Sweep 1 Flashcards

1
Q

mucogingival defect

A

Gingival recession
Lack of gingiva (Keratinization)
Gingival recession with abrasion

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

Recession - generalized - due to

A

Tissue biotype, oral hygiene

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

Recession - localized - due to

A

Anatomy, defective restoration

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

Brushing and recession - in young adults —- most involved

A

premolars

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

Hx of hard brush use

•Positive association with

A

% receded surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Miller class 1 when there is no

A
interproximal bone loss and the recession does not extend to mucogingival junction.
100% root coverage can be anticipated in miller class I recession defects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Miller class II When there is no

A
interproximal bone loss and the recession extends to or beyond mucogingival junction.
100% root coverage can be anticipated in miller class II recession defects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Miller class III there is

A
interproximal bone loss and the recession may or may not extend to mucogingival junction.
Only partial root coverage up to the level of interproximal bone can be anticipated in miller class III recession defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Miller class IV there is

A
interproximal bone loss beyond the level of recession
No root coverage can be anticipated in miller class IV recession defects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CAF - coronally advanced flap -

A

most predictable outcome. Full thickness, coronally positioned. Two vert incisions.

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

Tunnel -

A

no incision, raise flap through sulcus, tunnel to underlying bone, insert graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lateral sliding flap -

A

single tooth recession. Remove epi layer and slide flap from donor side over. Partial thickness, if concern for recession on donor side use collagen.

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

Double papilla -

A

like lateral sliding from two sides

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

SGCT -

Subepithelial connective tissue graft

A

increase tissue thickness at site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Allograft

• Recovered from

A

human donor skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

• Mucograft

A

• Xenograft porcine collagen type I and III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

• Emdogain

A

– an extract of enamel matrix and contains amelogenins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

—– provides best outcome for root coverage

A

SGCT, CAF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Free gingival graft INDICATIONS
• To increase ——-
• To increase —– depth
• To achieve ——-

A

KG/attached gingival

vestibular

root coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Free gingival graft - DISADVANTAGES
• Not predictable to achieve —–
• Esthetic concern: —— at recipient site
• Complications at —–

A

root coverage

color discrepancy

donor site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

FGG healing - Initial phase (0-3 days) –

A

“Plasmatic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

FGG healing - —— phase (2-11 days)

A

Revascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

FGG healing - ——- phase (11-42 days)

A

Tissue maturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Frenulum (frenum)

 A small band or fold of ——– that controls, curbs, or limits the movement of organ or part

A

integument or mucous membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aberrant Frenum
 Atypical/abnormal insertion of ——- frenula capable of retracting gingival margins, creating diastemas, and limiting lip and tongue movements.

A

labial, buccal, or lingual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Inability of —————- has been implicated in the persistence of aberrant frenum

A

frenum to migrate apically during alveolar growth and tooth development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Classification of labial frenum

A

 Mucosal
 Gingival
 Papillary
 Papillary penetrating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mucosal frenum

 Insertion of frenum ends in

A

mucosa or, at the most, at mucogingival junction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Gingival frenum

 Insertion of frenum ends in the

A

gingiva, between mucogingival junction and base of the interdental papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Papillary frenum

 Insertion of frenum ends at the

A

interdental papilla, but does not penetrate to the palatal aspect of the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Papillary penetrating frenum

 Insertion of frenum ends at the

A

interdental papilla, and penetrates to the palatal aspect of the tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

 Ellis-van Creveld syndrome  Orofacial-digital syndrome associated with

A

Prominent/Aberrant max frenum problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

 Ehlers-Danlos syndrome  Holoprosencephaly

A

Genetic Syndromes are associated with absence of maxillary labial frenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Studies of excised frena agree on presence of :

A

 both orthokeratinized and parakeratinzed epithelium.
 collagen fibers.
 chronic inflammatory infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

With excised frena -  Presence of ——- is inconsistent

A

muscle fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Aberrant labial frenum

 Can be associated with:

A

 Frenal tension
 Interference with oral hygiene procedures
 Gingival Recession
 Midline Diastema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q
 Recession
 Interference with oral hygiene procedure  Trauma
 Plaque retention
 Diastema
 Denture fabrication
A

 Indications of frenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

 Frenotomy: the cutting of a frenulum, especially the release of ———.

