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Perio II > Periodontal Flap Procedures Part I > Flashcards

Periodontal Flap Procedures Part I Flashcards

1
Q

Regeneration =

A

new alveolar bone, cementum, & PDL

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2
Q

Describe new attachment in tissue attachment healing:

A

the union of connective tissue with a root surface

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3
Q

The union of connective tissue with a roof surface that has been deprived of its original attachment apparatus.

A

New attachment

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4
Q

Give an example of new attachment seen in tissue attachment healing:

A

Reunion of connective tissue with a root surface which has been pathologically exposed.

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5
Q

The reunion of connective tissue with a root surface which has been pathologically exposed:

A

new attachment

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6
Q

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

A

reattachment

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7
Q

Example: where biologic width (now termed supracrestal tissue attachment) existed before a flap was reflected, and when the flap is replaced, reattachment occurs with the intact connective tissue fibers:

A

reattachment

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8
Q

New name for biologic width:

A

supracrestal tissue attachment

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9
Q

We select a flap, stitch it back down, and over time it heals back to normal. This is an example of:

A

reattachment

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10
Q

The healing of a wound that DOES NOT fully restore the architecture or function of the part:

A

repair

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11
Q

What is the primary example of repair?

A

Healing by a long junctional epithelium

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12
Q

Healing by a long junctionional epithelium

A

repair

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13
Q

Provide a term for the following definitions:

  1. Reproduction or reconstitution of a lost or injured part
  2. The union of connective tissue with a root surface that has been deprived of its original attachment apparatus
  3. The reunion of connective tissue with a root surface on which viable PDL tissue is present
  4. The healing of a wound that does not fully restore the architecture or function of the part
A
  1. regeneration
  2. new attachment
  3. reattachment
  4. repair
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14
Q

Scar formation is an example of :

A

repair

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15
Q

Why is scar formation an example of repair?

A

scar formation closes that area effective but does not fully restore architecture or function

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16
Q

When you have root planed an area and the 10mm pocket is now 3mm, the 7mm difference is due to:

A

repair

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17
Q

When ALL soft tissue including the periosteum is reflected exposing the underlying bone:

A

Full thickness flap

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18
Q

The most commonly used flap:

A

full thickness flap

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19
Q

A full thickness flap may also be called:

A

mucoperiosteal flap

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20
Q

A mucoperiosteal flap is another name for:

A

full thickness flap

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21
Q

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

A

Partial thickness flap

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22
Q

A partial thickness flap may also be called:

A

split thickness flap

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23
Q

A split thickness flap may be used to describe:

A

partial thickness flap

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24
Q

When creating a flap, the incisions should always:

A

be down to the bone

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25
Q

List the principles of tissue attachment: (5)

A
  1. preparation of soft tissue wall
  2. preparation of root surface
  3. debridement of bony defects
  4. adaptation of soft tissue to root surface
  5. control of etiology pre and post surgery
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26
Q

List the root changes hindering tissue attachment: (4)

A
  1. foreign body nature of exposed diseased root surfaces (presence of endotoxin)
  2. endotoxin absorbed on and into cementum
  3. Pathologic changes in root surface (hypo and hyper calcification areas)
  4. Decreased organic material in exposed cementum, (loss of fibers and alterations in the organic material related to endotoxin)
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27
Q

T/F: The presence of endotoxin will aid in tissue attachment

A

false- hinders tissue attachment

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28
Q

It is crucial that ____ is removed from the root surface to ensure good healing

29
Q

A functional, comfortable, healthy dentition with stable probing attachment levels:

A

therapeutic endpoint: success

30
Q

What are the factors to consider when determining what procedures to use?

A
  1. diagnosis
  2. knowing endpoint (regeneration, pocket elimination, pocket reduction)
  3. know indications and contraindications
  4. maintenance
31
Q

removal of the connective and epithelial attachment circumferentially with a curette

32
Q

Curettage can be used to treat:

A

soft tissue

33
Q

Removal of the connective and epithelial attachment circumferentially with a scalpel:

34
Q

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:

A

Gingivectomy

35
Q

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

A

gingivoplasty

36
Q

removal or the total piece:

37
Q

re-shaping the existing structure:

38
Q

a pocket above the bone level:

A

supra bony pocket

39
Q

Elimination of SUPRABONY pockets which can’t be adequately debrided without soft tissue removal would indicate:

A

gingivectomy

40
Q

Elimination of SUPRABONY pockets if the pocket wall is fibrous and firm and therefore will not shrink after non-surgical therapy would indicate:

A

gingivectomy

41
Q

What procedure should be performed for the following scenario?

