provide access to remove residual calculus create a stable/maintainable state promote regeneration
What is the most important factor for determining if a pocket is progressive?
Level of attachment! (We want to examine he apical displacement of attachment and not the increase in PD)
When should you never perform perio surgery?
When the gums are highly inflamed OR when the periodontitis is minimal. (moderate and up is ok)
What are the 4 critical zones of pocket therapy?
Soft tissue wall Tooth surface Underlying bone attached gingiva
List two disadvantages of non-surgical therapy
Incomplete root preparation, root damage from over instrumentation, time consuming and limited access/regen (any 2)
The indications for periodontal surgery are (5)
1 Areas with irregular bony contours 2 pockets that do not allow adequate debridement 3 Grade 2 or 3 furcation involvement 4 Intrabony pockets distal to terminal molars 5 Persistent inflammation in areas of moderate to deep pockets
When planning an incision on narrow attached gingiva, which incision type should be used?
When planning an incision on wide attached gingiva, which incision type should be used?
Collar of tissue
T/F the routine use of prophylactic antibiotics in healthy patients is not warranted when grafting
T/F Ibuprofen before an appointment is an okay idea
What should your patient do before the appointment?
Rinse with peridex
Your patient quits smoking before your gum surgery. When can he smoke again?
T/F Anticoagulants and hypertension are contraindications to perio surgery
What is in the historical periodontal dressing pack?
What is in a non eugenol pack?
What is the fungicide inside the CoE Pak?
What is the antibiotic in the CoE-pak?
T/F the coe-pak contains coconut
A Schluger isn't a pistol it's a ....
T/F Horizontal defects are conducive to regeneration
False. Use resective
Speaking of horizontal incisions, when would you use an external bevel
When would you use an internal bevel
What does an internal bevel incision do?
Removes pocket epithelium
When would you use a sulcular incision?
What instrument would you use to do a horizontal collar releasing incision?
Surgical curette or Orban
You're exploring the edentulous ridge of a patient looking for bony defects. What incision do you use?
You're starting a vertical incision. Where do you make your cut?
Made at the line angle of the tooth (NOT mid papilla or mid tooth)
T/F envelope flaps have vertical release?
What instrument is used for a full thickness flap?
What is the difference between a full and partial thickness flap?
Full thickness includes the periosteum
T/F use a #15 blade if you want to do a partial thickness flap
What is 1 advantage of a partial thickness flap
it is more moveable without the periosteum
When might you do an apically positioned flap?
Resective surgery for pocket reduction, crown lengthening.
Two objectives of osseous surgery
Reduce perio pocket depth Produce gingival morphology that mimics normal to facilitate OH
Three indications for Osseous surgery
Reduction of ledges, exotoses and tori Reduction of SHALLOW bony defects Enhance flap placement and adaptation Increase clinical crown length
If designing a flap in a deep palatal vault, where do you make your incision?
At the level of the base of the pocket
If designing a flap in a shallow palatal vault, where do you make your incision?
Close to the gingival margin
Recession in the anterior sextant creates what
The shape of the interdental radicular bone of anterior teeth is
The average distance from CEJ to furcation on maxillary molars ranges from
What type of incision is done for open flap debridement?
For open flap debridement, do you need a full or partial thickness flap?
Which procedure "buy's time" for a tooth with poor prognosis and horizontal bone loss?