A

ankyloglossia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Frenulectomy (frenectomy): the

A

excision (total removal) of a frenulum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

V-shaped incision, Archer incision, diamond-shaped incision

A

 Simplest procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Z-plasty incision

A

 More demanding, less relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

 Lasers (CO2, others)

A

 Better patient outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Frenectomy can result in scar formation between central incisors, which can lead to resistance to ——

A

orthodontic movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

 Orthodontic treatment should be considered before

A

the frenectomy. - however, Wide and thick frenum may require removal prior to space closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Ankyloglossia

A
 “Tongue tie”
 Congenital oral anomaly characterized by an
abnormally short lingual frenulum
 Partial or complete
 Incidence: 0.02 - 10.7%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

 Anatomic indications: for ankyloglossia removal
 notching of the ———
 inability of the tongue tip to contact the ——
 restriction of ——- movement
 restriction of tongue protrusion beyond the ——-

A

protruding tongue tip

maxillary alveolar ridge

lateral tongue

mandibular alveolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Ankyloglossia
 —– is a safe procedure
 Treatment may improve ——-

A

Frenotomy

breastfeeding,
tongue mobility, and speech articulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Laser: Common Components

A

 ActiveMedium
 ExcitationMechanism
 HighReflectanceMirror
 PartiallyTransmissiveMirror

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

 ActiveMedium

A

 solidcrystals(rubyorNd:YAG)

 liquiddyes(gaseslikeCO2orHelium/Neon)  semiconductorssuchasGaAs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

 ExcitationMechanism

A

 Excitation mechanisms pump energy into the active medium by one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

 HighReflectanceMirror

A

 A mirror which reflects essentially 100% of the laser light.
or more of three basic methods; optical, electrical or chemical.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

 PartiallyTransmissiveMirror

A

 A mirror which reflects less than 100% of the laser light and
transmits the remainder (this is the LASER beam).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

 Technical difficulties
 Lack of precision in depth of cut
 Tissue not available for histopathology
 Hazardous
 Dispersal of viable virus particles in the plume

A

disadvantages of lasers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q
Periodontal applications - laser
 Soft tissue surgery ------
 ------- uncovery 
 Frenectomy?
 Uncovering ------
A

 Gingivectomy
Implant

soft tissue impactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Lasers for tooth exposure

 Indications

A

 Soft tissue impactions

 Hard tissue palatal impactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Lasers for tooth exposure

Contra-indications

A

 Hard tissue impactions with variable bone

thickness  Esthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

LANAP

A

 Laser Assisted New Attachment Procedure

not a ton of evidence for this, most of their claims can be countered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

LANAP - Basic concept:

A

 Remove sulcular epithelium
 Modify root surface
 New attachment will occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Lanap - protocol

A

1 pass of laser, SRP x 3, pass 2 of laser, periostat one week before and 3 months after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q
Photo Dynamic Therapy (PDT)
 Advantages
 Useful for -----
 ------ specific – since the photosensitizer can be formulated to target certain tissues (e.g. iodine-coupled dyes will target thyroid only)
 No ----- (for bacteria)
A

hard to reach areas (inject the sensitizer through
IV, then shine a light on the target tissue)

Tissue

antibiotic resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

PDT Disadvantages
 Wavelength of light is very narrow (630-700nm), so big ——–
 Light source configuration is cumbersome (think rigid instrument in narrow spaces)
 Photosensitivity can cause —– injuries

A

tumors (and deep pockets) cannot be penetrated

severe burn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

PDT not

A

FDA approved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Peri-implantitis does not seem to be treatable by

A

non-surgical means

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

PMT =

A

Periodontal MaintenanceTherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q
Rationale for PMT
• tooth loss ------- to SPT frequency
• reduced risk of future attachment loss despite -------
• monitoring
• plaque removal
A

inversely proportional

incomplete plaque removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Components of PMT appointment

A

assessment of personal oral hygiene (cleaning more or less)
• active treatment (root planing, occlusal appliance, antimicrobials, surgery)
- communication
• planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Frequency of PMT
• For most patients presenting with gingivitis but without history of attachment loss- performed on a —–

For patients with a history of periodontitis, PMT should be performed at intervals of less than — months - most commonly every ——.

