Plastic Surgery Flashcards
T/F: Periodontal plastic surgery is only used after periodontal disease.
False
Can fix anatomical, developmental, or traumatic issues as well
What is a mucogingival defect?
Lack of keratinized attached gingiva
Which teeth are most often involved with brushing and recession?
Premolars in young adults
What is the adequate amount of attached gingiva?
None
You can be fine with no attached gingiva as long as you can keep it clean and esthetics is okay
Which teeth are the most vulnerable to recession?
Mandibular anteriors
What are some mechanical reasons for gingival recession?
Traumatic brushing/flossing, ortho, trauma, parafunctional habit (piercing)
What are some biological reasons for recession?
General: thin tissue biotype, poor oral hygiene
Localized: anatomy, defective restoration
T/F: Males tend to have more recession than females.
True
When there is no interproximal bone loss and the recession extends to/beyond the mucogingival junction it is classified as ________.
Miller class II
What is the miller classification when there is interproximal bone loss beyond the level of recession?
Class IV
How much root coverage is seen with various miller classifications?
Class I and II - full root coverage
Class III - partial root coverage
Class IV - no root coverage
What are some indications for soft tissue grafting?
- Gingival recession that is progressive or causes sensitivity
- Esthetics
- Limited soft tissue around tooth to be crowned
- Thin soft tissue prior to ortho
T/F: The expected outcome of grafting is soft tissue attachment to the root surface.
True
Doesn’t always happen and you get a pocket
T/F: Lack of attached gingiva is an indication for soft tissue grafting.
False
Has to cause a problem
What type of flap is most often used for a gingival graft?
Coronally positioned split thickness
T/F: Free gingival graft contains both epithelium and connective tissue.
True
Shouldn’t be covered with flap - could cause cysts
What makes a pedicle graft different from free gingival and sub-epithelial grafts?
Pedicle graft is not from another area - it uses tissue from adjacent teeth that is not cut all the way off
T/F: Sub-epithelial grafts create an open wound.
False
Free gingival - open wound, more pain
Sub-epithelial - take connective tissue and close the wound, less pain
How far must you elevate the flap to coronally position it?
To the mucogingival junction
Which type of graft often results in a color discrepancy at the site?
Free gingival graft
During which phase of healing do you see anastomoses of blood vessels between the graft and local tissue?
Revascularization phase (2-11 days) no brushing during this period
How long after grafting should you wait before starting restorative?
About 2 months