Periodontal Surgery Terms Flashcards
general indications for periodontal or implant surgery
- continued pocketing and inflammation following initial therapy with need for surgical access
- infrabony (intrabony) osseous defects
- grade 2 and 3 furcation involvement
- unstable mucogingival defects
- esthetic considerations
- replacing missing teeth with implants
- prescription surgery (requested by referring dentist)
examples of prescription surgery
- restorative: crown lengthening, gingival grafting
2. orthodontic: frenectomy and supracrestal circumfrential fiberotomy following ortho
contraindications to perio surgery
- uncontrolled medical problems
- patient non-compliance
- poor OH
apically positioned flap
flap of tissue replaced apical to its original position on closure
an apically positioned flap is important in establishing what?
surgical recession for pocket elimination or crown lengthening while preserving keratinized gingiva
in order for a flap to be apically positioned, it must be elevated past what?
mucogingival jxn
T/F: apically positioned flap may be performed on max facial, max palate, mand facial and mand lingual surfaces
false, not max palate
coronally positioned flap
periodontal flap that is replaced coronal to its original position
coronally positioned flap is used to cover what?
exposed roots but does not result in an increase in keratinized gingiva
crown lengthening
exposure of clinical crown usually for restorative purposes
distal wedge
periodontal surgical procedure for removal of excessive soft tissue distal to terminal molar with access gained to underlying bone
how is tissue removal accomplished in a distal wedge procedure?
via internal thinning (undermining incisions)
what is the goal of distal wedge procedure?
- remove excessive tissue
- reduce pocket depth
- facilitate oral hygiene at the area
free gingival graft (free soft tissue graft, detached gingival graft)
autogenous graft of masticatory mucosa or collagenous tissue completely detached from its original site and blood supply and placed in a prepared recipient bed
what determines the success of the free gingival graft?
survival of CT
frenectomy (frenulectomy)
surgical detachment and/or excision of a frenulum from its attachment into the mucoperiosteal covering of the alveolar process
alveolectomy
removal of all or a portion of alveolar process of jaw bone(s)
alveoloplasty
surgical procedure of altering alveolar ridge or its surrounding bony structures by cutting, smoothening, or reshaping to correct alveolar ridge external contour in preparation for prosthetic rehabilitation
vestibuloplasty
plastic surgery of vestibular region of the mouth designed to restore alveolar ridge height (deepen the vestibular trough) by lowering the muscles that attach to the buccal, labial, and lingual aspects of the jaws
full thickness flap (mucoperiosteal flap)
flap of mucosal tissue, which includes periosteum, reflected from bone
guided tissue regeneration
barrier method for promoting selective re-population of periodontal defect multi-potential cells from the PDL or bone through exclusion of gingival epithelium and flap CT
what type of flap will help insure flap coverage over the defect and GTR material in GTR procedure?
replaced or coronally positioned flap
gingivectomy
excision of soft tissue wall of periodontal pocket is uncomplicated by extension into underlying bone
the incision for gingivectomy forms what?
45 degree external bevel or surface that is exposed to oral cavity
when is gingivectomy contraindicated?
when pockets reach MG jxn or osseous defects are present
gingivoplasty
surgical procedure by which gingival deformities (particularly enlargements) are reshaped and reduced to create normal and functional form
inverse bevel incision
an internal (reverse) incision (faces the tooth) as opposed to external
what is used in most flap designs?
inverse beveled incision
resection of gingiva without elevation of flap is sometimes called what?
internal-bevel gingivectomy
modified widman flap
replace,d mucoperiosteal flap, accomplished with an internal bevel incision, that provides access for root preparation
modified widman flap was designed to maintain what?
as much interdental papilla as possible in order to effect primary closure whenever possible
mucogingival surgery
plastic surgical procedures designed to correct defects in morphology, position and/or amount of gingiva surrounding teeth
open curettage (flap curettage)
surgical debridement of roots and removal of granulation tissue after reflection of soft tissue flap (includes modified WIdman flaps)
osseous surgery
modification of bony support of teeth
osseous surgery is designed to modify and reshape what?
deformities in alveolar bone surrounding teeth
ostectomy
some supporting bone is sacrificed (with loss of attachment) to gain pocket elimination or crown lengthening
osteoplasty
surgical procedure that modifies the configuration of bone (only non-supporting bone is removed)
partial thickness flap (split thickness flap)
surgical flap of mucosa and CT but not including periosteum
pedicle graft
graft elevated from a donor site that remains attached at its base for nourishment and is transferred to an adjacent recipient site
suturing techniques commonly used in periodontics
- simple interrupted
- single sling
- continuous sling
simple interrupted suturing technique
interdental
single sling suturing technique
engages lingual or facial flap for 2 interdental papillae
continuous sling suturing technique
engages lingual or facial flap for several teeth for independent suturing
root resection
surgical removal of all or a portion of the root before or after endodontic tx
examples of root resection
- root amputation (usually performed on maxillary teeth)
2. hemisection (usually performed on mandibular teeth)
subepithelia CT graft
autogenous graft of CT wit ha small collar of epithelium or no epithelium taken from the palate and usually placed between a flap and the root, bone or periosteum at the recipient site
submarginal (scalloped) incisions
blade enters gingiva apical to gingival margin and is directed toward alveolar crest
what do submarginal (scalloped) incisions accomplished?
surgical recession
when should submarginal incisions be avoided?
when there is not a abundance of keratinized gingiva or when surgical recession is not a goal
sulcular incisions
blade enters the gingival sulcus and is directed toward the alveolar crest without incision of marginal gingiva
vertical incisions
generallly oblique incisions that diverge in an apical direction
where are vertical incisions placed?
near line angles of teeth but not over root prominences to aid in flap elevation without extending flap to adjacent teeth
when are vertical incisions avoided?
on palatal and lingual aspects
which type of flap does not have vertical incisions?
envelope flap
distraction osteogenesis
bone augmentation procedure where a portion of jaw is sectioned by osteotomy and progressively displaced by a mechanical device that is attached to the separated bone segment and the original bone
decortication
deliberate removal or repeated puncturing of cortical bone to initiate bleeding or a regional accelerated phenomenon for bone repair or to enable incorporation of bone graft into host bone
decortication is a method routinely used in what?
- ostemyelitis
- periodontal defects
…after removal of sequestrum, the surrounding vital bone is included in the removal to initiate bleeding to promote osseous healing
how is decortication performed in periodontal defects?
done through intramarrow penetration
lamina dura
sheet of compact bone that forms the tooth alveolar wall or tooth alveolus
crestal lamina dura
layer of compact bone existing at alveolar crest