A

semiannual basis

6

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

– poor plaque control =

A

no surgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

– single site =

A

nonsurgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

– continued inflammation =

A

surgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

– attachment loss =

A

S/RP + antibiotics or surgery

72
Q

– Increasing mobility =

A

occlusal adjustment

73
Q

Clinical Parameters Assessed During Maintenance with Implants

A
  • Tissue Health
  • Crevicular Fluid
  • Mobility and occlusion
74
Q
  • Blood clot or coagulum within the
A

first 24 hrs.

75
Q
  • Fibrinolysis within
A

1-3 days.

76
Q
  • Replacement of coagulum by granulation tissue

within

A

2-4 days.

77
Q
  • Vascular network is formed by the end of
A

week 1.

78
Q
  • Socket is covered with new connective tissue rich in vessels and inflammatory cells by
A

week 2.

79
Q
  • Soft tissue becomes keratinized by
A

week 4-6.

80
Q
  • Alveolus is filled with woven bone by
A

4-6 weeks.

81
Q
  • Mineral tissue is reinforced with layers of lamellar bone that is deposited on woven bone by
A

4-6 months

82
Q

*Significantly larger resorption in the —– in both maxilla and mandible.

A

buccal aspect of alveolus

83
Q

Tooth extraction and bone loss:

  • Loss in the horizontal dimension ..
  • Significant loss within —— following extraction
  • 40% of —–, 60% of —– within the first 6 months
  • Grafted versus non-grafted site..
A

5-7 mm within first year

8 weeks

height

width

1.2 versus 2.7 mm bone loss

84
Q

Bone defects:

Class I-

A

Extraction sockets

85
Q

Bone defects:

Class II and III-

A

Dehiscence defects

86
Q

Bone defects:

Class IV-

A

Horizontal defects

87
Q

Bone defects:

Class V-

A

Vertical defects

88
Q

Alveolar Ridge Preservation (ARP) is a ——– application at the time of tooth extraction to control ——–

A

guided bone regeneration (GBR)

bone resorption

89
Q

Guided Bone Regeneration (GBR) is Guided Tissue Regeneration (GTR) targeting specifically the regeneration of

A

already resorbed/lost bone

90
Q

Alveolar ridge preservation (ARP) Indicated After extractions to preserve original ridge dimensions and contours (hard and soft tissues), when ——-

A

immediate

implant placement is not possible.

91
Q

Contraindicaations to ARP

A

infection, immediate implant placement, soft tissue limitations

92
Q
  • Osteoconductive – acts as a ——
A

scaffold

93
Q
  • Osteoinductive – Stimulates the ——-
A

resident cells

94
Q

Autogenous graft materials

A

(osteogenic, osteoinductive and osteoconductive).

95
Q

Allografts

A

(osteoinductive and/or osteoconductive)

96
Q

Xenografts (mainly

A

osteoconductive)

97
Q

Synthetics

A

(fillers)

98
Q

*Extraoral and intraoral autogenous grafts-

A

Iliac cancellous bone and marrow

Bone obtained from maxillary tuberosity, extraction sites, or the osseous coagulum.

99
Q

Combined procedures

A

1- Non-absorbable membranes combined with bone grafts or synthetic grafts.
2- Absorbable membranes combined with bone grafts
3- Coronally positioned flaps combined with bone grafts.

100
Q

Factors affecting the outcome of

alveolar ridge preservation

A
  • Blood supply
  • Space maintenance
  • Membrane stability
  • Tension-free flap closure
101
Q

Compared to mandibular samples, maxillary samples had a lower percentage of —– and higher percentage of ————-

A

bone

residual material and vascularization

102
Q
  • ARP prevented —— following tooth

extraction in both maxilla and mandible.

A

ridge height loss

103
Q

Mean ridge width loss of ——mm in the maxilla

and ——-mm in mandible.

A
  1. 44±0.71

2. 54±0.5

104
Q

Higher percentage of immature tissue was noted in

———

A

mandible

105
Q
  • Micro CT analysis revealed greater mineralization per unit volume in ——- than in ———- in mandible (p=0.03).
A

newly forming bone

residual bone graft

106
Q

There was a higher rate of ——– in mandible following ARP, consistent with histologic and micro-CT analyses.

