Periodontal Surgery Flashcards
What is guided tissue regeneration?
- uses mechanical barrier to eliminate epithelium from wound to determine which cells repopulate wound
- promotes repopulation by cells derived from PDL and bone
- particularly useful for degree 2 furcation defects and infrabony pockets
- procedure which enables bone and tissue to regenerate in defects around periodontally compromised teeth
- can also be used to increase bone available for implant procedures
What are the two reasons why furcation involvement reduces prognosis?
- difficult to clean hence more difficult to control disease in such an area
- loss of vitality due to accessory canals running from the pulp chamber into the furcation area, these act as a conduit for bacteria and their products
What is the aim of furcation treatment?
- to expose the furcation for access to cleaning
- induce regeneration of new bone
What is a furcationplasty?
Treatment for degree 1 and 2 furcation
- surgical procedure to improve patients access to furcation for cleaning
- reflection of flap
- removal of deposit and soft tissue from furcation
- remove tooth substance to widen entrance to furcation and consider recontouring bone
- replace flap
What problems are associated with furcationplasty?
- hypersensitivity
- danger to vital pulp
- root caries
What is a tunnel preparation?
Degree 2 and 3 surgical procedure
- to expose entire furcation area, only for mandibular molars
- flaps reflected on either side
- debridement of roots
- inter-radicular bone removed
- flap repositioned to leave inter-radicular area exposed
- forms through-through defect, easier for patient to maintain
What is root amputation?
Surgical removal of a compromised root, conserves entire clinical crown
What is root resection/hemisection@
Removal of one or more roots from multirooted teeth
- root to be retained is RCT’d
- flaps reflected
- crown of tooth sectioned and unwanted root removed
What are the aims of guided tissue regeneration?
- aims to create an environment under a membrane, excluding epithelial and gingival connective tissue
- allows cells from PDL and bone to proliferate over root planed surface
- PDL cells migrate coronally and differentiate into functional cells for bone, cementum and PDL
What membrane is used in guided tissue regeneration?
- non-resorbable and bioresorbable available
- gore-tex (ePFTE) is mainly used: non-resorbable, anti-antigenic, non-inflammatory
What is the procedure of GTR?
- flaps reflected
- RSI
- membrane placed over defect
- sutured in place for 6 weeks
If non-resorbable material used, a second procedure is performed to remove membrane
What is the widman flap surgery?
- aims to eliminate inflamed gingival tissue by provided direct access for root surface debridement
What is a gingivectomy?
Surgical removal of overgrown gingiva
