Resective osseous surgery PERIO 830

Horizontal bone loss

Bone is lost equally on adjacent teeth.

Vertical (angular) bone loss

bone is lost more rapidly on one tooth than the adjacent tooth creating a defect. The defect can have one, two or three walls or a combination.

Radiographic examination

Reveals the existance of angular bone losses in the interdental spaces. The radiograph will not show the number of bony walls of the defect.

Clinical examination

determines the presence and depth of periodontal pockets on any surface of any tooth and can also give a general sense of the bony topography.

Transgingival probling

Can predict the many features of the underlying bony topography

Osseous surgery

May be defined as the procedure by which changes in the alveolar bone can be accomplished to rid it of deformities induced by the periodontal disease process or other related factors such as exostosis and tooth supraeruption.

Subtractive osseous surgery

designed to restore the form of pre-existing alveolar bone to the level existing at the time of surgery or slightly more apical to this level-bone resection.

Additive osseous surgery

includes procedures directed at restoring the alveolar bone to its original level- bone grafting/ regeneration

The shape

What feature of the osseous defect determines the surgery or technique used to treat the defect?

one wall angular defect treatment

usually have to be recontoured using surgical resection

Three wall defects

if they are narrow and deep, they can be treated with techniques that aim at new attachment and bone such as bone graft and regeneration

Two walled defects

Can be treated with either surgical recontouring or new attachment and bone regeneration. Interdental craters are two walled defects best dealt with by surgical recontouring

Goal of Resective surgery

Reshaping the marginal bone to resemble physiologic architecture. Performed in combination with apically displaced flaps. Thsi will eliminate periodontial pocket depth and improve tissue contour.

Osteoplasty

refers to shaping the bone without removing tooth-supporting bone.

ostectomy

includes the removal of tooth-supporting bone

Interdental bone to radicular bone

Positive and negative architecture refer to the relative position of which two types of bone?

Positive

Architecture is _______ when the radicular bone is apical to the interdental bone.

Negative

Bone has ________ archtecture if the interdental bone is more apical than the radicular.

flat

when the interdental bone and the radicular bone are reduced to the same height it is called ____ architecture.

Definitive osseous reshaping

Implies that further osseous reshaping would not improve the overall result

Compromise osseous reshaping

Indicates a bone pattern that cannot be improved without significant osseous removal that would be detrimental to the overall result.

Which technique is preferable when dealing with interproximal craters?

The technique that reduces the least amount of supporting bone.

Widow's peak

small bony discrepancies on the gingival line angles

higher

Failure to remove widow's peaks allow the tissue to rise to a _____ level than the base of the bone loss in the interdental area.

Osseous resection technique

1.Vertical grooving
2. Radicular blending
3. flattening interproximal bone
4. gradulalizing marginal bone