Sweep 2

Question 1

• Annual rate of Attachment Loss =

Answer 1

0.22 mm

Question 2

– Modified Kirkland flap (MKF) • uses ——– incisions

Answer 2

Sulcular incisions

Question 3

Flap

– —— beveled

Answer 3

Internally

Question 4

Exposed tissue during healing

Answer 4

gingivectomy

Question 5

Pocket depth, amount of keratinized gingiva and intended position of the flap are essential

Answer 5

pre-treatment considerations

Question 6

——– scalpel blades and handle for flap

Answer 6

Bard-parker

Question 7

• Elevation past the —— will fully reflect the flap

Answer 7

mucogingival junction

Question 8

• Coronally positioned

– For

Answer 8

regeneration or root coverage

Question 9

• Replaced

– For

Answer 9

conservative flaps (minimal recession)

Pretty much removing interior, placing exterior back where it was.

Question 10

• Apically positioned

– For

Answer 10

pocket elimination or crown lengthening

Same as replaced, but removed from alveolar bone, moved down.

Question 11

Creation of bleeding points as Gingivectomy

Answer 11

knife reference points for primary incision

Question 12

Thinned palatal flap

Answer 12

like a cross between gingivectomy and internal bevel. Cut gingiva down low, bevel, reattach at bone margin

Question 13

Mod widman Initial incision has ——- scallop, but may also be ——-

Answer 13

0.5 to 1 mm

intrasulcular

Question 14

With conservative flaps, there is little or no —-

Answer 14

bone resection

Question 15

 Simple loop modification  Figure 8 modification

Answer 15

Interrupted sutures

Question 16

 Single sling suture

 Continuous sling suture

Answer 16

Sling sutures

Question 17

Cut the suture —— as possible to avoid dragging bacteria into the wound

Answer 17

close to the tissue

Question 18

Phases of Postsurgical Healing

Answer 18

• Inflammation
• Fibroblastic granulation
• Matrix formation and remodeling

Question 19

Formationofbloodclotbetweenmarginsof wound and between flap and tooth or bone
• Clotincludesfibrin,neutrophils,platelets, red cells, cell debris, and capillaries at the edge of the wound

Answer 19

Healing: immediate response

Question 20

• Neutrophils infiltrate the connective tissue

* Epithelium begins to migrate from the wound margins

Answer 20

Healing: first 24 hours

Question 21

• Space between the flap and tooth or bone narrows

* Epithelial cells migrate over the border of the flap, contacting the tooth

Answer 21

Healing: 1-3 days

Question 22

• Epithelialmigrationcontinues
• Neutrophilsarereplacedbymacrophages,which eliminate dead/damaged cells
• Bloodclotisreplacedbygranulationtissue
• Revascularizationbegins

Answer 22

Healing: 3-7 days

Question 23

• Epithelium attaches to the root
• Blood clot is replaced by granulation tissue derived from gingival connective tissue, bone marrow and/or periodontal ligament

Answer 23

Healing: 1 week

Question 24

• Collagen fibers are oriented parallel to tooth surface (nonfunctional)
• Union of flap to tooth is weak • Collagen fibers are immature

Answer 24

Healing: 2 weeks

Question 25

* Inflammatory cells are mostly gone * Fibroblasts proliferate, synthesize collagen * Revascularization process regresses * Gingival crevice is fully epithelialized * Epithelial attachment is well defined * Functional arrangement of supracrestal fibers

Answer 25

Healing: 1 month

Question 26

* Collagenhasremodeledandcross-linked | * Thewoundhasregainedmostofitsoriginal tensile strength

Answer 26

Healing: 2 months

Question 27

When the bone is exposed by a full thickness flap, superficial bone necrosis occurs after 1 to 3 days • Osteoclastic resorption follows, peaking at

Answer 27

4 to 6 days.

Question 28

PDGF: induces

Answer 28

fibroblast and macrophage migration, fibroblast proliferation and macrophage activation

Question 29

• EGF: induces

Answer 29

epithelial proliferation

Question 30

• TGF-ß: induces

Answer 30

migration of inflammatory cells and proliferation of fibroblasts

Question 31

gingival inflammation extends along

Answer 31

collagen fiber bundles

Question 32

gingival inflammation follows course of

Answer 32

course of blood vessels

Question 33

gingival inflammation can enter maxillary sinus, leading to

Answer 33

[thickening of sinus membrane

Question 34

Bacterial plaque in a radius of ------m to bone will lead to resorption Angular defects if interdental septum is ------

Answer 34

1.5-2.5mm >2.5mm wide (Tal)

Question 35

Bone Loss due to Periodontal Disease can be due to

Answer 35

Increased resorption in the presence of normal or increased bone formation. • Decreased formation in the presence of normal resorption. • Increased resorption combined with decreased formation

Question 36

• Bone forms during periods of

Answer 36

remission

Question 37

Osseous surgery Full thickness flap, ----- positioned flap • Regenerative surgery Full thickness flap, ------- positioned flap

Answer 37

Apically Coronally

Question 38

Osseous surgery Generally ------ incision but sometimes sulcular incision only (if keratinized tissue is limited) Additional vertical incisions if needed to apically position

