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SP18: Perio MT2 > Suturing And Healing/Osseous Defects > Flashcards

Suturing And Healing/Osseous Defects Flashcards

1
Q

T/F: We use needles with an eye to thread the suture material.

A

False

Disposable, reverse cutting needle with press-fit suture

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2
Q

What is the preferred needle holder in perio suturing?

A

Castroviejo needle holders

More flexible

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3
Q

T/F: Silk sutures must be removed within ten days.

A

True

Will start to absorb food and cause a host response

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4
Q

What are the advantages and disadvantages of PTFE (polyester) as a suture?

A

Can be kept in the mouth for a long time

Expensive

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5
Q

How long does it take chromic gut to resorb?

Coated vicryl?

A

Chromic gut — 7-10 days (proteolytic enzymes)

Coated vicryl — 56-70 days (slow hydrolysis

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6
Q

Sutures should be entered into the more ___________ flap first, and should be placed at least ______ away from the edge of the flap.

A

Mobile; 2-3 mm

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7
Q

When might the figure 8 suture technique be used?

A

Mandibular molar area; keeps you from pointing the needle at the tongue

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8
Q

What is the advantage of the sling sutures?

A

Can suture multiple papillae with one suture

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9
Q

How do you tie a surgeons knot?

A

Wrap the long end around needle holder twice -> pull short end through -> wrap long end once in the opposite way -> pull short end through

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10
Q

What is a major disadvantage to using a periodontal dressing?

A

Can predispose to colonization underneath of dressing if left on too long

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11
Q

When would you use periodontal dressings?

A

Healing via secondary intention

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12
Q

T/F: You should cut the sutures as close as possible to the tissue in order to avoid pulling contaminated suture through the wound.

A

True

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13
Q

What are the three phases of post surgical healing?

A
  1. Inflammation (first few days)
  2. Granulation (7-10 days)
  3. Matrix formation and remodeling (several weeks)
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14
Q

__________ tissue replaces the blood clot in primary closure.

A

Granulation

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15
Q

How long does it take for epithelium to attach to the root during wound healing?

A

1 week

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16
Q

How long does it take for the wound to regain most of its original tensile strength?

A

2 months

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17
Q

What happens to the bone during healing after a full thickness flap?

A

Roughly 1mm of bone loss

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18
Q

T/F: There is more inflammation and granulation tissue with secondary intention.

A

True

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19
Q

Which growth factors are released from the blood clot that helps with healing?

A
  1. PDGF
  2. EGF
  3. TGF-beta
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20
Q

What factors are released by fibroblasts and macrophages that help with healing?

A
  1. TNF

2. IL-1beta

21
Q

How do we minimize bacterial colonization during healing?

A

Chlorohexidine rinse

22
Q

What type of attachment do you get after a gingivectomy?

A

Long junctional epithelium

No new PDL, bone, or cementum

23
Q

What type of attachment occurs after an apically positioned flap?

A

Long JE

No new bone, PDL, or cementum

24
Q

What type of attachment do you get after a modified Widman flap?

A

Long JE

Less bone resorption than an apically positioned flap

25
Q

T/F: Healing by long junctional epithelium is considered regeneration.

A

False

Long JE is repair because it does not replace PDL, bone, cementum

26
Q

What are the steps of healing after surgery?

A
  1. Debridement — inflammatory cells
  2. Regeneration — parenchymal cells
  3. Migration/Proliferation — parenchymal and CT cells
  4. Synthesis of extracellular matrix proteins
  5. Remodeling of connective tissue and parenchymal components
  6. Increase in strength
27
Q

What are three etiologies of alveolar bone loss?

A
  1. Extension of gingival inflammation
  2. Trauma from occlusion
  3. Systemic disorder

*must have plaque for all three

28
Q

What is the best way to determine the type of bony defect?

A

Bone sounding

29
Q

T/F: Patients with thin bone will often have horizontal bone loss rather than angular.

A

True

30
Q

What is the multiple burst model of perio disease?

A

Loss of equilibrium between formation and resorption is episodic

31
Q

What is buttressing bone formation?

A

Bone is trying to make up for bone loss and deposits bone in other areas

32
Q

T/F: Buttressing bone is removed as part of perio surgery.

A

True

33
Q

Which type of buttressing is seen when opening a flap for perio surgery?

A

Peripheral — occurs on the external surface (will trap plaque)

Central is the other type that occurs within the jaw

34
Q

Describe reverse architecture.

A

Interdental areas will lose bone before buccal-lingual areas

This creates a reverse U shape around the teeth, rather than the normal U shape of bone in health

35
Q

Which type of defect has the best prognosis for regeneration?

A

3 wall defect

36
Q

What are the classifications for Furcation loss?

A

F1 — feel concavity but not catching prob
F2 — Furcation catches prob
F3 — through and through

37
Q

T/F: Furcation involvement can be diagnosed with just X-rays.

A

False

Must have clinical exam

38
Q

T/F: Regeneration surgery works for class III furcation.

A

False

Just resective

39
Q

T/F: Class II furcations are good for regeneration.

A

True

40
Q

What are the main goals in treating horizontal bone loss?

A

Pocket reduction, and correct reverse architecture

41
Q

If you have a patient with horizontal bone loss and limited keratinized tissue what would be the best surgery?

A

Open flap debridement

OS — needed if reverse architecture needs corrected

GV — not indicated due to limited keratinized tissue

42
Q

What are the goals in treating angular defects?

A

Pocket reduction and restore attachment

43
Q

What are the treatment options for angular defects?

A

OS — especially for less walled defects

GTR — works best with 3 walled defects

44
Q

What are the treatment options for furcation defects?

A
  1. SRP — F1
  2. OFD — F1-2
  3. OS — F3
  4. GTR — F2
45
Q

What is the flap design for Osseous surgery?

A

Full thickness flap, apically positioned

46
Q

What is the flap design for regenerative surgery?

A

Full thickness flap, coronally positioned flap

47
Q

T/F: Scalloped incisions are mostly used during Osseous surgery.

A

True

Sulcular if keratinized tissue is limited

48
Q

T/F: Scalloped incisions are used with regenerative surgery.

A

False

Sulcular

49
Q

Why might vertical incisions be needed?

A

In order to make the flap more mobile

SP18: Perio MT2 (7 decks)

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