periodontal grafting?

Question 1

mucogingival conditions

Answer 1

1) gingival phenotype
- GT + KTW
2) periodontal phenotype
- GT + KTW + BT
2) recession
3) keratinized gingiva
4) decreased vestibular depth
5) aberrant frenum / muscle pull
6) gingival excess
7) abnormal color

Question 2

epidemiology of gingival recession

Answer 2

1) teeth that erupt in prominence
2) gingiva on prominent teeth is prone to receding
3) inadequate attached gingiva predisposes teeth to recession upon wounding
4) in absence of wounding, recession may not occur despite a predispotion

Question 3

predisposing factors

Answer 3

1) inadequate attached gingiva
2) prominent root
3) osseous dehiscence
4) thin gingiva

Question 4

the root of a tooth

Answer 4

1) cannot make new gingiva
2) only bone can make new gingiva

Question 5

dehiscence

Answer 5

1) cleft of absence of alveolar cortical plate resulting in denuded root surface

Question 6

precipitating factors

Answer 6

1) improper brushing
2) laceration
3) inflammation
4) iatrogenic factors

Question 7

gingival thickness

Answer 7

1) probe visible
- thin
- <1 mm
2) not visible >1 mm

Question 8

P.D. miller classification

Answer 8

1) class I
- no loss of interprox attachment, recession short of MGJ
- chance of total coverage
2) class II
- no loss of interprox attachment
- recession beyond MGJ
- chance of total coverage
3) class III
-loss of interprox attachment but less than buccal loss
4) class IV
- loss of interprox exceeds buccal
- low predictability for root coverage

Question 9

recession classification

Answer 9

1) RT1
- no loss of interprox attachment
2) RT2
- loss of interprox attachment <= buccal attachment
3) ST3
- loss of interprox attachment > buccal attachment

Question 10

KTW

Answer 10

1) keratinized tissue width
2) gingival margin to mucogingival junction

Question 11

is cej detectable

Answer 11

1) y or n
2) a or b

Question 12

step

Answer 12

1) + or -
2) abfraction

Question 13

attached gingiva

Answer 13

2) gingiva from bottom of pocket to the MGJ measured with thin probe
- KG - sulcus depth
2) free of inflammation
- probe would go into the CT
3) best time to measure is during the reevaluation

Question 14

free of inflammation

Answer 14

1) need 2 mm KG
2) 1 mm AG

Question 15

cementing a crown with subgingival margin and free of inflammation

Answer 15

1) need 5 mm KG
2) 3 mm AG

Question 16

longitudinal mucogingival studies

Answer 16

1) cannot evaluate the adequacy of AG based on width alone
2) control inflammation first
3) if inflammation persists, or recession advances, then surgery maybe

Question 17

possible indications for increasing AG width

Answer 17

1) when <= 1 mm AG
2) progressive recessive
2) persisting inflammation with good home care
3) subgingival margins to be placed
4) esthetic concern
5) orthodontics
* prophylactic grafting

Question 18

indications for mucogingival surgery

Answer 18

1) increase attached gingiva
2) root coverage

Question 19

free grafts

Answer 19

1) gingival graft, CT graft
- epithelialized (gold standard for increasing gingival width)
-CT graft (gold standard for root coverage)

Question 20

pedicle grafts

Answer 20

1) graft remains attached at donor site
- for root coverage

Question 21

epithelialized free grafts

Answer 21

1) prepare donor site
2) split thickness
- leave some periosteum on the bone
3) full is safer
- reflect periosteum and CT together
4) graft shape
- straight line on top, curve on bottom
- you can use a template
- cut palate and AVOID greater palatine artery
5) put collagen hemostatic agent over donor site