Periodontitis Bone Defects
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Questions and Answers

The prognosis of furcation-involved teeth can be improved by traditional surgical therapy.

False (B)

Regenerative periodontal therapy can be successfully used to treat 'hopeless' teeth with deep vertical defects.

True (A)

The stability of new attachment gained through guided tissue regeneration (GTR) procedures cannot be maintained long term.

False (B)

Poor oral hygiene is a factor that can lead to attachment loss.

<p>True (A)</p> Signup and view all the answers

The long-term effects of periodontal regeneration are still unknown.

<p>False (B)</p> Signup and view all the answers

Cigarette smoking is not a risk factor for attachment loss.

<p>False (B)</p> Signup and view all the answers

Regenerative periodontal therapy can only be used for teeth with minimal damage.

<p>False (B)</p> Signup and view all the answers

The prognosis of a tooth can be changed from 'questionable' to 'favorable' with regenerative periodontal therapy.

<p>True (A)</p> Signup and view all the answers

A one-wall defect is a type of bone defect that occurs in the interproximal space.

<p>True (A)</p> Signup and view all the answers

Radiographs are the primary method of diagnosing periodontal bone defects.

<p>False (B)</p> Signup and view all the answers

Furcation involvement is a type of periodontal bone defect.

<p>True (A)</p> Signup and view all the answers

A good knowledge of anatomy is not necessary for diagnosing periodontal bone defects.

<p>False (B)</p> Signup and view all the answers

Radiographs can provide information about the morphology of interradicular bone resorption.

<p>True (A)</p> Signup and view all the answers

Periodontal treatment always results in recession of the gingival margin after healing.

<p>True (A)</p> Signup and view all the answers

Regenerative surgical procedures are used to eradicate bone defects.

<p>False (B)</p> Signup and view all the answers

The indication for applying regenerative periodontal therapy is solely based on esthetic considerations.

<p>False (B)</p> Signup and view all the answers

Periodontal ligament cells can differentiate to osteoblasts to form new bone and to cementoblasts to form new cementum during the healing process after periodontal surgery.

<p>True (A)</p> Signup and view all the answers

Guided tissue regeneration involves the placement of a physical barrier to prevent the migration of periodontal ligament cells.

<p>False (B)</p> Signup and view all the answers

Non-resorbable membranes are no longer used in periodontal therapy.

<p>True (A)</p> Signup and view all the answers

Polytetrafluoroethylene (PTFE) membranes are effective in maxillary molar furcation problems.

<p>False (B)</p> Signup and view all the answers

Resorbable membranes are made of collagen, polylactic acid, or polyglycolic acid.

<p>True (A)</p> Signup and view all the answers

Titanium-supported non-resorbable membranes are preferred for small intrabony defects.

<p>False (B)</p> Signup and view all the answers

Collagen for bioabsorbable membranes is obtained from human sources.

<p>False (B)</p> Signup and view all the answers

A second surgical intervention is not necessary when using resorbable membranes.

<p>True (A)</p> Signup and view all the answers

Grafting materials in periodontal bony defects can be classified according to their function in healing into only two categories.

<p>False (B)</p> Signup and view all the answers

Osteoconductive grafting materials contribute to new bone formation per se.

<p>False (B)</p> Signup and view all the answers

Scaling of teeth before surgery is not necessary in all grafting procedures.

<p>False (B)</p> Signup and view all the answers

The papilla preservation method is not recommended for flap technique in periodontal surgery.

<p>False (B)</p> Signup and view all the answers

Autogenous grafts are not considered to be the gold standard in periodontal treatment.

<p>False (B)</p> Signup and view all the answers

Autogenous grafts can only be harvested from intraoral sites.

<p>False (B)</p> Signup and view all the answers

Block grafts are preferred over small bony chips in periodontal surgery.

<p>False (B)</p> Signup and view all the answers

The use of hip marrow (iliac crest marrow) is a commonly preferred approach in periodontal regenerative surgery.

<p>False (B)</p> Signup and view all the answers

Barrier membranes must be trimmed after placement.

<p>True (A)</p> Signup and view all the answers

Periodontal regeneration can only be used to treat class II furcation defects.

<p>False (B)</p> Signup and view all the answers

Root surface biomodification alone can provide more favorable treatment results than GTR alone.

<p>False (B)</p> Signup and view all the answers

Good oral hygiene and infection control are not necessary for long-term maintenance of periodontal regeneration.

<p>False (B)</p> Signup and view all the answers

Barrier membranes should allow the passage of undesirable cell types into the healing area.

<p>False (B)</p> Signup and view all the answers

Second surgery is always necessary after the initial treatment.

<p>False (B)</p> Signup and view all the answers

Treatment with flap surgery alone can provide better treatment results than treatment with flap surgery + barrier membranes + graft materials.

