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?
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What does periodontal regeneration consist of?
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What is the only way of confirming periodontal regeneration has occurred?
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What are the 6 clinical factors that affect the healing process of furcation defect treatment?
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What are the 3 patient factors that affect the healing process of furcation defect treatment?
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What clinical factors affect the outcome of furcation defect treatment?
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What treatment is indicated for class 1 furcation defects?
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What treatments are indicated for class 2 furcation defects with interproximal bone apical to the furcation entrance?
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What treatments are indicated for class 2 furcation defects with interproximal bone coronal to the furcation entrance?
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What treatments are indicated for class 3 furcation defects with a wide keratinized width?
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What treatment is indicated for class 3 furcation defects with a narrow keratinized width?
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What factors indicate a good prognosis after regenerative periodontal therapy in class 2 furcation cases?
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Is partial closure a realistic aim of treatment?
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Currently, is regeneration of class III defects possible?
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What is the ideal aim of treatment of class 2 furcation defects?
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What percentage is set to determine if periodontal disease is localized or generalized?
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What are the therapeutic goals of periodontal treatment?
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Why can bitewings not be used to diagnose periodontal disease?
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What is a prerequisite of the patient before engaging in periodontal surgery/treatment?
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Why can class 2 defects be harder to manage than class 3?
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What special investigations should you carry out prior to any periodontal treatment?
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How may furcation defects result in pulpal involvement/insult?
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What do you do with correct band, excess, and insufficient keratinized tissue?
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What is the 3-phase technique for surgical crown lengthening?
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For anterior teeth, when making the incision for crown lengthening, what thickness should the flap be?
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What combination of instruments do you use in phase 2 of surgical crown lengthening?
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When do sutures need to be removed post-surgery?
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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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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.