A

angiogenesis

107
Q

When placed in mature bone, an implant should have at least—-mm of
bone on all sides

A

1

108
Q

At least 7 mm of interocclusal (interarch) distance is needed from the top (shoulder) of the implant to the ——–

A

occlusal surface of the opposing tooth

109
Q

At least—– space between two adjacent implants and at least —— space between an implant and adjacent tooth.

A

3 mm

2-3 mm

110
Q

• Early placement: the implant is placed in a site where the

A

soft tissues have healed and a mucosa is covering the socket entrance.

111
Q

Late:

A

theimplantisplacedinanextractionsiteatwhich substantial amounts of new bone have formed in the socket.

112
Q

• Conventional:the implant placed in a

A

fully healed ridge

113
Q

Immediate implant placement • Disadvantages:

A
  • Site morphology may complicate optimal placement
  • Tissue biotype may compromise optimal outcome
  • Potential lack of keratinized mucosa for flap adaptation - Adjunctive surgical procedures may be required
  • Technique-sensitive procedure
114
Q

Immediate implant placement • advantages:

A
  • Less surgeries
  • Less overall treatment time
  • Optimal use of available/existing bone
115
Q

Implant placement in a fresh extraction socket may ——– physiologic modeling/ remodeling that occurs following tooth extraction

A

not prevent the

116
Q

Buccalportionoftheimplantgraduallylosesitshard tissue coverage, and the metal surface may become visible through a thin peri-implant mucosa with

A

immediate implant placement

117
Q

Early Implant Placement
• Advantages:
- Easier ——–
- Allows resolution of ——

A

flap adaptation

local pathology

118
Q
Early implant placement
• Disadvantages:
- Site morphology may complicate ------
- Longer ------ time
- Varying amount of --------- at socket walls
- Adjunctive -------- may be necessary
- Technique-sensitive procedure
A

optimal placement

treatment

bone resorption

surgical procedures

119
Q

With early and immediate - • Insiteswheretheavailableboneheightapicalto the socket is less than ——- it is frequently impossible to obtain primary implant stability.

A

3 mm,

120
Q

———- plays major role in immediate and early implant placement indications

A

Softtissuebiotype

121
Q

For immediate/early - • ——-socket walls have to be intact with/without a dehiscence or fenestration on buccal wall.

A

Threeoutoffour

122
Q

Late implant placement (typically >16 weeks)
• Advantages:
- Clinically healed ridge
- Mature soft tissues; easier —————
• Disadvantages:
- Increased treatment time
- Adjunctive surgical procedures may be required
- Large variation in available ——-

A

flap management

bone volume (increased bone loss with longer waiting time)

123
Q

• Theratefornewboneformationdecreasedafter——-months of healing.

A

3-4

124
Q

Two piece (——) versus one piece (——-) implants

A

submerged

non-submerged

125
Q

One-stagesurgicalprotocol:

The mucosal flap can be adapted to the

A

neck

(healing cap) of the implant

126
Q

Two-stagesurgicalprotocol:

The mucosal flap is sutured on top of

A

implant (cover screw) obtaining primary wound closure.

127
Q

Disadvantages of one-stage implant placement:
- Exposure to oral cavity during ——– period

- Difficult to control loading especially with removable temporary restoration

A

osseointegration

128
Q

Apicocoronally, the implant shoulder should be placed about—– apical to CEJ of the adjacent teeth in patients without gingival recession.

A

2 mm

129
Q

• Full thickness flap elevation with special incision designs to preserve papilla and/or keratinized mucosa for

A

implant placement - single tooth

130
Q

Implants - • Minimum of —- buccal bone thickness

• Minimum of —– interproximal bone thickness

A

2 mm

131
Q

Multiple Unit Implant Supported Restoration

  • Implants have to be —– to each other.
  • At least —– bone thickness should exist between two implants.
  • Apical-coronally, implants should be placed at the same —–
  • Buccal-lingually implants should be in harmony by leaving enough buccal space for —– work but not positioned to —– which would cause major cantilever or cross-bite type occlusion.
  • Angulation of the implants compared to —— should be minimal.
A

parallel

3 mm

level (sinked into bone about the same amount).

metal-ceramic

lingual

occlusal plate

132
Q
  • ———– is difficult to achieve and related surgical techniques lack prospective clinical long-term documentation.
A

Vertical bone augmentation

133
Q

——- cannot predictably be re-established

A

Inter-implant papillae

134
Q

• —— screw secures the prosthesis to the

abutment.

