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TEXTBOOK FALL EXAM 2021 > Surgical Principles > Flashcards

Surgical Principles Flashcards

1
Q

What advantages are offered by surgical treatment? (5)

A

a. ACCESS- primary objective
b. Modification of osseous defects
c. Repair or regeneration of the periodontium
d. Pocket Reduction
e. Provide acceptable soft tissue contours

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2
Q

What are the contraindications of surgery (4)

A

a. Uncontrolled medical conditions
b. Poor plaque control
c. High caries risk
d. Unrealistic patient expectations

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3
Q

What is the infection rate with perio surgery

A

4.4% - Checchi

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4
Q

According to Rose/Mealey, what is the single most important surgical principle?

A

blood supply must be maintained

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5
Q

3 Major branches of external carotid artery most important for the oral cavity

A

Maxillary
Facial
Lingial

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6
Q

Distance of the greater palatine neurovascular bundle in Shallow, Average, and Deep Palate

A

a. Shallow: 7mm
b. Average: 12 mm
c. Deep: 17m

-REISER study (measured from crest)

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7
Q

What are the number of days until Connect Tissue (CT) and Epithelial maturation?

A

CT: 21 - 28 days (Why we like to wait to remove sutures so we have the most flap strength)

Epithelial: 28 - 42 days

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8
Q

Where do you never place a releasing incision

A

Over a root prominence

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9
Q

What are the contraindications to gingivectomy

A
  1. Narrow zone of Keratinized Tissue
  2. Defect present amenable with regeneration
  3. Risk of root exposure and esthetic considerations
  4. Intrabony defects
  5. PD past MGJ
  6. Unfavorable anatomical characteristics
  7. High caries index
  8. Thermal sensitivity
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10
Q

First means to obtain hemostasis?

A

Direct pressure on the flap for 5 minutes

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11
Q

What are the types of absorbable sutures?

A

a. Plain gut
b. Chromic gut
c. Vicryl
d. Monovicryl

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12
Q

What is the advantage of double continuous sling suture?

A

Allows for apical positioning and facial and lingual flaps to be closed independently

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13
Q

What are the considerations of suture removal?

A

If sutures are no longer stabilizing the wound

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14
Q

What are the indications for surgery

A
  1. Access
  2. Modification of Osseous Defects
  3. Repair or Regenerate Periodontium
  4. Removal calculus
  5. Remove persistent disease
  6. Gingival Enlargement
  7. Implant Surgery
  8. Perio Plastic Surgery
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15
Q

What is the advantage of a shallow sulcus

A

Maintainable

Long Term stability

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16
Q

What are the 3 types of wound healing

A

Primary
Secondary
Tertiary

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17
Q

What are the phases of wound healing

A 
Inflammation
Proliferation
Granulation
Remodeling
Maturation
18
Q

What determines Local Anesthesia onset of action?

A
  1. Ionization constant

2. Tissue pH -Lower pKa, more free base, faster onset

19
Q

What determines LA duration of action

A

Protein binding capacity

20
Q

What is the maxmium dose of Lido

A

4.4mg / kg,

21
Q

What are the 3 types of flap design

A

Envelope
Pedicle
Triangular

22
Q

What is the average blood loss during the average periodontal surgery

A

134 ml (Baab)

23
Q

Topical Hemostatic Agents

A 
Oxidized cellulose
Absorbable collagen
Ferric sulfate 
Topical Thrombin
LA with vasoconstrictor 
Absorbable gelatin sponge (gelfoam)
Bone Wax
24
Q

Key suturing principles

A
  1. Flap adaption and stability
  2. Passive Tension
  3. Minimal material under flap
  4. Suture Knots at side
  5. Adequate tissue bites
  6. Smallest diameter needle possible
  7. Remove carefully
25
Q

Why do we use perio dressings?

A

They assist/increase flap adaption

26
Q

What are the perio dressings available

A

Coe Pack: Zn Oxide, mineral oil, bacteriocidal

Barricaid: VLC gel, UDMA

Cyanacrylate: Not FDA approved, used over soft tissue allografts

27
Q

Indications gingivectomy

A
  1. Eliminate Suprabony pocket
  2. Esthetics
  3. Remove soft tissue crater
  4. Gingival enlargement
28
Q

Types of Gingivectomy

A

Internal or external bevel

29
Q

Why is internal bevel incision better?

A

Less sore
Heal primary intention

(Remove pocket epithelium and provide direct apposition of healthy CT to the root surface)

30
Q

What are 2 other types of gingivectomy procedures

A

Electrosurgery

Laser

31
Q

How often do you change perio dressings

A

Every 5 - 7 days for 2 - 3 weeks

Synatzke’s Lecture Notes:
First post op appointment is 7-10 after surgery—assess healing, remove dressing

32
Q

What is the Main objective of Modified Widman Flap (MWF)

A

Maximum healing

33
Q

What are the advantages of Modified Widman Flap (MWF)

A 
Healthy collagen attached to tooth
New cementum
Optimal root coverage
bone conservation
increased regeneration potential
34
Q

What are the tuberosity reduction techniques

A

(1) Triangular wedge
(2) Inverse bevel linear wedge technique
(3) Pedicle flap

35
Q

What are the results of open flap debridement

A

Increased removal of plaque
Reduced PD
Some gain CAL
Heal long Junctional Epithelium (JE)

Roots are planed, defects are degranulated, and flaps are closed either at or apical to their original position

36
Q

What is the distance from the CEJ to the alveolar bone crest in health

A

2.0 mm

37
Q

What is the size of Shallow, Medium and Deep Craters?

A

Shallow: 1 - 2 mm
Medium: 3 - 4 mm
Deep: 5+ mm

38
Q

Why do we use palatal approach technique?

A

Avoid buccal furcation
Increased embrasure space
Increase access
Palate is all keratinized

39
Q

Why use lingual technique

A

Improve access
Tooth angulation toward lingual
Lingual plate thickness

40
Q

How much Bone loss do you get after surgery:

  1. Flap reflection
  2. Flap Reflection and osseous
A

Flap refelction: 0.2 mm

Flap and osseous 0.6 mm

41
Q

What size defect is regenerable

A

below 3 mm

TEXTBOOK FALL EXAM 2021 (11 decks)

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