W2 - Surgical Perio Therapy Part 1 - Sharma Flashcards
How can prognosis of the periodontically involved tooth be improved? (3)
- Create accessibility for effective debridement
- Improve gingival or tooth morphology to improve pt self-care
- Regenerate lost periodontal attachment
What is the True End point of periodontal therapy VS Surrogate end points?
True End point: Prevention of tooth loss
Surrogate end points: No BOP, pocket “closure” (<4mm)
What are some relative medical contraindications to perio surgery? (4)
Relative bc you can still do perio surgery, just be cautious. Very few conditions exist where surgery should not commence
- Bleeding disorders (haemophilia, anticoagulants)
- Poorly contolled diabetes
- Uncontrolled hypertension
- Immunocompromised patients (leukemia, pt taking cyclosporin)
Wall defect card
What are the 4 possible pocket therapy results
- Recurrence of pocket
- Root resorption / ankylosis
- Long junctional epithelium
- New attahcment: regeneration GTR
What is the most common pocket therapy result? Why?
Long junctional epithelium
- they are the fastest growing cells
Indications for Periodontal Surgery (6)
- Irregular bony contours / structure
- Persistent inflammation in moderate-deep pockets
- Deep pockets on teeth where complete removal of root irritants is not clinically possible (posterior)
- Grade II or III furcation
- Infrabony pockets on distal surfaces of last molars causing irritation (pericoronitis)
- Areas with shallow pockets but persistent inflammation due to mucogingival problem
List 5 examples of hemostasis products
- Gelfoam
- Oxycel
- Surgicel absorbable hemostat
- CollaCote/CollaTape/CollaPlug
- Thrombostat
Kirkland knife used for gingivectomy
Orban (interdental) knife
Periosteal elevator
What are the 6 types of incisions in periodontal surgery?
- External bevel
- Internal bevel
- Sulcular
- Releasing
- Cutback
- Periosteal
What is an external bevel and what is it used for?
Coronally directed incision
- Used for gingivectomy, crown lengthening
- to remove height of soft tissue
What is an internal bevel and what is it used for?
Apically directed incision
- Removes thickness but not height, height remains the same
- Excisional new attachment procedure, flaps, gingival enlargement
What is a sulcular incision and what is it used for?
Apically directed incision, placed in gingival crevice and directed toward alveolar crest
- Used when preservation of gingiva is critical (aesthetic areas or guided tissue regeneration procedures)