A

Prosthetic retention (if not cement retained)

135
Q

: Inflammatory reactions associated with loss of supporting bone around an implant in function

A

Peri-implantitis

136
Q

A reversible inflammatory reaction in the soft tissues surrounding a functioning implant

A

Peri-implant mucositis:

137
Q

Ailing implant

A

Peri-implant mucositis

138
Q

Failing implant to failed implant

A

Peri-implantitis

139
Q

Treatment of failing implants

A

• Resolve inflammation
– debride plaque
– Improve oral hygiene
– adjunctive antibiotics as indicated
• Correct unfavorable soft tissue morphology (pseudopockets) by flap surgery or gingivectomy
• Re-osseointegration - decontaminate implant surface with citric acid or tetracycline solutions, guided bone regeneration

140
Q

Periimplantitis

Class 1

A

Slight horizontal bone loss with minimal peri- implant defects

141
Q

Periimplantitis

Class 2

A

Moderate horizontal bone loss with isolated vertical defects

142
Q

Periimplantitis

Class 3

A

Moderate to advanced horizontal bone loss with broad, circular bony defects

143
Q

Periimplantitis

Class 4

A

Advanced horizontal bone loss with broad, circumferential vertical defects, as well as loss of the oral and/or vestibular bony wall

144
Q

Peri implantitis Class 1

Treatment protocols

A
  • Surgical reduction of pocket depth, thinning of mucosal flaps and apical repositioning of flaps at a bone edge level, using the corresponding suture technique.
  • The implant surface is cleaned and decontaminated.
  • Implantoplasty is only performed if threads are exposed.
145
Q

Peri implantitis Class 2 treatment protocols

A
  • Similar to class 1, but repositioning is performed more apically, leaving more implant surface exposed, thus requiring an implantoplasty.
  • If local vertical resorption has three or more walls, this bone defect is restored using classical GTR techniques.
  • In cases where the defect involves one or two walls, osteoplasty or bone leveling is performed to favor soft tissue repositioning, to fulfill self-cleaning criteria.
146
Q

Peri implantitis Class 3+4 treatment protocols

Class 3 and 4

A

• In peri-implantitis class 3 and 4, the presence of vertical defects almost always requires the use of GTR techniques.

147
Q

Human BMP-2 (INFUSE®)
• Action: stimulation of bone formation via ———
• With INFUSE, rhBMP-2 powder is mixed with sterile water and applied to ——

A

recombinant human bone morphogenetic protein-2

collagen sponges

148
Q

Plastic probes used when checking around

A

implants

149
Q

Prophy paste and a rubber cup on a prophy head / handpiece can be used to polish —— when removal is not indicated

A

implant bars

150
Q

Plastic scalers are appropriate for cleaning around ——- supporting implant bar substructures, —— and implant supported —– restorations.

A

standard abutments

hybrid prostheses

splinted

151
Q

ANUG: Early Clinical Signs

A
  • Necrotic lesion of the papilla initially then progressing to gingival margin. Punched-out appearance
  • Spontaneous bleeding
  • Pain
152
Q
ANUG: Advanced Lesion
• Lack of -------
• Merging of -------- involvement
• Characteristic -----
• Central necrosis results in -------
A

deep pockets

papillary and marginal

foetor

crater formation

153
Q

ANUG: Other Findings

A
  • Fever and malaise. Moderate elevation of temperature can be observed
  • Poor oral hygiene.
  • White membrane of desquamated cells, bacteria, saliva proteins.
  • Membrane can be easily removed
154
Q

ANUG microbiology

A

TypicalfloraincludesTreponemasp.,Selenomonassp., Fusobacterium sp., and Provetella intermedia.
– Somespecies(Treponemasp.;P.intermedia)invadetissue and release endotoxins

