Resective Osseous Surgery

 All the questions have been directly picked from Carranza 11th edition

1.      Allografts are

a.       bone obtained from the same individual

b.      bone obtained from a different individual of the same species

c.       bone from a different species.

d.      Bones obtained from identical twins

 

 

  Hint✅🔑

Ans: B

·         autografts are bone obtained from the same individual;

·         allografts are bone obtained from a different individual of the same species; and

·         xenografts are bone from a different species

·         Bones obtained from identical twins are called isografts

 

2.      A physical effect by which the matrix of the graft forms a scaffold that favors outside cells to penetrate the graft and form new bone is called

a.       Osteogenesis

b.      Osteo-induction

c.       Osteo-conduction

d.      Guided tissue regeneration

 

 

  Hint✅🔑

Ans: C

·         Osteogenesis refers to the formation or development of new bone by cells contained in the graft.

·         Osteoinduction is a chemical process by which molecules contained in the graft (e.g., bone morphogenetic proteins) convert the neighboring cells into osteoblasts, which in turn form bone.

·         Osteoconduction is a physical effect by which the matrix of the graft forms a scaffold that favors outside cells to penetrate the graft and form new bone.

 

 

 

3.      The flap technique best suited for grafting purposes (reconstructive surgery ) is

a.       papilla preservation flap

b.      modified Widman flap

c.       undisplaced flap

d.      apically displaced flap

 

 

  Hint✅🔑

ans: A

·         The flap technique best suited for grafting purposes is the papilla preservation flap because it provides complete coverage of the interdental area after suturing.

 

4.      A technique using a mixture of bone dust and blood is called as

a.       bone blend technique

b.      bone swaging technique

c.       bone grind technique

d.      osseous coagulum

 

 

  Hint✅🔑

ans: D

Robinson described a technique using a mixture of bone dust and blood that he termed osseous coagulum.  The technique uses small particles ground from cortical bone. The advantage of the particle size is that it provides additional surface area for the interaction of cellular and vascular elements.

 

 

 

5.      Advantages of osseous coagulum are

a.       ability to procure adequate material for large defects

b.      ease of obtaining bone from an area already exposed during surgery

c.       relatively high predictability

d.      all of the above

 

 

  Hint✅🔑

ans: B

·         Sources of the graft material include the lingual ridge on the mandible, exostoses, edentulous ridges, the bone distal to a terminal tooth, bone removed by osteoplasty or ostectomy, and the lingual surface of the mandible or maxilla at least 5 mm from the roots

·         The obvious advantage of this technique is the ease of obtaining bone from an area already exposed during surgery.

·         The disadvantages are its relatively low predictability and the inability to procure adequate material for large defects.

 

 

 

 

6.      Allograft closely associated with bone morphogenetic proteins (BMPs) is

a.       freeze-dried bone allograft (FDBA)

b.      demineralized FDBA (DFDBA)

c.       Kiel bone

d.      Bio-Oss (Osteohealth)

 

 

  Hint✅🔑

Ans: B

·         Kiel bone is calf or ox bone denatured with 20% hydrogen peroxide, dried with acetone, and sterilized with ethylene oxide.

·         Bio-Oss (Osteohealth) is a bovine-derived bone. It is an osteoconductive material.

·         Demineralization of DFDBA in cold, diluted hydrochloric acid exposes the components of bone matrix, which are closely associated with collagen fibrils and have been termed bone morphogenetic proteins (BMPs).

·         Freeze-dried bone allograft (FDBA) is considered an osteoconductive material, whereas demineralized FDBA (DFDBA) is considered an osteoinductive graft. Hence, DFDBA has a higher osteogenic potential than FDBA and is therefore preferred.

 

 

 

7.      Untrue about Biologic Mediators are:

a.       used to stimulate periodontal wound healing

b.      promote the differentiation of cells to become osteoblasts

c.       recombinant human PDGF (rhPDGF) -BB is approved by the US Food and Drug Administration (FDA) only for periodontal regeneration

d.      research shows that macrophages play no role in the secretion of the biological mediators.

