Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Periodontics > S2 - Aesthetic Periodontal Surgery > Flashcards

S2 - Aesthetic Periodontal Surgery Flashcards

1
Q

What is gingival (marginal tissue) recession?

A

displacement of location of marginal periodontal tissue apical to the CEJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name some predisposing factors of recession (NOT precipitating)

A
  • gingival biotype
  • aberrant frenal attachment
  • bone dehiscence
  • quantity of attached gingiva
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

5 types of predisposing* and precipitating+ factors of recession. Specify each and give examples. Which are most/less common?

A

Mechanical forces

  • faulty toothbrushing+
  • oral piercing+
  • occlusal injury+

Iatrogenic

  • orthodontic movement+
  • restorative dentistry+

Pathological
plaque induced inflammation (smoking+)

Ageing

Anatomy

  • bone dehiscence*
  • malocclusion+
  • tooth position+
  • gingival biotype*
  • aberrant frenal attachment*
  • quantity of attached gingiva*

mechanical and anatomy (often in combo) more common than pathological)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Miller’s 1985 classification of recession. (4)

A

Class I: marginal tissue recession that does not extend to the MGJ with no interproximal tissue loss

Class II: marginal tissue recession that extends to or beyond the MGJ with no periodontal attachment loss in interdental area

Class III: marginal tissue recession that extends to or beyond the MGJ with periodontal attachment loss in the interdental area or malpositioning of teeth

Class IV: marginal tissue recession that extends to or beyond the MGJ, with severe bone or soft-tissue loss in interdental area, to a level apical to buccal/labial soft tissue margin and/or severe malpositioning of teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 indications for root coverage

A
  1. reduce root sensitivity
  2. improve esthetics
  3. manage muco-gingival defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a pedicle soft tissue graft?

A

one end of graft still attached to donor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a free soft tissue graft?

A

graft completely detached from donor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an additive graft treatment?

A

graft material sourced commercially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2 categories of pedicle soft tissue grafts and 2 subcategories of each

A

Rotational Flaps

  • laterally positioned flap
  • double papilla flap

Advanced Flaps

  • coronally positioned flap
  • semilunar flap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2 categories of free soft tissue grafts. What do they mean?

A

Non-submerged grafts
- free gingival graft

Submerged grafts
- subepithelial connective tissue graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 types of submerged graft approaches

A
  • Connective tissue graft + lateral pedicle flap
  • CTG + double papilla
  • CTG + coronally positioned flap
  • tunnel approach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 types of additive treatments

A

GTR

Enamel protein derivatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Indications (2) and contraindications (3) of laterally positioned flap.

A

Indications:

  • Millers class I and II
  • adequate adjacent donor

Contraindications:

  • deep inter-proximal pocket or bone loss
  • significant loss of interproximal bone height*
  • excessive root prominences

*will just shrink as bone dictates where soft tissue will heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Procedure for laterally positioned flap (5)

A
  1. V-shaped incision on denuded roots to remove adjacent epithelium and CT
  2. Parallel incision at an oblique angle toward the recipient tooth
  3. Partial thickness flap extending into mucosa
  4. Pedicle flap positioned laterally
  5. Interrupted sutures and sling sutures
    (Sutures removed after 10-14 days)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Advantage (1) and disadvantages (4) of pedicle flap

A

Advantages: good vascularity of pedicle flap

Disadvantages:

  • possibility of recession at donor site
  • limited by amt of adjacent tissue
  • dehiscence or fenestration at donor site
  • can be used in single or 2 teeth recession
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a double papilla laterally positioned flap? What are the 2 indications?

A

flap using 2 adjacent papillae to cover a denuded root surface

  • wide adjacent interproximal papilla
  • insufficient attached gingiva for lateral pedicle graft
17
Q

Key points to note about free gingival graft? (5)

A
  • increases width of attached gingiva
  • colour mismatch
  • raw wound in palate
  • single source of blood supply
  • more useful in less visible areas
18
Q

What is a sub-epithelial connective tissue graft (1)

A
  • a wedge of palatal CT is inserted below the exisitng epithelium of recipient site
19
Q

What are some possible donor sites for sub-epithelial connective tissue graft?

A
20
Q

Key points about sub-epithelial CT graft (5)

A
  • most consistently predictable method of root coverage
  • colour match
  • technique sensitive
  • primary closure in palate
  • dual source of blood supply - donor bed and flap on top (by combining with pedicle flap, it takes advantage of the blood supply from CT, periosteum as well as overlying flap)
21
Q

Key points about tunnel technique (4)

A
  • increased blood supply to CT graft
  • better adaptation and stability
  • useful in recession on multiple teeth (can use single piece of donor tissue)
  • but more challenging
22
Q

What are 2 acellular dermal matrix derivatives? (2) And main contents? (1) Advantage (1)

A

Alloderm - human source

Mucoderm - derived from porcine dermis

main content: collagen

advantages: tx of multiple defects

23
Q

What factors should be considered in root coverage procedures?

A
  • quality of marginal tissues
  • esthetic aspect of treated site
24
Q

What are Bio-active Molecules? How are they made? Name the 2 types.

A

promotes healing

obtained by centrifugation of pt’s blood sample to sequester and concentrate platelets

Platelet Rich Plasma (PRP) & Platelet Rich Fibrin (PRF)

  • PRP has anticoagulant (liquid - low density fibrin)) PRF doesn’t and is done at lower speed (jelly-like - high density fibrin)
25
Q

How are Bio-active molecules usually used for perio surgery

A

PRP + Bone graft + GTR

(more things included to increase chances of regeneration - put bone graft into IP area, cover with GTR, bone graft acts as a scaffold are for short term but after it resorbs, bone must be replaced by pt’s own osteoblasts → GTR)

26
Q

What are bone morphogenic proteins? Where can you get it from? Why do you need carriers and give some examples.

A

BMPs secreted by osteoblasts stimulate new bone formation (osteogenic)

native BMP is present in minute amounts (1mg/kg of bone), so need large amt of bone is needed to produce (cant be autogenous) → therefore, recombinant BMPs have been developed

BMPs needs a carrier to get effective bone initiation, ideal carrier still not found, cariers:

  • Demineralised Bone Matrix
  • Collagen
  • Resorbable polymers
  • Calcium phosphate materials
27
Q

What are enamel matrix derivatives? E.g. Emdogain

A

derived from porcine tooth germ

contains amelogenin, a matrix protein produced by ameloblasts and reduced enamel epithelium of root sheaths (idea that tooth germ will have messages to re-produce structures such as cementum)

combination approaches often used e.g. can be used in sandwich technique or with mucoderm for recession coverage

Periodontics (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions