Surgery

Question 1

Any surgical procedure used to treat periodontal disease or to modify the morphology of the periodontium is called what?

Answer 1

Periodontal surgery

Question 2

What is the goal of periodontal surgery?

Answer 2

restore health and function to the periodontium and improve prognosis

Question 3

Which surgical procedure may be used to correct soft tissue defects affecting the cleans ability of the distal side of the most posterior molar?

Answer 3

Distal wedge

Question 4

Removal of gingival tissue is referred to as?

Answer 4

Gingivectomy (large amount) or gingivoplasty (small amount)

Question 5

How fast does gingival tissue typically grow back?

Answer 5

1 mm per day (on both sides, 4 mm grows in 2 days)

Question 6

Osseous recontouring is performed to correct what?

Answer 6

Osseous defects or deformities

Question 7

How much will the bone resorb/remodel simply by reflecting back the periosteum?

Answer 7

1 mm

Question 8

At what temperature does bone die?

Answer 8

Above 42 degrees celsius

Question 9

What are the three main regenerative procedures?

Answer 9

1-Guided Tissue Regeneration
2-Ridge Augmentation Procedures
3-Sinus Lift

Question 10

What are 5 examples of corrective mucogingival defect surgeries?

Answer 10

1-Apically positioned flaps
2-Frenectomy
3-Free gingival grafts
4-Connective tissue grafts
5-Pedicle flaps

Question 11

Which biotype is more likely to have recession?

Answer 11

Thin biotype

*Thick biotype resists recession more

Question 12

Adequate plaque control must happen before what?

Answer 12

Surgery

Question 13

Incisions where the edges come back together when sutures are called what?

Answer 13

Primary intention

*secondary intention-edges do not come all the way together

Question 14

Which type of incision preserves as much tissue as possible?

Answer 14

Intrasulcular

Question 15

As a general rule what are the thicknesses of intrasulcular, junctional epithelium, and CT attachment areas (biological width)?

Answer 15

1 mm each, making 3 mm for total biological width

Question 16

Where is the connective tissue taken from for connective tissue grafts?

Answer 16

Typically the roof of the mouth

Question 17

Extrasulcular incisions are made using what?

Answer 17

External bevel

Question 18

What is the average attached gingiva width on the maxilla for incisors and premolars?

Answer 18

• incisor: 3.5-4.4 mm

- premolar: 1.9 mm

Question 19

What is the average attached gingiva width on the mandible for incisors and premolars?

Answer 19

• incisor: 3.3-3.9 mm

- premolar: 1.8 mm

Question 20

What incision should be made if the procedure would involve the need to remove diseased epithelium and apically positioning the flap?

Answer 20

Extrasulcular incision

Question 21

A conventional gingivectomy is done with what type of incision?

Answer 21

External bevel incision

*goal is to remove excess tissue without raising a flap

Question 22

What are the two types of flaps based on thickness?

Answer 22

• Full Thickness flap

- Partial thickness flap

Question 23

Which flap is also known as a mucoperiosteal flap because it includes the periosteum, uses an elevator to make a blunt dissection, allows access to bone, is less technique sensitive and may have crestal resorption up to 1 mm?

Answer 23

Full thickness flap

Question 24

Which flap is also known as a split thickness flap, leave periosteum intact, uses a sharp blade for dissection, is technique sensitive, can be sutures to the periosteum but does not allow full access to the bone?

Answer 24

Partial thickness flap

Question 25

Which flap has no vertical releasing incisions, is esthetically more predictable, is used when anatomic limitations are present, is helpful when primary closure is necessary and usually is full thickness?

Answer 25

Envelope flap

Question 26

Which flap has one or two vertical releasing incisions, access flexibility, may be repositioned apical/coronally easily, can be an esthetic nightmare, and extends beyond the MGJ?

Answer 26

Released flap (relaxed, pedicle)

*Placed at line angles and should avoid papilla and midcervical areas

Question 27

What are 4 indications for crown lengthening?

Answer 27

1-Decayed or fractured below gingival margin
2-Excessive wear on dentition and clinical crown is inadequate
3-Unesthetic gingival margin (gummy smile)
4-Function (inadequate space)

Question 28

What are periodontal dressings used for?

Answer 28

• May be useful in protecting the tissue
• Comfort of the patient

*no real curative properties

Question 29

What are 4 types of Periodontal dressings?

Answer 29

1-Zinc oxide-Eugenol (wondr pak, may cause allergic rxn)
2-Noneugenol (coe-pak, most common, comes in two tubes)
3-Cyanoacrylates (Krazy glue)
4-Methacrylate gels

Question 30

What are 4 common non-resorbable suture materials?

Answer 30

1-Silk sutures
2-Nylon: Monofilament (ethilon)
3-ePTFE Gore-tek
4-Polyester: Braided (Ethibond)

Question 31

What are 3 resorbable/absorbable suture materials?

Answer 31

1-Surgical: gut
2-Plain gut: monofilament (30d)
3-Chromic gut: monofilament (45-60d)

Question 32

What are 6 synthetic suture materials?

Answer 32

1-Polyglycolic: braided (16-20d)
2-Vicryl (eticont)
3-Dexon (Davis and Geck)
4-Polyglycaprone (90-120d)
5-Monocryl (Ethicon)
6-Polyglyconate: mononfilament (maxon)