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Questions and Answers
Which of the following best defines osteogenesis?
Which of the following best defines osteogenesis?
What characterizes the anatomic defect remaining after periodontitis resolution?
What characterizes the anatomic defect remaining after periodontitis resolution?
Which approach to eliminating anatomic defects in periodontitis is primarily focused on retaining existing structures?
Which approach to eliminating anatomic defects in periodontitis is primarily focused on retaining existing structures?
What does osteoconduction primarily provide during therapeutic bone regeneration?
What does osteoconduction primarily provide during therapeutic bone regeneration?
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Which of the following is NOT a primary component of periodontal therapy post-periodontitis?
Which of the following is NOT a primary component of periodontal therapy post-periodontitis?
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In periodontal therapy, which of the following describes the purpose of osteoinduction?
In periodontal therapy, which of the following describes the purpose of osteoinduction?
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Which technique involves surgical removal of diseased bone structures?
Which technique involves surgical removal of diseased bone structures?
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What is a key advantage of regenerative surgical techniques in periodontal therapy?
What is a key advantage of regenerative surgical techniques in periodontal therapy?
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Which of the following factors is NOT typically an indication for reconstructive osseous surgery?
Which of the following factors is NOT typically an indication for reconstructive osseous surgery?
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What is the primary aim of periodontal therapy following treatment for periodontitis?
What is the primary aim of periodontal therapy following treatment for periodontitis?
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What is the primary purpose of using barrier membranes in guided bone regeneration?
What is the primary purpose of using barrier membranes in guided bone regeneration?
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Which of the following is NOT a type of membrane used in bone regeneration?
Which of the following is NOT a type of membrane used in bone regeneration?
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What is the initial step in the procedure for root biomodification?
What is the initial step in the procedure for root biomodification?
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What is the correct procedure after debridement of the osseous defect?
What is the correct procedure after debridement of the osseous defect?
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Which of the following is a contraindication for using barrier membranes?
Which of the following is a contraindication for using barrier membranes?
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What is a primary characteristic of nongraft-associated new attachment techniques?
What is a primary characteristic of nongraft-associated new attachment techniques?
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Which technique involves the removal of junctional and pocket epithelium?
Which technique involves the removal of junctional and pocket epithelium?
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Which is NOT a method of preventing epithelial migration?
Which is NOT a method of preventing epithelial migration?
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Guided Tissue Regeneration (GTR) is based on the assumption that which cells can regenerate the attachment apparatus?
Guided Tissue Regeneration (GTR) is based on the assumption that which cells can regenerate the attachment apparatus?
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What type of defects is nongraft-associated new attachment achievable in?
What type of defects is nongraft-associated new attachment achievable in?
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What characterizes positive architecture in osseous surgery?
What characterizes positive architecture in osseous surgery?
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Which method is often used in conjunction with curettage to enhance the removal of epithelium?
Which method is often used in conjunction with curettage to enhance the removal of epithelium?
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Which type of osseous reshaping indicates that further improvement is not possible?
Which type of osseous reshaping indicates that further improvement is not possible?
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After the treatment of which condition can destructive procedures occur rapidly, enabling nongraft-associated new attachment?
After the treatment of which condition can destructive procedures occur rapidly, enabling nongraft-associated new attachment?
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Which condition is a contraindication for resective osseous surgery?
Which condition is a contraindication for resective osseous surgery?
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Which surgical method is considered for new attachment in gingival treatment?
Which surgical method is considered for new attachment in gingival treatment?
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What does subtractive osseous surgery aim to achieve?
What does subtractive osseous surgery aim to achieve?
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Which of the following best describes flat architecture?
Which of the following best describes flat architecture?
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What is the best definition of an autograft?
What is the best definition of an autograft?
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Which term describes the process where graft material promotes the formation of new bone?
Which term describes the process where graft material promotes the formation of new bone?
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What type of osseous surgery is directed towards restoring bone to its original levels?
What type of osseous surgery is directed towards restoring bone to its original levels?
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What type of graft is derived from a different species than the recipient?
