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5th ICP - ACS - PERIO > Periodontal Surgery 1 > Flashcards

Periodontal Surgery 1 Flashcards

1
Q

What is RSD/ PMPR

A

Removal of deposits (plaque/ calculus) and thin layer of cementum bound endotoxins on the root surface

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2
Q

What are the limitations of RSD?

A

May not stop progressive/ aggressive disease completely

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3
Q

What cases are RSD of limited use?

A

Persistent acute episodes e.g abscess
Deep complex bone defect
Severe hyperplasia
Pathology

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4
Q

What are the aims of periodontal surgery?

A 
Gain direct access root surface
Visualisation of defect
Improve tissue contour 
Reduction pocket depth - gain tissue attachemnet
Removal chronically inflammed tissue 
Encourage regeneration
Removal hyper plastic tissue
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5
Q

What is the chronically inflamed tissue at bottom of pocket and why is it present?

A

Granulation tissue

Lost bone replaced granulation tissue

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6
Q

What is a gingivectomy?

A

Resect the excess gingival

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7
Q

What cases are gingivectomny indicated?

A

Hyperplasia

False pockets

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8
Q

When is open flap debridement indicated?

A

Deep persistent bleeding/ suppurating pockets

Inflammatory/ intra-bony defect

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9
Q

When is an apical repositioned flap indicated?

A

For pocket elimination

Crown lengthening

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10
Q

Give example of when crown lengthening can be useful?

A

When have ginigvally encroaching restoration - inadequate biological width

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11
Q

What needs to be considered prior perio surgery?

A

Has non-surgical tx been carried out and reviewed?
Is pt suitable - medical
Consent
Oral hygiene adequate

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12
Q

What would be contraindication for gingivectomy?

A

Inadequate attached gingiva

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13
Q

What surgical technique is used for gingivectony?

A

Excision

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14
Q

What is a false pocket?

A

Position of margin of pocket is above the CEJ

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15
Q

Stages of gingivectomy?

A
  1. LA
  2. Pocket depth marking
  3. Incisions
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16
Q

What LA should be given when carrying out gingivectomy?

A

Normal and inter-papilla

Inter-papillary - reduce bleeding

17
Q

What is Goldman’s technique used for?

A

Pocket depth marking

18
Q

How is Goldman’s technique used?

A

Probe to measure depth of pocket
Pierce from outside to create bleeding point
Correspond to depth of pocket
Incision leave 1-2mm pocket depth

19
Q

What incisions are used in gingivectomy?

A

External bevel incisions

Base of incision lies bleeding point

20
Q

Stages of gingival flap?

A
  1. LA
  2. Relieving incision
  3. Raise flap
  4. Curettage
  5. PMPR
  6. Irrigation
  7. Suture reposition flap
21
Q

Difference curettage and PMPR?

A

Curettage - remove granulation tissue

PMPR - remove deposits and thin layer cementum bound endotoxins

22
Q

Adv of internal bevel incision?

A

Preserve tissue while elimination pocket

23
Q

Adv of reliving incision?

A

Allows flap to be raise for better visulisation

24
Q

Adv of crevicular incision?

A

Maintains soft tissue - indicated aesthetic regions

25
Q

When is odontoplasty used?

A

When furcation invovlement

26
Q

What is osteoplastys used?

A

If bone is causing prominent gingival appearance - supporting bone removed

27
Q

What does modified Widman flap preserve?

A

Interdental papilla

28
Q

What instrument used to raise flap?

A

Periosteal elevator

29
Q

What post-op care should be given following periodontal surgery?

A

Analgesia advice
Removable suture 7-10 days
CHX mouth rinse 2x day 2/3 weeks - pt not to chew in treated area in this period
Use of soft toothbrush after 3 weeks

30
Q

How long before probing surgery sites?

A

3 months

6 months if regeneration

31
Q

Signs of healing?

A

Good contour

Good parameter: PD, bleeding, aesthetic and attachment

32
Q

Signs of success for flap surgery?

A 
Decrease in inflammation
Less BOP
Decrease in pocket depth 
Increase attachment 
Elimination suppuration
Improvement tissue contour
Stabilisation bone levels
33
Q

What sutures are useful for XLA socket?

A

Horizontal mattress

34
Q

What sutures are good for root coverage proceudre?

A

Sling suture

35
Q

Other types of suture methods?

A

Interrupted
Vertical mattress
Horizontal mattress

5th ICP - ACS - PERIO (6 decks)

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