Osseous Surgery

What is the major rationale for osseous surgery?

Discrepancies in level and shapes of the bone and gingiva predispose patients to the recurrence of pocket depth post-surgically

The technique of osteotomy is best applied to patients with what?

Early to moderate bone loss with moderate-length root trunks that have bony defects with one or two walls

The bone is consistently more coronal where?

On the inter proximal surfaces than on the facial and lingual surfaces

In periodontics, osteotomy is done to correct what?

Or reduce deformities caused by periodontitis in the marginal and inter alveolar bone and includes the removal of bone that is attached to the tooth

So in conclusion, these techniques reserve what while getting rid of what?

Preserves the width of the attached tissue while removing granulomatous tissue and providing access for debridement of the radicular surfaces

What about mesial?

3.6mm

What is the average distance from CEJ to furcations on maxillary molar measures for buccal?

4.2mm

What about distal?

4.8

The technique is performed in combination with what type of flaps?

Apically positioned flaps, and the procedure eliminates periodontal pocket depth and improves tissue contour to provide a more easily maintainable environment

The position of the bony margin mimics the contours of what?

The CEJ

What determines the extent that bone and attachment is removed during resection?

The relationship between the depth and configuration of the bony lesion(s) to root morphology and the adjacent teeth

Bonny lesions have been classified according to what?

Their configuration and number of bony walls

What is the most common bony defects?

Two-walled defects (craters)

What is Reverse (negative) architecture?

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

What is Positive Architecture?

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

Does the procedure induce loss of radicular bone in the healing phase?

Yes

What is Osseous Surgery?

Procedures to modify bone support altered by periodontal disease, either by reshaping the alveolar process to achieve physiologic form without the removal of a alveolar supporting bone, or by the removal of some alveolar bone, thus changing the position of the crystal bone relative to the tooth root

The incisions depend on what?

Amount of keratinized gingiva

Recession in the anterior sextant creates what?

Black triangles between the teeth and exposes darker colored CEJ and cementum

What is Physiologic Architecture?

Concept of soft tissue or bony form that includes positive architecture in a vertical dimension, buccal-lingual contours devoid of ledges and exostoses, and interrradicular grooves

What is an ostectomy (osteotomy)?

Excision of a bone or portion of a bone.

Craters occur at the expense of what?

Interseptal bone

Are patients with advanced attachment loss and deep intrabony defects candidates for resection to produce positive contour?

No, so much bone would have to be removed that the survival of the teeth could be compromised

The conversion of the periodontal pocket to a shallow gingival sulcus enhances the patients ability to do what?

Remove plaque and oral debris from the dentition

What is Osteoplasty?

Reshaping of the alveolar process to achieve a more physiologic form without removal of alveolar bone proper

What is the objective of flap design?

To crete thin flaps of even thickness positioned at the level of the osseous crest

What is the goal of osseous respective therapy?

To reshape the marginal bone to resemble that of the alveolar process undamaged by periodontal disease