<p>False (B)</p> Signup and view all the answers

Periodontal regeneration has not demonstrated significant clinical improvements in intrabony defects and furcation problems.

<p>False (B)</p> Signup and view all the answers

Flashcards

Periodontal Bone Defects

Spaces between adjacent teeth roots where bone loss occurs. Classified by walls (one-wall, two-wall, three-wall).

Radiographic Evaluation

Using X-rays to assess bone loss and attachment levels in teeth.

Interproximal Craters

A type of periodontal bone defect, characterized by a crater-like shape.

Regenerative Periodontal Therapy

Restores lost periodontal tissue in bone defects.

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Clinical Indications for Regeneration

Treating teeth with furcations (problem areas), protecting aesthetics, improving function/prognosis.

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Attachment Levels

Distance from the bone to the tooth's cementum, a critical diagnosis factor.

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Guided Tissue Regeneration (GTR)

Using barriers to encourage new tissue growth in the periodontal area.

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Bone Grafts (Autogenous)

Bone grafts from the patient's body, the gold standard.

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Osteoproliferative Grafts

Bone grafts that enhance bone growth.

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Osseoconductive Grafts

Grafts that act as a pathway for bone growth.

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Osteoincuctive Grafts

Grafts that induce bone cell growth.

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Barrier Membranes

Physical barriers placed to guide new tissue growth.

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Resorbable Membranes

Membranes that break down naturally over time.

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Non-resorbable Membranes

Membranes that remain in the body for longer periods.

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Long-term Effects

Clinical improvements remain after periodontal regeneration.

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Support Periodontal Care

Ongoing care to maintain healthy gums & teeth.

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Poor oral hygiene

Lack of adequate oral care.

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Cigarette Smoking

A significant risk factor for gum disease.

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Furcation Involvement

Bone loss around the area where the roots come together.

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Parallel Technique

X-ray technique used for accurate measurement of bone level.

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Flap Surgery

Surgical procedure to access the periodontal tissue and bone.

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Root Surface Biomodification

Treatments to improve the surface of the tooth root to reduce infection.

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Study Notes

Periodontal Bone Defects

  • Occur between two adjacent roots, typically in narrow interproximal spaces
  • Classified as one-wall, two-wall, or three-wall defects, or interproximal craters
  • Identification mainly based on morphology after raising a periodontal flap, rather than radiographic evaluation

Diagnosis and Radiographs

  • Radiographs taken with parallel technique and good diagnostic quality help with diagnosis
  • Information about attachment levels is crucial for proper diagnosis
  • Radiographs of good diagnostic quality provide information about interradicular bone resorption

Clinical Indications of Regenerative Periodontal Therapy

  • Prevent poor esthetics in anterior areas of the dentition
  • Improve function or long-term prognosis of treated teeth
  • Indicated for furcation-involved teeth, especially when the furcation area is inaccessible to adequate instrumentation

Regenerative Periodontal Therapy

  • Can restore lost periodontal attachment in bone defects
  • Can improve long-term prognosis of furcation-involved teeth
  • Can be successful in treating "hopeless" teeth with deep vertical defects or through-and-through furcations

Long-term Effects and Benefits of Regeneration

  • Clinical research indicates that attachment level gains can be maintained on a long-term basis
  • Stability of new attachment gained through guided tissue regeneration (GTR) procedures can be maintained
  • Risk factors for attachment loss include poor compliance with supportive periodontal care, poor oral hygiene, and cigarette smoking

Grafting Materials

  • Classified into osteoproliferative, osteoconductive, and osteoinductive materials
  • Autogenous grafts are considered the gold standard in periodontal treatment, promoting bone healing through osteogenesis and/or osteoconduction

Autogenous Grafts

  • Can be harvested from intraoral and extraoral sites
  • Common sources include edentulous areas of the jaw, healing extraction sites, maxillary tuberosities, or the mandibular retromolar area

Guided Tissue Regeneration (GTR)

  • Involves the placement of a physical barrier to ensure that the periodontitis-affected root surface becomes repopulated by cells from the periodontal ligament
  • Typically performed in combination with bone grafting materials
  • Membranes used can be resorbable or non-resorbable, with titanium-supported non-resorbable membranes preferred for large intrabony defects or implants

Barrier Membranes

  • Must meet certain criteria, including biocompatibility, ability to act as a barrier, and ease of trimming and placement
  • Resorbable membranes are made of collagen, polylactic acid, or polyglycolic acid, and are preferred to avoid the need for a second surgical intervention

Clinical Outcomes

  • Periodontal regeneration has demonstrated significant clinical improvements in intrabony defects and furcation problems
  • Treatment with flap surgery, barrier membranes, and graft materials provides better treatment results than flap surgery alone
  • Combined use of root surface biomodification and GTR provides more favorable treatment results

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Description

Identify and classify periodontitis bone defects, including one-wall, two-wall, and three-wall defects, and interproximal craters.

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