DENTISTRY
Periodontal nomenclature
An alveolectomy is the removal of some or all of the
alveolar bone.
An alveoloplasty is a form of alveolectomy performed to
restore physiological contours or achieve smooth contours
of the alveolar bone.
An apically positioned flap is moved apical to its original
location.
An envelope flap is retracted away from a horizontal
incision; there is no vertical incision.
Closed periodontal debridement involves the removal
of damaged, infected, inflamed or necrotic tissue from
periodontal pockets and dental deposits from the tooth
surface without the creation of a flap; this includes gingival
curettage (or excisional new attachment procedure) and
root planing.
A coronally positioned flap is moved coronal to its original
location.
Gingival curettage refers to the removal of damaged,
infected, inflamed or necrotic tissue from the soft tissue
lining of a periodontal pocket.
Gingival enlargement is a clinical term referring to the
overgrowth or thickening of gingiva in the absence of a
histological diagnosis.
A gingival flap contains gingiva.
attachment loss (Figure 3A and 3B). The resultant
pseudopocket accumulates plaque and calculus,
which, if left untreated, may progress to attachment
loss. Surgical treatment, including gingivectomy and
gingivoplasty, is performed using a scalpel blade, laser
or radiosurgery to sculpt the gingiva and decrease or
eliminate the pseudopockets. What to do when you
find a pocket
The goal of periodontal therapy is to decrease the size
of or eliminate pockets in cases of early and moderate
periodontal disease by removing subgingival plaque
and calculus, using locally applied antimicrobials,
performing gingivectomy, or extracting the affected
teeth. Extraction is indicated when more than half of
the root is not supported by the periodontium.
Subgingival cleaning: ultrasonic scaling.
Bacteria-coated calculus left on the root surface
contributes to the progression of periodontal disease.
In order for the ultrasonic scaler to therapeutically
débride a periodontal pocket, it needs to contact every
part of the accessible root surface. Using ultrasonic
thin periodontal tips specifically manufactured for root
surface use, place the scaler tip’s side parallel to the
long axis of the tooth, similar to positioning a diagnostic
periodontal probe. To avoid iatrogenic damage,
decrease the power and increase the amount of water
Gingival hyperplasia is a histological term referring to
an abnormal increase in the number of normal cells
in a normal arrangement resulting in clinical gingival
enlargement.
Gingival recession refers to root surface exposure caused
by apical migration of the gingival margin or loss of gingiva
Gingivectomy refers to removal of some or all gingiva
surrounding a tooth.
Gingivoplasty is a form of gingivectomy performed to
restore physiological contours of the gingiva.
A mesiodistally or distomesially positioned flap is moved
distal or mesial to its original location along the dental
arch; this flap has also been called a laterally positioned
flap.
Open periodontal debridement is the removal of
damaged, infected, inflamed or necrotic tissue from
periodontal pockets and dental deposits from the tooth
surface after flap creation; this includes the removal of
affected gingiva and granulation tissue upon flap creation
and management, root planing, and osseous resective
procedures such as an alveolectomy and alveoloplasty.
A periodontal flap contains gingiva and alveolar mucosa.
Root planing refers to the removal of dental deposits
from and smoothing of the root surface of a tooth; it is
described as closed when performed without a flap and
open when performed after flap creation.
Figure 4: An air/water syringe is used to show plaque and calculus
not removed during scaling and polishing
irrigation to remove subgingival plaque and calculus.
After you’ve completed ultrasonic tooth scaling, use
an air/water syringe to gently blow the gingival margin
away from the tooth and examine the tooth surface
for remaining plaque and calculus to remove (Figure
4). You can then use water from the air/water syringe
to lavage unattached debris from the sulcus or pocket.
Subgingival cleaning: curette-assisted root
planing.
The goal of root planing is to make the root less
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Issue 05 | NOVEMBER
2018
28
Issue
04 | | AUGUST
2017 28