Recession/Furcation Lesions Flashcards
what is recesssion?
Inflammation free clinical condition characterised by apical retreat of the periodontium
ID papillae remain at normal level
are teeth lost due to true recession?
NO
patients with perio disease often have?
shrinkage
what is a window in bone?
a fenestration. Usually in buccal aspect
what is a lack of bone?
dehisence. Commonly where a tooth is proclined
causes of recession?
initiated due to morphologic and anatomic situations and:
- chronic minor trauma - TB
- mild chronic inflammation
- parafunction
- frenum pulls
- ortho tx
- excessive scaling
clinically what are the features of recession?
McCalls festoons - gum has rolled margin
Stillmans cleft - V shape in gum
recession has associations with?
dentine hypersensitivity/ root caries/ TB abrasion
what may be the cause of recession locaised to the lower anteriors?
frenum pull
How to monitor recession?
LOA
PPD
photographs
study models
how to treat recession?
eliminate causative factors eliminate areas of mild chronic inflammation - e.g repair restoration margin frenectomy tx hypersensitivity prevent caries perio surgery
what type of sugery could be used to treat recession?
soft tissue/hard tissue?
soft - gingival gratfs
hard - repair fenestration defect
how to diagnose a furcation?
radiographs and clincial exam
what may be seen on a radiograph to suggest a furcation?
an arrowhead lesion
check what roots in maxillary molars?
mandibular?
max - 3 roots, mesialbuccal/distobuccal/buccal
mandib - buccal and lingual
what does grade 1, 2, 3 mean?
1 - horizontal loss less than one third
2 - horozontal loss over one third
3 - through and through furcation
why do furcations reduce the prognosis of a tooth?
harder to clean = hard to control disease in the area
poss loss of vitality b/c accessory canals - bacteria get to pulp
what is used to vitality test a tooth?
ethyl chloride
electric pulptester
how often to regrade a furcation?
how often to vitality test?
regrade 6 monthly or yearly
vitality test yearly
how to treat furcations?
expose furcation for easy cleaning access
induce regeneration of new bone
tx for degree 1?
s/p
RSD
furcationoplasty
tx for degree 2?
furcationoplasty tunnel prep make it through and through GTR root resection tooth extraction
tx for degree 3?
tunnel prep
root resection
extraction
