bone
• Furcation exposure
• Aesthetic concerns
• Anatomic landmarks
• Poor oral hygiene
• Medical considerations

Question 12

GINGIVECTOMY
 Definition:

Answer 12

 Definition: The excision of a portion of the gingiva; usually performed to reduce the soft tissue wall of a periodontal pocket.

Question 13

Gingivectomy INDICATIONS

Answer 13

• Elimination of suprabony pockets
• Elimination of gingival enlargements

Question 14

gingevetomy contraindications

Answer 14

• The need for bone surgery.
• Bottom of the pocket is apical to the mucogingival junction
• Esthetic considerations

Question 15

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

Answer 15

 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

Question 16

Prior to surgery:
 If endodontic treatment is indicated?
 A proper what is needed?

Answer 16

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.

Question 17

HEALING
 - Surface epithelization is complete in?
 - Vascularity appears normal after?
 - Complete epithelial repair takes about?
 - Complete repair of CT takes about?

Answer 17

 - 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.

Question 18

HEALING
- More bone density loss ? weeks post surgically,
- After 1 year, marginal tissue can grow?
-Tissue rebound following CL is stable after?

Answer 18

 - 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

Question 19

ELECTROSURGERY

Answer 19

Division of tissue by high-frequency electrical current applied locally with a metal instrument or needle.

Question 20

electrosurgery uses?

Answer 20

alternating current at high frequency.

Question 21

electrosurgery actions
- Electrocutting :
- Electrocoagulation:
-Electrofulguration:
-Electrodessication:

Answer 21

• Electrocutting : Minimun energy used
• Electrocoagulation: Greater energy used
  -Electrofulguration: Considerable energy used
  -Electrodessication: Uncontrolled action

Question 22

Electrosurgery vs scalpel

Answer 22

• Healing was delayed
• ES wound had more inflammatory response and more tissue destruction