 

 

  Hint✅🔑

Ans: D

 

 

 

8.      Most common type of bone defect is

a.       horizontal

b.      vertical

c.       combination of horizontal and vertical

d.      ledges formation

 

 

  Hint✅🔑

ans: C

Bone loss has been classified as either “horizontal” or “vertical,” but in fact, bone loss is most often a combination of horizontal and vertical loss.

 

 

 

9.      Untrue about horizontal bone loss

a.       generally results in a relative thickening of the marginal alveolar bone

b.      may result from chronic periodontitis

c.       is seen in case of trauma from occlusion

d.      may occur in combination with vertical bone loss

 

 

  Hint✅🔑

ans: C

·         Horizontal bone loss generally results in a relative thickening of the marginal alveolar bone because bone tapers as it approaches its most coronal margin.

 

 

 

10.  Osseous surgery designed to restore the form of preexisting alveolar bone to the level present at the time of surgery or slightly more apical to this level

a.       Additive osseous surgery

b.      Substractive osseous surgery

c.       Resective osseous surgery

d.      Non- Resective osseous surgery

 

 

  Hint✅🔑

Ans: B

·         Osseous surgery can be either additive or subtractive in nature.

·         Additive osseous surgery includes procedures directed at restoring the alveolar bone to its original level,

·         Subtractive osseous surgery is designed to restore the form of preexisting alveolar bone to the level present at the time of surgery or slightly more apical to this level

 

 

 

11.  One-wall angular defects

a.       usually need to be recontoured surgically

b.      treated with techniques that strive for new attachment and bone reconstruction

c.       treated with either method, depending on their depth, width, and general configuration

d.      treated with guided tissue regeneration

 

 

  Hint✅🔑

ans: A

·         One-wall angular defects usually need to be recontoured surgically.

·         Three-wall defects, particularly if they are narrow and deep, can be successfully treated with techniques that strive for new attachment and bone reconstruction.

·         Two-wall angular defects can be treated with either method, depending on their depth, width, and general configuration.

 

 

 

12.  Not a disadvantage of osseous surgery

a.       performed at the expense of bony tissue

b.      least predictable pocket reduction technique

c.       increased loss of attachment

d.      technique sensitive.

 

 

  Hint✅🔑

Ans: B

·         Osseous resective surgery is the most predictable pocket reduction technique

 

 

 

13.  When the bone is consistently more coronal on the interproximal surfaces than on the facial and lingual surfaces, the osseous architecture is considered to be

a.       positive

b.      negative

c.       flat

d.      ideal

 

 

  Hint✅🔑

ans: D

·         Note that not all of the above positive architectures are ideal.

·         Osseous form is considered to be “ideal” when the bone is consistently more coronal on the interproximal surfaces than on the facial and lingual surfaces. The ideal form of the marginal bone has similar interdental height, with gradual, curved slopes between interdental peaks.

·         The architecture is “positive” if the radicular bone is apical to the interdental bone.

·         The bone has “negative” architecture if the interdental bone is more apical than the radicular bone.

·         Flat architecture is the reduction of the interdental bone to the same height as the radicular bone.

 

 

 

14.  Most common bony defects found in the periodontitis patients is

a.       One –walled defect

b.      Two-walled defect

c.       Three- walled defect

d.      Spiral defects

 

 

  Hint✅🔑

Ans: B

·         Two-walled defects (craters) are the most common bony defects found in patients with periodontitis.

 

 

 

 

15.  The sequence of resective osseous surgery are

a.       Vertical grooving , Flattening interproximal bone, Radicular blending, Gradualizing marginal bone

b.      Vertical grooving , Radicular blending,  Flattening interproximal bone, Gradualizing marginal bone

c.       Vertical grooving , Radicular blending, Flattening interproximal bone, Gradualizing marginal bone

d.      Vertical grooving , Flattening interproximal bone, Gradualizing marginal bone, Radicular blending

 

 

  Hint✅🔑

Ans: B

Vertical grooving is the first step of the resective process because it can define the general thickness and subsequent form of the alveolar housing.

 

 

 

16.  Hand instruments are preferred over the rotary instruments in

a.       Vertical grooving 

b.      Radicular blending  

c.       Flattening interproximal bone 

d.      Gradualizing marginal bone

 

 

 

  Hint✅🔑

Ans: D