Regeneration Flashcards
Best material to get gain in zero wall defect
Autograft
70:30 FDBA/ DFDBA
What about the decalcification in DFDBA promotes osteoinduction
only 2% or less residual calcium
This makes BMP available
Which is better for osteogenesis cortical or cancellous bone
Cancellous due to haematopoetic marrow
How is calcium sulphate resorbed
Giant cell reaction
Advantage of bioresorbable membrane
Tissue compatable
No 2nd surgery
Regulated by amount of cross linking
Which BMP in DFDBA
BMP - 2
How does biogide degrade
Collagenase
Then Gelatiniase and peptidase
What are collagen membranes made of
Porcine/ Bovine
Type I and Type III
What determines is a wound repairs or regenerates
Cell type that repopulates
Mesenchyme - Regeneration
How do you most accurately assess regeneration
Histopathology
Radiographic
How does dense HA heal
Long JE and CT attachment
No new attachment
What are progressive and competence factors
Competence: Prime cell to enter cell prolif cycle
Progression: Needed for cell division
What is regeneration
Cementum
Bone
Functionally orientated PDL
What is reattachment
Non Dx site
What is repair
Long JE and CT - Scar
What is a root conditioner
Remove smear layer
Expose collagen
Open tubules
Citric Acid, EDTA, Tetracycline
what is osteogenic
Vital cells
Produce new bone
autograft
Amount of cancellous key
What is osteoinductive
Induces bone formation by recruiting undiff mesenchymal cells that are mitogenic for pre osteoblast
DFDBA/FDBA
What is osteoconductive
Scaffold for bone formation
What is a xenograft
Different species
Scaffold
Osteoconductive
What is alloplast
Inorganic material
What is GTR
A barrier membrane allowing formation of new periodontium
What are the available membrane types
Resorbable
Non Resorbable
Positive of non resorbable membrane
Stiff
Negative of non resorbable membrane
2nd surgery needed.
Positive of resorbable membrane
No second surgery
Negative of resorbable membrane
Lack stiffness
Discuss emdogain
Osteopromotive: From developing porcine teeth, they mimic matrix proteins. Allow faster primary closure
Discuss PDGF
Platelet derived growth factor
Mitogenic and chemotactic for mesenchymal cells
What are BMP
Regulatory glycoproteins that stimulate mesenchymal stem cells differentiation to chondroblast and osteoblast.
Risk of ankylosis
What influences success of regen
Tooth type Defect Surgical management OH Compliance Smoking Keep cells out No infection
How do resorbable membranes break down
Krebs Cycle
What is the ideal material for ridge preservation
Osetoconductive
What is the point of decalcification
Open marrow spaces and allow osteopromotive cells out
What influences the osteoinductive potential of the graft
Age of the donor
Why does regen fail
Mechanical Instability
Poor blood supply
Competing tissue
When graft and bolt
Ridge 4 mm wide and primary stability
Why do you get early membrane exposure
Not aseptic No passive closure Inadequate flap mobility Smoking Diabetis Pressure from prosthesis Shallow vestibule
What bacteria colonize exposed membrane
P Ging
A Actino
Bone resorption following XLA
40-60% horizontal in 3/12.
What is PASS
Primary closure
Angiogenesis
Space Maintenance
Stability
What is the gain in a ridge split
3.5 mm
How long auto/allo block grafts last
3/12
How much vertical bone be gained
3 - 5 mm
How do you obtain vertical augmentation
Onlay block
Distraction
Ortho Extrude