  • SUPRABONY pockets which can’t be adequately derided without tissue removal
A

gingivectomy

42
Q

What procedure should be performed for the following scenario?

  • SUPRABONY pockets if the pocket wall is fibrous and firm and therefore will not shrink after non-surgical therapy
A

gingivectomy

43
Q

What procedure should be performed for the following scenario?

  • Access for restorative therapy in the presence of supra bony pockets
A

gingivectomy

44
Q

What is the most common indication for gingivectomy?

A

elimination of gingival enlargements

45
Q

What procedure should be performed for the following scenario?

  • patient presents with gingival enlargement due to taking Dilantin
A

gingivectomy

46
Q

What procedure should be performed for the following scenario?

  • patient presents with asymmetrical or anesthetic gingival topography
A

gingivectomy and/or gingivopalsty

47
Q

What procedure should be performed for the following scenario?

  • patient presents needing exposure of unerupted teeth when adequate keratinized tissue is present:
A

gingivectomy

48
Q

List the CONTRAINDICATIONS for performing a gingivectomy:

A
  1. access is needed to INFRABONY defects
  2. base of pocket is apical to MG junction
  3. keratinized tissue is inadequate
  4. severely inflamed tissue
  5. esthetics
  6. anatomical preclusion
49
Q

Why would we not perform a gingivectomy in the following situation?

  • keratinized tissue is INADEQUATE
A

a gingivectomy would remove all of the keratinized tissue

50
Q

Why would we not perform a gingivectomy in the following situation?

  • severely inflamed tissue
A

Needs SRP instead

51
Q

Why would we not perform a gingivectomy in the following situation?

  • anterior maxilla area
52
Q

Why would we not perform a gingivectomy in the following situation?

  • anatomical preclusion
A

lack of keratinized tissue

53
Q

The following are contraindications for:

  • access is needed to infra bony defects
  • base of pocket is apical to MG junction
  • lack of keratinized tissue
  • anterior maxilla esthetics
  • severely inflamed tissue
  • anatomical preclusion
A

gingivectomy

54
Q

List the advantages of a gingivectomy:

A

relatively simple and fast

55
Q

List the disadvantages of a gingivectomy:

A
  1. limited applicability (supra bony defect)
  2. longer healing period (4-5 weeks)
  3. most post-op discomfort
  4. less effective than flap surgery (no access to osseous defects)
56
Q

What type of pockets are necessary to perform a gingivectomy?

A

SUPRAbony defects

57
Q

How long is the healing period for a gingivectomy?

58
Q

T/f: A gingivectomy is more effective than flap surgery

A

false- a gingivectomy is LESS effective than flap surgery because no access to osseous defects

59
Q

A gingivectomy does not allow for access to:

A

osseous defects

60
Q

Gingivetomy technique involves:

  1. ___ of the pocket depth
  2. ____ of the gingiva with incision starting ____ to the pocket base and externally beveled at 45 degree angle
A
  1. marking
  2. resection; apical
61
Q

During a gingivectomy, the incision should start ______.

The incision should be externally beveled at:

A

apical to the pocket base;

45 degree angle

62
Q

What should be AVOIDED during a gingivectomy?

A

bone exposure

63
Q

If possible during a gingivectomy, there should be:

A

complete removal of pocket

64
Q

When performing a gingivectomy, thick tissue will require:

A

a more apical start of the incision

65
Q

During a gingivectomy, what requires a more apical start of the incision?

A

thick tissue

66
Q

T/F: With the gingivectomy technique, it can be accomplished with an internal bevel incision, however it is more difficult with this approach:

A

true- we typically prefer an external bevel

67
Q

The 45 degree angle in the gingievtomy technique is located at:

A

mucogingival surface

Perio II (12 decks)

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