What type of graft is derived from a different species than the recipient?
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Which of the following is NOT a specific indication for resective osseous surgery?
Which of the following is NOT a specific indication for resective osseous surgery?
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What is a key characteristic of negative architecture?
What is a key characteristic of negative architecture?
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Which of the following describes a barrier membrane's primary function in bone grafting?
Which of the following describes a barrier membrane's primary function in bone grafting?
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Which of the following systemic health issues could be a contraindication for resective osseous surgery?
Which of the following systemic health issues could be a contraindication for resective osseous surgery?
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What is the primary purpose of osteoconduction in graft-associated new attachment?
What is the primary purpose of osteoconduction in graft-associated new attachment?
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Which resective configuration is specifically characterized by one-walled angular defects?
Which resective configuration is specifically characterized by one-walled angular defects?
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Which type of tissue transfer is known as an allograft?
Which type of tissue transfer is known as an allograft?
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Which of the following is NOT an indication for utilizing reconstructive techniques?
Which of the following is NOT an indication for utilizing reconstructive techniques?
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What is the role of a dressing after a surgical procedure involving a graft?
What is the role of a dressing after a surgical procedure involving a graft?
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In what scenario is a reabsorbable membrane preferred for graft procedures?
In what scenario is a reabsorbable membrane preferred for graft procedures?
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What is a contraindication for implant treatment regarding bone volume?
What is a contraindication for implant treatment regarding bone volume?
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Degradable membranes include materials such as collagen and Teflon.
Degradable membranes include materials such as collagen and Teflon.
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Positive architecture in osseous surgery is typically characterized by conditions that promote healing and bone regeneration.
Positive architecture in osseous surgery is typically characterized by conditions that promote healing and bone regeneration.
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The use of barrier membranes is contraindicated when there is inadequate blood supply to the area.
The use of barrier membranes is contraindicated when there is inadequate blood supply to the area.
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A full thickness mucoperiosteal flap should be reflected at least 5 mm beyond the defect.
A full thickness mucoperiosteal flap should be reflected at least 5 mm beyond the defect.
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Nongraft-associated new attachment can be achieved in perioendodontal abscesses.
Nongraft-associated new attachment can be achieved in perioendodontal abscesses.
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Root biomodification involves using substances like citric acid to prepare the root surface for new connective tissue attachment.
Root biomodification involves using substances like citric acid to prepare the root surface for new connective tissue attachment.
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Removal of junctional and pocket epithelium can eliminate the risk of epithelial migration completely.
Removal of junctional and pocket epithelium can eliminate the risk of epithelial migration completely.
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Guided Tissue Regeneration (GTR) relies on the potential of periodontal ligament cells for regenerating the attachment apparatus.
Guided Tissue Regeneration (GTR) relies on the potential of periodontal ligament cells for regenerating the attachment apparatus.
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Curettage can remove up to 70 percent of junctional epithelium and pocket epithelium effectively.
Curettage can remove up to 70 percent of junctional epithelium and pocket epithelium effectively.
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Chemical agents used for epithelium removal are often used alone without other methods.
Chemical agents used for epithelium removal are often used alone without other methods.
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The excisional new attachment procedure is performed using a coronal bevel incision.
The excisional new attachment procedure is performed using a coronal bevel incision.
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Combination techniques for new attachment always involve the use of grafts.
Combination techniques for new attachment always involve the use of grafts.
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Rapidly occurring destructive procedures can happen after treatment of pockets with acute periodontal abscess.
Rapidly occurring destructive procedures can happen after treatment of pockets with acute periodontal abscess.
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Osteogenesis is the principle that involves the direct transfer of vital cells to regenerate new bone.
Osteogenesis is the principle that involves the direct transfer of vital cells to regenerate new bone.
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Osteoconduction solely relies on the presence of growth factors to stimulate new bone formation.
Osteoconduction solely relies on the presence of growth factors to stimulate new bone formation.
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The elimination of bacterial plaque is one of the two primary components of periodontal therapy for periodontitis.
The elimination of bacterial plaque is one of the two primary components of periodontal therapy for periodontitis.
