Periodontal Flap Procedures (Part II) Flashcards

1
Q

Surgical debridement of the root surface and removal of granulation tissue from osseous defects following reflection of a mucoperiosteal flap:

A

Open flap debridement

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2
Q

List the possible modifcations of an open flap debridement:

A
  1. modified widman
  2. curtain procedure (maxillary anteriors)
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3
Q

The curtain procedure (modified open flap debridement) is used for:

A

maxillary anteriors

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4
Q

What is the MOST IMPORTANT aspect of open flap debridement?

A

Access

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5
Q

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

A

Open flap debridement

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6
Q

Open flap debridement allows for less:

A

post-operative discomfort

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7
Q

Give an example of when we might use an open flap debridement as an exploratory procedure:

A

we think we have a fractured root and we need to get in there to see

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8
Q

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

A

Open flap debridement

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9
Q

What type of incision is indicated in open flap technique?

What type of incision is NOT indicated due to being ineffective?

A

intrasulcular; step-back

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10
Q

In open flap debridement technique, _____ are thinned to a uniform thickness

A

papillas

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11
Q

What type of flap is reflected in open flap technique?

A

Mucoperiosteal

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12
Q

What type of incisons can be used in an open flap technique?

A

Vertical incisions

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13
Q

In an open flap debridement technique ____ are placed dependent on the extent of the defects and the amount of pocket reduction planned

A

palatal incisions

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14
Q

What determines if palatal incisons are placed during open flap debridement technique?

A
  1. extent of the defects
  2. amoint of pocket reduction planned
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15
Q

Flap necrosis may result from:

A

Compromised blood supply due to over-thinning of flap or vascular compromise

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16
Q

What is the source of healing for an open flap?

A
  1. PDL
  2. Flap margin
  3. Underlying bone
17
Q

What is the primary source of healing for open flap?

A

PDL

18
Q

A modification of subgingival curettage with flap reflection:

A

Modified Widman flap

19
Q

Where is the FIRST incision started in the modified widman technique?

A

First incison is started 0.5-1.0mm apical to the gingival margin and “aimed” at alveolar crest

20
Q

In the modified widman technique minimal removal of interproximal tissues occurs for:

A

primary closure

21
Q

Where is the SECOND incison in the modified widman technique?

A

intrasulcular

22
Q

Where the THIRD incision made in the modified widman technique?

A

made following the alveolar crest

23
Q

Objective of this modification of open flap technique is to gain access to interproximal defects in the maxillary anterior region with minimal recession:

A

anterior curtain

24
Q

The technique for the anterior curtain procedure includes:

  1. ____ flap
  2. incisions ONLY in the ____ areas, with no direct facial incisions
  3. ____ and then closure
A
  1. palatal flap
  2. facial interproximal areas
  3. debridement
25
Q

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

A

Anterior curtain

26
Q

What is the only contraindication for anterior curtain procedure?

A

Facial bone loss

27
Q

When trying to determine the best treatment for your patient you should consider: (4)

A
  1. diagnosis
  2. goal of therapy
  3. limitations of each technique
  4. personalized therapy
28
Q

The goal of all periodontal surgery is to:

A

access defects

29
Q

Success of all periodontal surgical procedures is dependent upon:

A

patient’s home care & maintenance

30
Q
A