Periodontal Surgery Flashcards
Name 3 categories of periodontal surgery?
Resective
Regenrative
Plastic
Name the 6 types of Resective Perio Surgery?
Gingivectomy
* Open flap
debridement
* Modified Widman
flap
* Apically
repositioned flap
* Furcation plasty
* Root separation +
resection
+/- ossesous
recontouring
Name the 4 types of Regenrative Perio Surgery?
Guided tissue
regeneration +/-
bone substitute
* Biologic root surface
modification
* Other grafting
biomaterials
* Combined therapies
Name the 7 types of Plastic Perio surgery?
Free tissue grafts
* Connective tissue
grafts
* Xenografts
* Allografts
* Coronally
positioned flaps
* Tunnel techniques
* Crown lengthening
surgery
Name the 3 indications and purpose of periodontal surgery?
The management of residual sites of
deep periodontal pockets.
* Crown lengthening.
* Management of gingival excess.
* Management of gingival recession.
What are the tx options fort non-responding periodontal pocketing?
No treatment
* Palliative care
* Continuous non-surgical therapy and
maintenance +/- adjunctive agents
- Surgical regeneration
- Surgical debridgement
Name the short term and long term risks of periodontal surgery?
Short:
- Bleeding
- Infection
- Swelling
- Pain
- Sensitivity
Long:
- Mobility
- Recession
- Futher LoA
- Failure
- Black traingles
Name the 6 oral contraindications to periodontal surgery?
Poor plaque control
* Poor compliance with non-surgical therapy
* Unrestorable teeth
* Grade III mobility
* Unrestored caries
* Untreated endodontic pathology
Name the 8 medical contradindications to periodontal surgery?
Poorly controlled diabetes
* Uncontrolled hypertension
* Immunocompromised patients (e.g. leukaemia)
* Immunosuppressive drugs (e.g. cyclosporin)
* Chemotherapy
* Radiotherapy
* High risk of MRONJ
* Increased bleeding risk - INR ≥ 4
- Multiple antiplatelet drugs
- NOAC
Decision making balance between non-surgical and surgiucal approach?
Non-surgical:
- Pockets < 6mm
- Systemic conditions with
adverse effect on healing
- Limited plaque control
- Limited motivation
- Other uncontrolled dental
disease
- Limited ability to understand
and/or tolerate surgery
Surgical:
- Pockets ≥ 6mm
- Systemic health
- Excellent plaque control
- Excellent motivation
- No other dental disease
- Good ability to understand
and/or tolerate surgery
Primary goals of surgical perio treatment?
To create accessibility for optimal root
surface instrumentation.
* To establish a gingival morphology that
facilitates efficient oral hygiene as
performed by the patient.
Secondary goals for surgical perio treatment?
Decrease pocket depth to enable
stability an maintenance
* Reduce BoP and disease activity
* Improve tooth longevity
What are the 5 general principles of periodontal surgery?
Flap must have a broad base to enable sufficient blood supply
* Flap length: width should not exceed 2:1
* Flap big enough to provide access to the roots with bony defects
* Mucoperiosteal flaps should be used, except when grafting
* Minimal tension when suturing
Name the 8 principl;es of MIST flap design?
Performed under magnification using microsurgery equipment
* Minimal incisions
* Continuous incisions avoided
* Vertical incisions avoided
* Extensive reflections avoided
* Flap reflection by sharp dissection
* Use of regenerative materials & EMD where possible
* Flaps secured using vertical matress sutures
What are the idnciations and contrainditcaitons for MIST?
Indications:
- isolated defects
Contra:
- Generalised horizontal defects
- Multiple interconnected defects
