Periodontology Furcation Defects Flashcards

Questions and Answers

What does ILOs stand for?

Competent at completing and charting a comprehensive periodontal/peri-implant examination.

What is the definition of a furcation defect?

A lesion within the interadicular area of multi-rooted teeth.

What are the 3 Hamp classifications of furcation defect?

Class I, Class II, Class III.

What impact does the combination of bone grafts and guided tissue regeneration (GTR) have on the outcome of furcation treatment?

Higher clinical improvements. Signup and view all the answers

What does periodontal regeneration consist of?

New cementum, a functionally oriented periodontal ligament, and alveolar bone. Signup and view all the answers

What is the only way of confirming periodontal regeneration has occurred?

By taking a tissue sample and histologically analyzing it. Signup and view all the answers

What are the 6 clinical factors that affect the healing process of furcation defect treatment?

Site Selection, Patient selection, Gingival phenotype, Gingival recession, Exposure of membrane/infection, Initial pocket depth. Signup and view all the answers

What are the 3 patient factors that affect the healing process of furcation defect treatment?

Oral hygiene, Compliance, Smoking. Signup and view all the answers

What clinical factors affect the outcome of furcation defect treatment?

Morphology of the defect, Soft tissue management, Space maintenance. Signup and view all the answers

What treatment is indicated for class 1 furcation defects?

Non-surgical therapy. Signup and view all the answers

What treatments are indicated for class 2 furcation defects with interproximal bone apical to the furcation entrance?

Resective surgery, apically repositioned flap, tunnel, root amputation or hemisection. Signup and view all the answers

What treatments are indicated for class 2 furcation defects with interproximal bone coronal to the furcation entrance?

Regenerative therapy, grafting materials, biologics, bone substitutes, membrane. Signup and view all the answers

What treatments are indicated for class 3 furcation defects with a wide keratinized width?

Resective surgery, gingivectomy, tunnel, root amputation or hemisection. Signup and view all the answers

What treatment is indicated for class 3 furcation defects with a narrow keratinized width?

Resective surgery, apically positioned flap. Signup and view all the answers

What factors indicate a good prognosis after regenerative periodontal therapy in class 2 furcation cases?

Minimal gingival recession, narrow defects, furcation entrance below the mesial and distal bone. Signup and view all the answers

Is partial closure a realistic aim of treatment?

Yes, conversion of a class II into a class I. Signup and view all the answers

Currently, is regeneration of class III defects possible?

No, only resective surgery. Signup and view all the answers

What is the ideal aim of treatment of class 2 furcation defects?

Partial closure of the defect by tissue regeneration. Signup and view all the answers

What percentage is set to determine if periodontal disease is localized or generalized?

30% Signup and view all the answers

What are the therapeutic goals of periodontal treatment?

Periodontal stability, treat infection, eliminate bleeding on probing, pocket reduction. Signup and view all the answers

Why can bitewings not be used to diagnose periodontal disease?

Cannot see the full length of the tooth/roots, therefore cannot calculate % bone loss. Signup and view all the answers

What is a prerequisite of the patient before engaging in periodontal surgery/treatment?

Extremely good compliance, engagement, and well-maintained oral hygiene. Signup and view all the answers

Why can class 2 defects be harder to manage than class 3?

Cannot clean class 2 defects as easily as class 3 with single tufted brushes. Signup and view all the answers

What special investigations should you carry out prior to any periodontal treatment?

Full mouth periapical assessment, radiographic evaluation. Signup and view all the answers

How may furcation defects result in pulpal involvement/insult?

Via accessory canals. Signup and view all the answers

What do you do with correct band, excess, and insufficient keratinized tissue?

Correct band: conserve, Excess: gingivectomy/gingivoplasty, Insufficient: graft. Signup and view all the answers

What is the 3-phase technique for surgical crown lengthening?

Incision, degranulation and osteotomy/ostectomy, sutures. Signup and view all the answers

For anterior teeth, when making the incision for crown lengthening, what thickness should the flap be?

Full thickness flap. Signup and view all the answers

What combination of instruments do you use in phase 2 of surgical crown lengthening?

Ultrasonics and hand instruments. Signup and view all the answers

When do sutures need to be removed post-surgery?

7-10 days post-surgery if not resorbable. Signup and view all the answers

Study Notes

Furcation Defects Overview

ILOs refer to competencies in conducting comprehensive periodontal examinations, including charting furcation involvement and managing associated lesions.
A furcation defect is defined as a lesion located in the interadicular area of multi-rooted teeth.

Classification of Furcation Defects

Hamp classification categorizes defects into classes:
- Class I: Horizontal loss within 1/3 of tooth's width.
- Class II: Bone loss varies; may require resective surgery or regenerative therapy depending on bone position.
- Class III: Complete involvement; management varies based on keratinized width.

Treatment Modalities and Outcomes

Class I defects are typically treated with non-surgical therapy.
Class II defects with interproximal bone apical to the furcation may necessitate resective surgery (e.g., tunnel approaches, root amputation).
Class II defects with interproximal bone coronal to the furcation can benefit from regenerative therapies like grafting materials and membranes.
Class III defects may require resective surgery or apically positioned flaps based on keratinized tissue availability.

Regeneration and Healing Factors

Periodontal regeneration involves forming new cementum, functional periodontal ligament, and alveolar bone.
Successful regeneration is confirmed via histological analysis.
Clinical factors impacting healing include selection of treatment site, patient compliance, gingival phenotype, recession, and initial pocket depth.

Prognostic Indicators for Treatment Success

Good prognosis for class II defects linked to factors such as minimal gingival recession, narrow defects, and furcation entrance below the surrounding bone.
Partial closure of defects (from Class II to I) is a realistic treatment goal.
Regeneration of Class III defects is generally not feasible; focus remains on resective methods.

Therapies and Clinical Goals

Therapeutic goals for periodontal treatment include achieving stability, infection control, reducing bleeding, and pocket reduction.
A thorough radiographic evaluation, such as a full mouth periapical assessment, is crucial before any treatment.
Proper management of associated factors, including maintenance of keratinized tissue, significantly influences treatment outcomes.

Clinical Health Definitions

Pristine periodontal health: No bleeding on probing, normal sulcus depth, and controlled modifying factors.
Gingivitis: Presence of bleeding on probing with normal sulcus depth and bone height.
Periodontitis: Defined by depth of pockets and associated bleeding, with stability or remission categorized based on control of modifying factors.

Surgical Techniques and Considerations

Surgical techniques like crown lengthening involve multi-phase approaches: incision, degranulation, and suturing, with attention to maintaining tissue integrity and aesthetics.
Specific techniques, such as full thickness versus split thickness flaps in anterior and posterior teeth, cater to varying clinical presentations.
Healing is influenced by factors like tissue phenotype, underlying bone quality, and periodontal fiber integrity.

Suture Management and Postoperative Care

Suture removal is typically conducted 7-10 days post-surgery unless absorbable sutures are used; this timing aligns with stages of wound healing.
Correct management of keratinized tissue around surgical sites is essential for optimal healing outcomes.

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Description

Enhance your understanding of furcation defects with these flashcards. This resource covers essential concepts related to periodontal examination and surgical management, focusing on factors such as plaque accumulation and clinical attachment levels. Perfect for dental students and professionals looking to deepen their knowledge in periodontology.