Answer 38

scallop

Question 39

Regenerative surgery ------- incision | Additional vertical incisions if needed to coronally position

Answer 39

Sulcular

Question 40

Reverse architecture

Answer 40

When the crest of the interdental bone or gingiva is located apical to its mid- facial and mid-lingual margins

Question 41

Reverse architecture is the opposite of

Answer 41

physiological architecture

Question 42

Osteoplasty | Reshaping of the alveolar process to achieve a more physiologic form without removing --------------

Answer 42

alveolar bone proper

Question 43

Class I crater :

Answer 43

2-3mm deep, thick facial and lingual walls. •

Question 44

Class I crater Manage by

Answer 44

palatal ramping

Question 45

Class II crater :

Answer 45

4-5 mm deep, thinner facial and lingual walls.

Question 46

Class II crater - Manage by

Answer 46

facial and palatal ramping

Question 47

• Class III crater :

Answer 47

6-7 mm deep, thin walls, sharp drop to base.

Question 48

Class III crater - Manage by

Answer 48

facial and palatal ramping

Question 49

• Class IV crater :

Answer 49

Variable depth, very thin walls.

Question 50

Class IV crater - Remove

Answer 50

both walls

Question 51

remove e-PFTE -------- weeks post op

Answer 51

4-6

Question 52

Functionally graded membranes

Answer 52

core, outer, inner layers for specific purpose

Question 53

Reinforce the membrane • Create a

Answer 53

``` scaffold • Using tenting screws • Using fillers – Bone – Bone substitutes – Collagen sponge incorporated with growth factors ```

Question 54

• Osteogenesis –

Answer 54

Viable cells

Question 55

• Osteoinduction | –

Answer 55

Uncommitted CT cells induced

Question 56

• Osteoconduction

Answer 56

– Non viable scaffold

Question 57

Enamel Matrix Derivative (Emdogain®) | • Action:

Answer 57

formslayerofextracellularmatrixontheroot surface that promotes selective cell colonization (enhances mesenchymal cell adhesion and inhibits epithelial cell adhesion)

Question 58

Human Platelet-Derived Growth Factor in Tri-calcium Phosphate (GEM 21S ®) • Action:

Answer 58

PDGF stimulates migration and proliferation of osteoblasts, fibroblasts and cementoblasts, leading to formation of new bone, PDL and cementum

Question 59

Max molars root concavities

Answer 59

* Maxillary Molars | * 94% mesiobuccal roots • 31% distobuccal roots • 17% palatal roots

Question 60

Incidence of enamel pearls:

Answer 60

1.1% - 9.7%

Question 61

• Trauma from occlusion may cause inflammation and tissue destruction within the

Answer 61

interradicular area of a multirooted tooth

Question 62

Bone ramps into the furcation to

Answer 62

enhance plaque control

Question 63

Sequence of treatment at RSR

Answer 63

* Endodontic treatment * Provisional restoration * RSR * Periodontal surgery * Final prosthetic restoration

Question 64

Tunneling | for grade---- furcation

Answer 64

III

Question 65

Hemisection for

Answer 65

* Mandibular molars | * Grade III furcation

Question 66

For hemisection, • Soft tissue positioned

Answer 66

below level of pulp chamber

Question 67

Root Separation | • Root separation involves the

Answer 67

sectioning of the root complex and the maintenance of all roots

Question 68

GTR for furcation defects only doable for

Answer 68

grade II

Question 69

All subgingival margins should be placed within ------ mm apical to the free gingival margin whenever possible.

Answer 69

1 to 2

Question 70

Lateral incisor gingival line should be ------ more coronal than for central incisors and canines

Answer 70

0.5 mm

Question 71

Dentogingival complex (DGC): -------------- • epithelial attachment (junctional epithelium) • connective tissue attachment

Answer 71

• gingival sulcus

Question 72

• From sound tooth structure to alveolar crest: (allowance to drop margin during prep): – Textbook: general rule- at least

Answer 72

4 mm

Question 73

Internal (inverse) Bevel – Scalloped (submarginal incisions) as if to ------- – Removes tissue without -----------

Answer 73

raise a flap exposing wound during healing

Question 74

Apically Positioned flap with Osseous Resection • Performed when ------------ is needed to establish a biologic width: – Prevents ------- rebound – Maintains integrity of --------

Answer 74

osseous resection gingival attachment apparatus

Question 75

• Two options for lengthening clinical crown with osseous surgery:

Answer 75

– Submarginal (scalloped) incisions- if adequate keratinized tissue – Sulcular incisions and apical positioning- if limited keratinized tissue

Question 76

After osseous resection and suturing, biologic width re-established: ----- from gingival margin to bone

Answer 76

>3 mm

Question 77

Time to wait after Crown lengthening for Restoration | • If correct procedure for crown lengthening was done, at least

Answer 77

6 weeks

Question 78

Management of mucogingival | problems

Answer 78

* Subepithelialconnectivetissuegraft • Freegingivalgraft | * Vestibular extension

Question 79

Ridge Augmentation Procedures | METHODS:

Answer 79

* Soft tissue augmentation only * Hard tissue augmentation only * Soft and hard tissue augmentations