Sweep 3 Flashcards
Contraindications to gingivectomy - one of them is to not extend beyond MGJ - because
this is beyond keratinized tissue, you will be in mucosa if you do this.
Suprabony pocket
attachment loss, soft tissue issue however
partial thickness good for
soft tissue grafting (blood supply still on PDL)
Coronallypositionedflaps
(needtoelevate past MGJ; do not need to do significant scalloped incisions)
- Laterallypositionedflaps
needtoelevatepast MGJ)
It is not possible to perform an apically positioned flap on the
palate.
Expected conservative flaps
Expected outcome = pocket reduction through resolution of inflammation and LJE
faster epithelial migration along the inner surface of the wound resulting in a
LJE interface
- Debridement by
inflammatory cells.
- Regeneration of
parenchymal cells.
- Migration and proliferation of
parenchymal and connective tissue cells.
More than 70% bone loss around root, better to extract than
osseous surgery.
Osseous defects can be regenerated in most
Class II, most 3 wall defects, some 2 wall defects.
The goal in Periodontal Regeneration is
new attachment (“true” new attachment
Apically positioned flap:
*can move soft tissue apically without removing it.
Note: 6-8 weeks healing time necessary prior to final impressions
Ridge Augmentation
• Preparation of a pontic area:
The best approaches are
onlay grafting and
submucosal connective tissue grafting
The best approach is the hard tissue augmentation procedure
• Coronally positioned
– For regeneration or root coverage
Mod widman flap
cut in front of sulcus, in sulcus, perpendicular to sulcus to remove that tissue.
Epithelial healing requires ——–, and healing is complete in ———. Bone resorption and attachment loss are common.
7 to 14 days
6 to 7 weeks
Less post surgical bone resorption due to increased cancellous bone
palatal approach
Electrosurgery ⇒ cauterizes, but lose
tactile feedback (potential osteonecrosis if burn root)
o Resection (both hard & soft tissue)’
• Elimination of periodontal pockets (can remove outer moat defect)
With partial thickness flaps, o Suture gingiva so
mucogingival jxn positioned apically
In partial thickness flaps, o Exposed coronal CT directs
epithelial formation
