⭐ PERIODONTAL PLASTIC SURGERY
📌 POINTS TO PONDER
🔹Cut back incision is given at the distal corner of the lateral displaced flap into the alveolar mucosa, pointing in the direction of the recipient site.
🔹The free epithelial graft is usually covered by whitish mass, termed as ghost graft, which consists of sloughing epithelial cells after 7-10 days postoperatively. This matter can be rinsed away with gentle stream ofwater.
🔹Pull syndrome: A detaching movement of the marginal gingiva transferred from the lip by the frenum has been termed the pull syndrome (Placek 1974).
📣 Periodontal plastic surgery is defined as the surgical procedures performed to correct/ eliminate anatomic, developmental/ traumatic deformities of the gingiva/alveolar mucosa.
⭐ It includes the following:
🔸 Periodontal prosthetic corrections
🔸 Crown lengthening
🔸 Ridge augmentation
🔸 Aesthetic surgical corrections
🔸Coverage of the denuded root surface
🔸Reconstruction of papillae
🔸 Aesthetic surgical correction around implants
🔸Surgical exposure of unerupted teeth for orthodontics
📌 MULTIPLE CHOICE QUESTIONS MCQs
💡 Ideal thickness of graft should be:
A. 1.0 to 1.5 mm
B. 0.25 to 0.5 mm
C. 0.5 to 1 mm
D. 2 to 3 mm
Answer : A
💡 Mucogingival defect with recession beyond mucogingival line with no loss of bone or soft tissue is:
A. Class I defect
B. Class II defect
C. Class III defect
D. Class IV defect
Answer : B
💡Langers technique is used in:
A. Subepithelial connective tissue grafts
B. Free soft tissue autografts
C. Fenestration operation
D. Vestibular extension operation
Answer : A
💡Vestibular extension procedure results in:
A. Increase in width of keratinized attached gingiva
B. Decrease in width of keratinized attached gingiva
C. Increase in width of non – keratinized attached gingiva
D. Decrease in width of non – keratinized attached gingiva
Answer : C
💡The flap technique for pocket elimination and toincrease in width of attached gingiva:
A. Modified widman flap
B. Lateral pedicle flap
C. Apically displaced flap
D. Coronally repositioned flap
Answer : C
💡 In a free gingival graft, what happens to epitheliumof the graft?
A. Degenerates
B. Proliferates
C. Remain as such
D. Has to be removed by surgeon
Answer : A
💡The flap technique procedure which does not increasethe width of attached gingiva:
A. Free gingival graft
B. Apically displaced flap
C. Fenestration operation
D. Undisplaced flap
Answer : D
📌 VIVA VOICE
Q1. What are the effects of loss of interdental papilla?
Ans. The effects of loss of interdental papilla are following:
▪️ Cosmetic deformities
▪️ Phonetic problems
▪️ Lateral food impaction
Q2. What is creeping attachment?
Ans. In 1964, Goldman et al. noted a second mechanism of gaining root coverage by phenomenon of creeping attachment. This occurs between 1 month and 1 year and was the result of coronal migration of newly grafted attached gingiva over the portions of a previously denuded root.
Q3. Which root coverage grafting procedure is considered as gold standard?
Ans. Connective tissue grafting procedure.
Q4. What is the main disadvantage of epithelial grafting?
Ans. Color difference between the grafted area and the adjacent tissues.
Q5. Which flap technique increases the width of attached gingiva?
Ans. Apically displaced flap.
Q6. What is the main postoperative instruction given to the patient after grafting procedure?
Ans. Patient should not retract the lip or cheek to observe the graft.
Q7. Who gave subepithelial connective tissue grafting procedure?
Ans. Langer and Langer in 1985.
Q8. Who originally developed laterally positioned pedicle flap?
Ans. Grupe and Warren in 1956.
Q9. Who gave semilunar Coronally displaced flap technique?
Ans. Tarnow in 1986.
Q10. What is the basic difference between frenectomy and frenotomy?
Ans. Frenectomy is the complete removal of the frenum, including its attachment to the underlying bone, whereas frenotomy is the incision of the frenum.