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Regenerative techniques aim to completely create new tissue rather than repairing existing structures.
Regenerative techniques aim to completely create new tissue rather than repairing existing structures.
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A persistent loss of bone and ligament is a characteristic of an anatomic defect that remains after periodontitis has been resolved.
A persistent loss of bone and ligament is a characteristic of an anatomic defect that remains after periodontitis has been resolved.
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Resective techniques primarily aim to regenerate tissue in the periodontal environment.
Resective techniques primarily aim to regenerate tissue in the periodontal environment.
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The formation of a long junctional epithelium is a positive outcome of periodontal therapy.
The formation of a long junctional epithelium is a positive outcome of periodontal therapy.
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Osteoinduction converts pluripotential, mesenchymal-derived cells into osteoblasts for bone formation.
Osteoinduction converts pluripotential, mesenchymal-derived cells into osteoblasts for bone formation.
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Guided Tissue Regeneration (GTR) relies on the ability of cells from the epithelium to regenerate the attachment apparatus.
Guided Tissue Regeneration (GTR) relies on the ability of cells from the epithelium to regenerate the attachment apparatus.
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Negative architecture in osseous surgery improves the outcomes of periodontal therapy.
Negative architecture in osseous surgery improves the outcomes of periodontal therapy.
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An allograft involves tissue transfer between individuals of different species.
An allograft involves tissue transfer between individuals of different species.
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Osteoinduction promotes the formation of new periodontal ligament and osteogenesis.
Osteoinduction promotes the formation of new periodontal ligament and osteogenesis.
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Barrier membranes are utilized primarily to allow epithelial cells to proliferate freely over the graft.
Barrier membranes are utilized primarily to allow epithelial cells to proliferate freely over the graft.
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A wide and deep vertical bone loss on #19 indicates a favorable prognosis for implant placement.
A wide and deep vertical bone loss on #19 indicates a favorable prognosis for implant placement.
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An autograft is derived from the same individual in a different area of the body.
An autograft is derived from the same individual in a different area of the body.
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Contact inhibition is the process by which graft material prevents the proliferation of epithelial cells.
Contact inhibition is the process by which graft material prevents the proliferation of epithelial cells.
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Xenografts are grafts sourced from individuals of the same species.
Xenografts are grafts sourced from individuals of the same species.
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The use of a dressing after surgery is solely for the purpose of aesthetic improvement.
The use of a dressing after surgery is solely for the purpose of aesthetic improvement.
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Osteoconduction refers to the process where graft material actively aids in new bone formation.
Osteoconduction refers to the process where graft material actively aids in new bone formation.
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The presence of calculus is an indicator of bone health and is generally ignored in initial examinations.
The presence of calculus is an indicator of bone health and is generally ignored in initial examinations.
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Positive architecture occurs when the radicular bone is more coronal than the interdental bone.
Positive architecture occurs when the radicular bone is more coronal than the interdental bone.
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Compromise osseous reshaping suggests that additional reshaping is possible without detrimental effects.
Compromise osseous reshaping suggests that additional reshaping is possible without detrimental effects.
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Shallow crater formations are an indication for resective osseous surgery.
Shallow crater formations are an indication for resective osseous surgery.
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Improper oral hygiene is a contraindication for resective osseous surgery.
Improper oral hygiene is a contraindication for resective osseous surgery.
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Subtractive osseous surgery aims to enhance bone levels above their pre-existing state.
Subtractive osseous surgery aims to enhance bone levels above their pre-existing state.
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Ideal architecture is characterized by the bony surfaces consistently being more coronal on the inter-proximal surfaces.
Ideal architecture is characterized by the bony surfaces consistently being more coronal on the inter-proximal surfaces.
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Thick, bony margins are not considered an indication for resective osseous surgery.
Thick, bony margins are not considered an indication for resective osseous surgery.
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Extreme root sensitivity is a potential indication for resective osseous surgery.
Extreme root sensitivity is a potential indication for resective osseous surgery.
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Additive osseous surgery is aimed at reducing the bone to pre-existing levels.
