Clinical
the bone Close to
Dr Alan Maxwell takes us a on a step-by-step journey through resective bone surgery, a procedure often employed to correct defects found at moderate to advanced stages of periodontal disease
T
he term resective bone surgery is applied to all procedures employed to eliminate crater and angular defects caused
by the bone reabsorption typical of periodontal disease. Elimina- tion of craters and osseous angular defects is therefore vital to obtaining an optimum gingival profile and maintaining shallow pockets after periodontal surgery.
Bone defects Bone defects consist of localised reabsorption of the osseous alveolar crest around the tooth. They are also known as intraosseous defects as they are formed within the bone mass and are classified according to the number of constituent walls. Bone defects may occur in various sites around the same tooth and are usually located in the inter-proximal space. However, they may also occur in the buccal and/or palatal and
lingual bone tissue. If they occur in the bone tissue of a root furcation, there may also be some degree of reabsorption between the roots, in the severest cases, establishing communication between the buccal and palatal or lingual sectors (Figs 1-4). Resective bone surgery is not
indicated for very large bone defects which are more effectively treated Continued »
RESTRICTIVE BONE SURGERY INDICATIONS
Bone reshaping Elimination of small
bone defects Creation of a
physiological profile
TECHNIQUE Osteoplasty
Ostectomy
Osteoplasty Ostectomy
BONE SURGERY
RESECTIVE Osteoplasty Ostectomy
ADDITIVE
Bone grafts Bone implants
REGENERATIVE Guided tissue regeneration (GTR)
CONTRA INDICATIONS None
Grade 2/3 tooth mobility
>50 per cent bone reabsorption Grade 2/3 tooth mobility
Scottish Dental magazine 43
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