Preprosthetic Perio Surgery

Question 1

Thin Biotype vs Thick

Answer 1

Thin more risky for restorations

Question 2

Tooth Prep in relation to gingival margin

Answer 2

• Avoid gingival 1/3 if possible
• all subginigival margins should be w/in 1-2 mm of the free ginigival margin
• all inflammation should be resolved before restorations placed

Question 3

RPD Design and Reduced Periodontium

Answer 3

• Progressive Perio destruction in teeth included in RPD
• controversy with metal plates (cover more than bar)
• avoid distally extending cantilevered pontics!

Question 4

Indications for Perio Surgery- Pockets adjacent to endentulous ridges

Answer 4

• to eliminate extraneous mucosal tissue to permit adequate vertical space for replacements
• provide firm, healthy mucosal base for placement of saddles or pontics
• establish healthy gingival sulcus

Question 5

Perio Surgery Methods for Restorative considerations

Answer 5

Gingivectomy/gingivoplasty

Flap and Osseous Surgery

Question 6

Gingivectomy and Gingivoplasty Indications

Answer 6

• gingival enlargement present AND
• horizontal bone loss present AND
• Adequate keratinized tissue present

Question 7

Flap and Osseous Surgery Indications

Answer 7

• Infrabony defect is present AND/OR

- thin band of keratinized tissue is present

Question 8

Management of Mucogingival Problems Indications

Answer 8

• lack of keratinized tissue and/or attached gingiva
  
  • at abutment teeth or edentulous site
• shallow vestibular depth - for RPD or partial

Question 9

Perio Surgery Methods for Mgmt of Mucogingival Problems

Answer 9

Subepithelial CT graft
Free ginigival graft
Vestibular extension

Question 10

How to deal w/ Class V cervical defects?

Answer 10

If recession follows restoration, use subepithelial CT graft

Question 11

Vestibular Extension- what cut to use

Answer 11

Split thickness cut

Question 12

If close to mucogingival line and need to crown lengthen, what should you do?

Answer 12

Flap surgery with sulcular incisions, and push things apically - this way dont lose keratinized tissue like would with gingivectomy

Question 13

Ridge Augmentation Indications

Answer 13

To correct excessive loss of alveolar bone that occurred due to:
advanced perio disease
periapical lesion
traumatic tooth extractions
external trauma

Question 14

Ridge Augmentation Methods

Answer 14

• Soft Tissue augmentation
• Hard Tissue augmentation
• Hard and Soft tissue augmentation

Question 15

Ridge Augmentation Techniques

Answer 15

• Place thick mucosal autograft obtained from palate or tuberosity
• Place CT graft beneath full or partial thickness flap or in tunnel formed by lateral incision
• Roll technique- elevate flap over deformed area, depithelialize its terminal half, and roll it under the flap- good for not losing blood supply
• Guided bone regeneration