Additive osseous surgery is aimed at reducing the bone to pre-existing levels.
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Radicular bone being more apical than interdental bone indicates flat architecture.
Radicular bone being more apical than interdental bone indicates flat architecture.
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Study Notes
Reconstructive Surgical Techniques
- Three main types: Nongraft-associated, Graft-associated, Combination of both.
Nongraft-associated New Attachment
- Effective in:
- Three-walled defects (Infrabony defect)
- Perioendodontal abscesses
- Rapid destructive procedures, like acute periodontal abscess treatment
- Techniques inclusively:
- Removal of Junctional and Pocket Epithelium
- Prevention of Epithelial Migration
- Guided Tissue Regeneration (GTR)
Removal of Junctional and Pocket Epithelium Methods
- Curettage removes approximately 50% of epithelium
- Chemical agents complement curettage
- Ultrasonic methods have tactile issues
- Surgical methods include:
- Excisional New Attachment Procedure (ENAP)
- Gingivectomy
- Modified Widman flap
- Coronal displacement of flap
Prevention of Epithelial Migration
- Junctional and pocket epithelium removal must avoid rapid epithelium proliferation post-excision.
Guided Tissue Regeneration (GTR)
- Based on the regenerative potential of periodontal ligament cells for attachment apparatus recovery.
Periodontal Therapy
- Focus on eliminating bacterial plaque and anatomical defects post-periodontitis, characterized by:
- Reformed gingival fibers
- Reduced inflammation
- Bone and ligament loss
- Formation of long junctional epithelium
Approaches to Eliminate Anatomical Defects
- Resective surgery: removes tissue
- Regenerative surgery: restores tissue
- Both techniques are surgical interventions.
Therapeutic Bone Regeneration Principles
- Osteogenesis: Vital cell transfer for bone regeneration
- Osteoconduction: Providing space for bone formation
- Osteoinduction: Mesenchymal cell conversion to osteoblasts.
Types of Osseous Surgery Architecture
- Positive architecture: Radicular bone apical to interdental bone
- Negative architecture: Interdental bone more apical
- Flat architecture: Both bones level
- Ideal architecture: Interproximal bone more coronal than facial/lingual
Types of Osseous Surgery Techniques
- Definitive reshaping: No further reshaping needed
- Compromise reshaping: Substantial improvements detrimental
- Additive surgery: Restoring bone to original levels
- Subtractive surgery: Form restoration, possibly slightly apical
Indications for Resective Osseous Surgery
- One-walled angular defects
- Thick bony margins
- Shallow crater formations
Contraindications for Resective Osseous Surgery
- Proximity of roots to critical anatomical features
- Patient's age and systemic health
- Poor oral hygiene
- High caries index
- Extreme root sensitivity
- Advanced periodontitis
- Esthetic concerns
Post-operative Steps
- Suture with silk for primary closure
- Dressing may aid comfort without displacing graft
- Provide post-operative instructions and antibiotics
- Non-resorbable membranes should be removed after 4-6 weeks
Graft-associated New Attachment
- Graft: Transplanted tissue/organ for repair and remodeling
- Types include:
- Xenograft: Different species donor
- Allograft: Same species donor, non-identical genes
- Autograft: Same individual transfer
- Alloplastic graft: Synthetic material used
Graft Properties
- Osteoinduction: Promotes new periodontal structures
- Osteoconduction: Passive matrix for bone coverage
- Contact inhibition: Prevents epithelial proliferation apically
Types of Membranes
- Degradable: Collagen, Polylactic acid, etc.
- Non-degradable: Require removal after 3-6 weeks
Root Surface Preparation
- Conditioning uses citric acid, fibronectin, or tetracycline for new tissue attachment.
Procedures for Reconstructive Surgery
- Full thickness mucoperiosteal flap reflected beyond the defect
- Debridement and curettage of the defect
- Root planning and surface conditioning
- Promote bleeding at the defect site for cell movement
- Membrane trimming for primary tension-free closure
- Membrane stabilization with sutures or tacks
Reconstructive Surgical Techniques
- Three main types: Nongraft-associated, Graft-associated, Combination of both.
