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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 root 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 the root surface which has been pathologically exposed

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5
Q

The reunion of connective 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 attachment

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9
Q

We reflect 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 junctional epithelium:

A

Repair

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13
Q

Provide a term for the following definitions:

  1. Reproduction or reconstitution of a loss or rendered 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 effectively 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 thickenss 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

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 attachments: (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- & 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 & into cementum
  3. Pathologic changes in root surface (hypo- & hypercalcification 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

28
Q

It is crucial _____ 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. know your 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 currette:

32
Q

Curettage used to 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 shaped and reduced to create a normal and functional form. The incision creates an external bevel:

A

gingivoplasty

36
Q

removal of the total piece:

37
Q

re-shaping the existing structure:

38
Q

A pocket above the bone level:

A

suprabony pocket

39
Q

Elimination of SUPRABONY pockets which cannot be adequately debrided without tissue removal would indicate:

A

Gingivectomy

40
Q

Eliminatino 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 in the following scenario?

Suprabony pockets which can’t be adequately debrided without tissue removal:

A

gingivectomy

42
Q

What procedure should be performed in 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 in the following scenario?

Needing access for restorative therapy in the presence of suprabony 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 in the following scenario?

Patient presents with gingival enlargement due to taking dilantin:

A

gingivectomy

46
Q

What procedure should be performed in the following scenario?

Patient presents with assymetrical or unesthetic gingival topography

A

gingivectomy and/or gingivoplasty

47
Q

What procedure should be performed in the following scenario?

Patient presents needing exposure of interrupted teeth when adequate keratinized tissue is present:

A

gingivectomy

48
Q

List the CONTRAindications for performing a gingivectomy:

A
  1. access is needed for 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 (we don’t want this to occur)

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

In this case there is a lack of keratinized tissue

53
Q

The following are contraindications for: ______

-access is needed to infrabony defects
-base of pocket is apical to MG junction
-keratinized tissue is inadequate
-anterior maxilla/esthetics
-severly inflamed tissue
-anatomical preclusion

A

Gingivectomy

54
Q

List the advantages to a gingivectomy;

A

Relatively simple and fast

55
Q

List the disadvantages to a gingivectomy:

A
  1. limited applicability (suprabony defects)
  2. longer healing period (4-5 weeks)
  3. more 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 gingivectomy?

58
Q

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

A

False- a gingvectomy 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

Gingivectomy technique invovles:

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

During a gingivectomy, the incision should start ________

The incision should be externally beveled at a ______

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 typcially prefer an external bevel

67
Q

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

A

Mucogingical surface

Perio II (12 decks)

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