Osseous Craters

An osseous crater is an interproximal, two-wall deled that does not improve with orthodontic treatment. Some shallow craters (i.e., 4- to 5-mm pocket) may be maintainable nonsurgically during orthodontic treatment. However, il surgical correction is necessary, this type ot osseous lesion can easily be eliminated In reshaping the defect12,1 * and reducing the pocket depth lFig. 53-1) (see Chapter 62). Ibis in turn enhances the ability to maintain these interproximal areas during orthodontic treatment. The need for surgery is based on the patient's response to initial root planing, the patient's periodontal resistance, the location of the delect. and the predictability ol maintaining defec ts nonsurgically while the patient is wearing orthodontic appliances.

Osseous Craters Periodontal Defects

Fig. 53-1 This patient had a 6-mm probing defect distal to the maxillary right lirst molar (A). When this area was flapped (B), a cratering defect was apparent. Osseous surgery was used to alter Ihe bony architec lure on the buccal and lingual to eliminate the deiect (C and D) After 6 weeks, the probing pocket delect had been reduced to 3 mm, and orthodontic appliances were placed on the teeth (E) By eliminating the crater before orthodontics, the patient could maintain the area during and after orthodontics (F)

Fig. 53-1 This patient had a 6-mm probing defect distal to the maxillary right lirst molar (A). When this area was flapped (B), a cratering defect was apparent. Osseous surgery was used to alter Ihe bony architec lure on the buccal and lingual to eliminate the deiect (C and D) After 6 weeks, the probing pocket delect had been reduced to 3 mm, and orthodontic appliances were placed on the teeth (E) By eliminating the crater before orthodontics, the patient could maintain the area during and after orthodontics (F)

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Three-Wall Intrabony Defects

I hree-vvall delects are amenable to |H>ckct reduction with regenerative periodontal therapy.1 bone grafts using either autogenous bone from the surgical site or allografts along with the use of resorbable membranes have been successful in filling three-wall delects.M It the result ol periodontal therapy is stable (Fig. 5A-2) ^ to months after periodontal surgery, orthodontic treatment may be initiated.

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Responses

  • Addolorata
    Are 2 wall craters the most amenable to osseous surgery?
    8 years ago

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