Periodontal Flap Procedures (Part II) Flashcards
Surgical debridement of the root surface and removal of granulation tissue from osseous defects following reflection of a mucoperiosteal flap:
Open flap debridement
List the possible modifcations of an open flap debridement:
- modified widman
- curtain procedure (maxillary anteriors)
The curtain procedure (modified open flap debridement) is used for:
maxillary anteriors
What is the MOST IMPORTANT aspect of open flap debridement?
Access
What treatment would be indicated in the following scenario?
-advanced disease where access is needed to root surfaces and osseous defects
-situations in which regeneration may be possibly
-to preserve tissue for esthetics
-as an exploratory procedure or as part of the non-surgical phase of treatment for fibrous tissue
Open flap debridement
Open flap debridement allows for less:
post-operative discomfort
Give an example of when we might use an open flap debridement as an exploratory procedure:
we think we have a fractured root and we need to get in there to see
The following are contraindications for:
-Patient is unable to tolerate surgical procedure
-Increased tissue recession may result in esthetic compromise
-Potential of root caries and root sensitivity due to greater root exposure post-surgically
Open flap debridement
What type of incision is indicated in open flap technique?
What type of incision is NOT indicated due to being ineffective?
intrasulcular; step-back
In open flap debridement technique, _____ are thinned to a uniform thickness
papillas
What type of flap is reflected in open flap technique?
Mucoperiosteal
What type of incisons can be used in an open flap technique?
Vertical incisions
In an open flap debridement technique ____ are placed dependent on the extent of the defects and the amount of pocket reduction planned
palatal incisions
What determines if palatal incisons are placed during open flap debridement technique?
- extent of the defects
- amoint of pocket reduction planned
Flap necrosis may result from:
Compromised blood supply due to over-thinning of flap or vascular compromise
What is the source of healing for an open flap?
- PDL
- Flap margin
- Underlying bone
What is the primary source of healing for open flap?
PDL
A modification of subgingival curettage with flap reflection:
Modified Widman flap
Where is the FIRST incision started in the modified widman technique?
First incison is started 0.5-1.0mm apical to the gingival margin and “aimed” at alveolar crest
In the modified widman technique minimal removal of interproximal tissues occurs for:
primary closure
Where is the SECOND incison in the modified widman technique?
intrasulcular
Where the THIRD incision made in the modified widman technique?
made following the alveolar crest
Objective of this modification of open flap technique is to gain access to interproximal defects in the maxillary anterior region with minimal recession:
anterior curtain
The technique for the anterior curtain procedure includes:
- ____ flap
- incisions ONLY in the ____ areas, with no direct facial incisions
- ____ and then closure
- palatal flap
- facial interproximal areas
- debridement
What procedure would be indicated in the given situation:
-maxillary anterior region with interproximal or palatal osseous defects and no facial bone loss with esthetic concern
Anterior curtain
What is the only contraindication for anterior curtain procedure?
Facial bone loss
When trying to determine the best treatment for your patient you should consider: (4)
- diagnosis
- goal of therapy
- limitations of each technique
- personalized therapy
The goal of all periodontal surgery is to:
access defects
Success of all periodontal surgical procedures is dependent upon:
patient’s home care & maintenance
