week 11 and 9 Flashcards
Laser stands for?
absored vs not
Light Amplification by Stimulated Emission of Radiation
absorbed= ablation
not well absored= scattered and charring/melting
common dental lasers
CO2, Nd:YAG, Er:YAG, GaAs (diode)
Regeneration
healing occurs through reconstitution of a new periodontium (alveolar bone, PDL, cementum) THE GOAL
repair
healing by replacement with epithelial and/or connective tissue that matures into nonfunctional types of scar tissue (new attachment)
reconstructive surgical techniques
1) non-graft
2) graft associated/combined therapy (GTR +bone graft)
3) biologic mediator
non-graft reconstructive surgical technique
- GTR – guided tissue regeneration, originally a non-graft-associated procedure but now mostly used with graft (USA)
• LANAP – laser-assisted new attachment procedure (controversial and need bootcamp)
graft associated/combined therapy (GTR +bone graft) reconstructive surgical technique
- autografts
- allografts – FDBA, DFDBA
- xenografts - BioOss
biologic mediator reconstructive surgical technique
Tissue engineering: wound healing process is manipulated so that tissue
regeneration occurs
two options:
* Enamel Matrix Derivative (EMD) (Emdogain)
• Platelet-derived growth factor (rhPDGF)
GTR – guided tissue regeneration
objectives: 1) prevent epithelial migration into site, 2) maintain
space for clot stabilization
*Favors repopulation of area by
PDL and bone cells (which develop more slowly than epithelium)
Osteogenic vs Osteoconductive vs Osteoinductive
Osteogenic: formation or development of new bone by cells contained in the graft
Osteoconductive: material that functions as physical scaffold that favors outside
cells to penetrate and form new bone
Osteoinductive: material that allows a chemical process to occur that converts
neighboring cells into osteoblasts
autografts
1) intraoral sites with osseous coagulum or bone blend
2) bone marrow transplants from MX tuberosity or healing extraction sites
3) bone swaging- edentulous area is pushed into defect without fracturing bone
4) extraoral sites are tibia and iliac crest
Osseous coagulum vs Bone blend
Osseous coagulum – “bone dust” and blood, uses small particles ground from cortical bone, small particle size yields increased surface area for cellular/vascular interaction
Bone blend – autoclaved plastic capsule and pestle, bone triturated in capsule to packable mass
allografts: FDBA vs DFBA
FDBA: freeze-dried bone allograft
• osteoconductive
* hot magnet for bacteria, must take out if graft is exposed
DFDBA: demineralized freeze-dried bone allograft, preferred over FDBA (PREFERRED- doesn’t need taking out if exposed)
• Osteoinductive
• Demineralization in hydrochloric acid exposes molecules called bone morphogenic proteins
(BMPs)
• Cannot see on radiographs immediately postop (problem for direct/indirect sinus lifts)
EMD – enamel matrix derivative (Emdogain)
comparable to GTR
Concern remains about whether commercial batches of EMD will be consistent and comparable- conflicting studies
what is OFD?
Open flap debrivment
* everything better than this*