Nongraft-associated New Attachment
- Effective in:
- Three-walled defects (Infrabony defect)
- Perioendodontal abscesses
- Rapid destructive procedures, like acute periodontal abscess treatment
- Techniques inclusively:
- Removal of Junctional and Pocket Epithelium
- Prevention of Epithelial Migration
- Guided Tissue Regeneration (GTR)
Removal of Junctional and Pocket Epithelium Methods
- Curettage removes approximately 50% of epithelium
- Chemical agents complement curettage
- Ultrasonic methods have tactile issues
- Surgical methods include:
- Excisional New Attachment Procedure (ENAP)
- Gingivectomy
- Modified Widman flap
- Coronal displacement of flap
Prevention of Epithelial Migration
- Junctional and pocket epithelium removal must avoid rapid epithelium proliferation post-excision.
Guided Tissue Regeneration (GTR)
- Based on the regenerative potential of periodontal ligament cells for attachment apparatus recovery.
Periodontal Therapy
- Focus on eliminating bacterial plaque and anatomical defects post-periodontitis, characterized by:
- Reformed gingival fibers
- Reduced inflammation
- Bone and ligament loss
- Formation of long junctional epithelium
Approaches to Eliminate Anatomical Defects
- Resective surgery: removes tissue
- Regenerative surgery: restores tissue
- Both techniques are surgical interventions.
Therapeutic Bone Regeneration Principles
- Osteogenesis: Vital cell transfer for bone regeneration
- Osteoconduction: Providing space for bone formation
- Osteoinduction: Mesenchymal cell conversion to osteoblasts.
Types of Osseous Surgery Architecture
- Positive architecture: Radicular bone apical to interdental bone
- Negative architecture: Interdental bone more apical
- Flat architecture: Both bones level
- Ideal architecture: Interproximal bone more coronal than facial/lingual
Types of Osseous Surgery Techniques
- Definitive reshaping: No further reshaping needed
- Compromise reshaping: Substantial improvements detrimental
- Additive surgery: Restoring bone to original levels
- Subtractive surgery: Form restoration, possibly slightly apical
Indications for Resective Osseous Surgery
- One-walled angular defects
- Thick bony margins
- Shallow crater formations
Contraindications for Resective Osseous Surgery
- Proximity of roots to critical anatomical features
- Patient's age and systemic health
- Poor oral hygiene
- High caries index
- Extreme root sensitivity
- Advanced periodontitis
- Esthetic concerns
Post-operative Steps
- Suture with silk for primary closure
- Dressing may aid comfort without displacing graft
- Provide post-operative instructions and antibiotics
- Non-resorbable membranes should be removed after 4-6 weeks
Graft-associated New Attachment
- Graft: Transplanted tissue/organ for repair and remodeling
- Types include:
- Xenograft: Different species donor
- Allograft: Same species donor, non-identical genes
- Autograft: Same individual transfer
- Alloplastic graft: Synthetic material used
Graft Properties
- Osteoinduction: Promotes new periodontal structures
- Osteoconduction: Passive matrix for bone coverage
- Contact inhibition: Prevents epithelial proliferation apically
Types of Membranes
- Degradable: Collagen, Polylactic acid, etc.
- Non-degradable: Require removal after 3-6 weeks
Root Surface Preparation
- Conditioning uses citric acid, fibronectin, or tetracycline for new tissue attachment.
Procedures for Reconstructive Surgery
- Full thickness mucoperiosteal flap reflected beyond the defect
- Debridement and curettage of the defect
- Root planning and surface conditioning
- Promote bleeding at the defect site for cell movement
- Membrane trimming for primary tension-free closure
- Membrane stabilization with sutures or tacks
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Description
This quiz explores various reconstructive surgical techniques, including nongraft-associated and graft-associated methods, as well as combinations of both. It focuses on achieving new attachment without grafts in specific dental conditions. Test your knowledge about these techniques and their applications in treating periodontal defects.
