Surgical Principles

Question 1

What advantages offered by surgical treatment

Answer 1

Increased visibility
Increased access
Increased SRP effectiveness
Modify osseous defect
Repair/Regen possible
Reduce PD
Improve contour
Perio plastic surgery

Question 2

What are the contrindications of surgery

Answer 2

High caries
Uncontrolled medical condition
Poor plaque control
Unrealistic expectation

Question 3

What is the infection rate with perio surgery

Answer 3

4%

Question 4

What is the single most important surgical principle

Answer 4

blood supply must be maintained

Question 5

What are the major branches of the external carotid

Answer 5

Maxillary
Lingial
Facial

Question 6

How far away is the greater palatine bundle in palates

Answer 6

Depends on contour: 7, 12 , 17

Question 7

How many days until CT maturation

Answer 7

CT 21 - 28 days

JE 28 - 42 days

Question 8

Where do you never place a releasing incision

Answer 8

Over a bony prominence

Question 9

What are the contra indication to gingivectomy

Answer 9

Intrabony defect
Narrow KT
PD past MGJ
Root exposure
Aesthetics
High Caries risk
Thermal sensitivity

Question 10

what used for first lie haemostasis

Answer 10

5 min of pressure

Question 11

What are the absorbable sutures

Answer 11

Surgical Gut
Surgical gut chromic
Vicryl
Monocryl

Question 12

Advantage of double continuous sutures

Answer 12

Allow positioning of FL flap independent of opposing flap

Question 13

What are the considerations of suture removal

Answer 13

removed when not stabilizing the tissue

Question 14

What are the indications for surgery

Answer 14

Access
Remove Calculus
Remove persistent disease
Alter periodontium for aesthetics or reconstruction

Question 15

What is the advantage of a shallow sulcus

Answer 15

Maintainable

Long Term stability

Question 16

What are the 3 types of wound healing

Answer 16

Primary
Secondary
Tertiary

Question 17

What are the phases of wound healing

Answer 17

Inflammation
Proliferation
Granulation
Remodelling
Maturation

Question 18

What determines LA onset of action

Answer 18

Ionization constant

Tissue pH

Question 19

What determines LA duration of action

Answer 19

Protein binding capacity

Question 20

What is the maxmium dose of Lido

Answer 20

4.4mg / kg,

Question 21

What are the 3 types of flap design

Answer 21

Envelope
Pedicle
Triangular

Question 22

Normal blood loss foloowing surgery

Answer 22

134 ml

Question 23

Local haemostatic agents

Answer 23

Oxidized cellulose
Ferric Sulphate
Topical Thrombin
Absorbable
Gelatin sponge
LA with vasoconc
Bone Wax

Question 24

Key suturing principles

Answer 24

Flap adaption and stability
Passive
Minimal material under flap
Knots at side
Adequate tissue bites
Smallest diameter possible
Remove carefully

Question 25

Why use perio dressings

Answer 25

increase flap adaption

Question 26

What are the perio dressings available

Answer 26

Coe Pack: Zn Oxide, mineral oil, bacteriocidal Barricaid: VLC gel, UDMA Cyanacrylate: Not FDA approved, used over soft tissue allografts

Question 27

Indications gingivectomy

Answer 27

Eliminate Suprabony pocket Aesthetics Remove soft tissue crater Gingival enlargement

Question 28

Types of gingivectomy

Answer 28

Internal or external bevel

Question 29

Why is internal bevel better

Answer 29

Less sore | Heal primary intention

Question 30

Other gingivectomy procedures

Answer 30

Electrosurg | Laser

Question 31

How often do you change perio dressings

Answer 31

Every 5 - 7 days for 2 - 3 weeks

Question 32

What is the objective of MWF flap

Answer 32

maximum healing

Question 33

What are the advantages of MWF flap

Answer 33

``` Healthy collagen attached to tooth New cementum Optimal root coverage bone conservation increased regen potential ```

Question 34

What are the tuberosity reduction techniques

Answer 34

Inverse bevel triangular distal wedge Inverse bevel linear distal wedge Tuberosity pedicle flap

Question 35

What are the results of open flap debridement

Answer 35

Increased removal of plaque Reduced PD Some gain CAL Heal long JE

Question 36

Distance to CEJ in bone and health

Answer 36

2.0 mm

Question 37

Shallow, medium and deep craters

Answer 37

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

Question 38

Why palatal technique

Answer 38

Avoid buccal furcation Increased embrasure Increase access Palate all keratinized

Question 39

Why use lingual technique

Answer 39

Improve access Tooth tilt Lingual plate thickness

Question 40

Recession after surgery: Flap reflection and flap and osseous

Answer 40

Flap refelction: 0.2 mm | Flap and osseous 0.6 mm

Question 41

What size defect is regenerable

Answer 41

below 3 mm