155
Q

Treatment of ANUG
• Alleviation of the acute inflammation by reducing the —— and removal of ——-
• Treatment of chronic disease either underlying the ——- or elsewhere in the oral cavity
• Alleviation of generalized symptoms such as fever and malaise
• Correction of systemic conditions that contribute to the initiation or progression of gingival changes

A

bacterial load

necrotic tissue

acute involvement

156
Q

Gingival Abscess

A

– A localized purulent infection that involves the marginal gingiva or interdental papilla

157
Q

• Pericoronal Abscess

A

– A localized purulent infection within the tissue surrounding the
crown of a partially erupted tooth. • Periodontal Abscess
– A localized purulent infection within the tissues adjacent to the periodontal pocket that may lead to destruction of periodontal ligament and alveolar bone.

158
Q

• Periapical Abscess

A

– Inflammatory condition characterized by formation of purulent exudate involving the dental pulp remnants and the tissue surrounding the apex of the tooth.

159
Q

Gingival Abscesses

• Treatment

A

– Removal of noxious agent(s)
– Incision and drainage (if necessary) – Antibiotics are contraindicated
– Home care: rinse with warm NaCl H20

160
Q

Pericoronal Abscesses

• Treatment

A
– Removal of noxious agent(s)
– Irrigation under soft tissue operculum – Systemic complications: antibiotics
– Home care: rinse with warm NaCl H
O – When infection under control:
• Extraction
• Operculectomy
161
Q

Peri-Apical Abscesses

• Treatment

A

– Removal of tooth – Root canal therapy

162
Q

Periodontal Abscesses • Types

A

– Periodontitis-related

– Non-periodontitis-related

163
Q
– Periodontitis-related
• Acute infection as the result of ----
in a deep periodontal pocket
– Non-periodontitis-related
• Acute infection from bacteria originating from -------
A

subgingival bioflim

another source - e.g., foreign body impaction

164
Q

Periodontal Abscesses • Treatment

A
– Drainage through pocket retraction or incision
– Scaling and root planing
– Periodontal surgery
– Systemic complications: antibiotics*
– Extraction
165
Q

 Excluding third molars, the frequency of impaction is as follows:

A
 MAXILLARY CANINE
 Mandibular 1st premolar
 Mandibular 2nd premolar
 Mandibular canine
 Maxillary premolars
166
Q

Estimated incidence of maxillary canine impaction is

A

~2%.

167
Q

—of patients with impacted canines have bilateral impactions.

A

8%

168
Q

 Several local factors may become an obstacle to the normal eruption process:

A

 Failure of deciduous tooth roots to resorb
 Abnormal position (eruptive path)
 Supernumerary tooth
 Tooth crowding
Dentigerous cyst (enlarged dental follicle)
 Thickened oral soft tissues (genetics, trauma)  Oral soft tissue pathology
 Hard tissue pathology (odontoma)
 Premature extraction of deciduous teeth

169
Q

Systemic factors may also affect the normal eruption process:

A

 Childhood diseases  Hereditary factors  Genetic syndromes

170
Q

Surgical Techniques

 Open eruption.

A

 Window technique.

 Apically positioned flap technique.

171
Q

Techniques -  Closed eruption.

A

 Flap elevated, orthodontic appliance applied, flap closed.

172
Q

Open Eruption Approach
 Advantages:
 If bonding of bracket/chain fails, ——–

 Disadvantages:
 Greater ------- 
 Interference with -------
 Delayed --------
 Bone exposure
A

no
additional surgery needed

discomfort (pain, bad taste)

function (eating)

healing (secondary intention) 

173
Q

 —— movement of teeth did not lead to gingival recession

A

Labial

174
Q

—— out of alveolar bone may be associated with higher tendency for developing gingival recession.

A

Incisor movement

175
Q

Ortho Tx in Perio Patient

 Key Considerations:

A

 Eliminate or reduce plaque accumulation  Eliminate or reduce gingival inflammation

176
Q

 PRE-ORTHO TX

A

 Tooth exposure  Root coverage  Frenectomy
 PAO
 Periodontally-
accelerated orthodontics  Implants for anchorage

177
Q

POST-ORTHO TX

A

 Fiberotomy
 Frenectomy
 Gingivectomy
 Root coverage