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Perio - Exam 2 > ABX - Part II > Flashcards

ABX - Part II Flashcards

1
Q

What are some implications of oxygenating products for the control of plaque and gingivitis?

A

MOA: Inhibits anaerobic bacteria, short term anti-inflammatory properties

Safety?

  • Black, hairy tongue
  • Tissue injury
  • Co-carcinogen
  • Delayed wound healing

*Research does NOT support its use

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2
Q

What are some oxygenating products?

A

OxyFresh
-Peroxide, Peroxyl

Plax

  • Na benzoate, Na lauryl sulfate, Na salicylate
  • 8.7% alcohol
  • Pre-brush rinse

Sanguinarine

  • Bloodroot plant
  • Questionable results, no longer available

Povidone iodine (Betadyne)

  • Broad-spec
  • Pre-procedural rinse
  • Good outcomes when used with SRP

Sodium Hypochlorite

  • Bleach
  • Broad spec
  • Low cost, easy to use
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3
Q

Tell me about SnF2.

A

Anticarogenic effect

Reduces gingivitis, but not plaque scores

Limited benefits as subgingival irritant

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4
Q

Tell me about baking soda + NaCl + H2O2.

A

Can be used as an antimicrobial

  • Associated with Keyes’ technique
  • Put bacteria on slide
  • Add the formulation and it kills the bacteria
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5
Q

What is Triclosan?

A

Broad spec antimicrobial

MOA: Bacterial cytoplasmic membrane

  • Colgate is the ONLY toothpaste w/ ADA seal for plaque/gingivitis reduction
  • Not used much here in US
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6
Q

T/F - Studies have NOT documented effectiveness of topical chemical plaque control agents in the tx of periodontitis.

A

TRUE

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7
Q

T/F - Studies have documented that Biotene DOES have an effect on periodontal disease.

A

TRUE

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8
Q

What are the 3 areas for irrigation?

A

Supragingival
-Coronal to the gingival margin

Marginal
-Angled apically to FGM

Subgingival
-Into sulcus

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9
Q

3 rationales for irrigation.

A

Flush away bacteria

LPS is loosely adherent

Non-specific reduction of microbes

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10
Q

T/F - Subgingival irrigation can get 75-93% of the pocket depth, NOT all of it.

A

TRUE

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11
Q

What angle should the tip be at for supragingival irrigation?

A

90 degrees

IF doing marginal irrigation
—45 degrees

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12
Q

T/F - There is a strong relationship b/t plaque accumulation and gingivitis.

A

TRUE

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13
Q

What is hydrokinetics?

A

Pulsating water w/ compression and decompression phases

Displaces debris and bacteria

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14
Q

What are the results of supragingival irrigation as a mono therapy?

A

Varied results

Do NOT use in lieu of tooth brushing

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15
Q

Irrigation plus oral hygiene does what for mild or moderate periodontitis?

A

Significant reduction of proinflammatory cytokines (IL-1, PGE2)

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16
Q

What is the greatest pt benefit with gingivitis in using supragingival irrigation?

A

Interproximal cleaning is improved

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17
Q

T/F - 0.2% CHX in irrigation systems slightly reduced probing depths (Improved PERIODONTITIS slightly)

A

TRUE

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18
Q

How is subgingival penetration of solutions after supragingival irrigation?

A

3 mm subg

Beneficial in treating gingivitis not periodontitis

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19
Q

T/F - Suprag irrigation appears to similar levels of bacteremia as toothbrushing, floss, perio dressing changes, SRP and chewing.

A

TRUE

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20
Q

3 pt groups that are good candidates for suprag irrigation?

A

Inadequate oral hygiene

Ortho pts

Gingivitis pts

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21
Q

Methods of subg irrigation?

A

Syringe

Jet irrigator

Ultrasonic

*Should be preceded by SRP

**Limited by calculus, lateral dispersion

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22
Q

How far into the pocket should the syringe tip be inserted?

A

3 mm

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23
Q

T/F - Subg irrigation resulted in a reduction of pathogens, but then a return to baseline at 1-8 weeks.

24
Q

T/F - Subg irrigation should be used as an adjunct to SRP.

25
T/F - Currently insufficient data to indicate routine use to augment SRP.
TRUE
26
Subg irrigation: CHX vs. Betadine
CHX -No significant difference than with H2O —Possible difference in pockets 4-6 mm, but not more than 6 Betadine -Possible enhanced effect in depths >7mm
27
What are some limitations to Subg irrigation with medicaments?
Short half life Minimal dispersion Blood contact inactivates CHX GCF flows outward
28
T/F - A single episode of in-office subg irrigation to enhance SRP does NOT improve clinical healing.
TRUE
29
What should be used at home for irrigation?
CHX, Listerine, Fluoride Daily delivery benefit*
30
Is Arestin a replacement for irrigation therapy?
NO
31
How are Arestin-type products effective?
Reach the base of the pocket Must be high enough concentrations to destroy the bacteria Drug must stick around
32
What are advantages of Arestin-like products?
Sustained higher drug conc in GCF Better pt compliance/acceptance Drug resistance has not become a problem Site specific
33
What are the characteristics of minocycline?
Bioadhesive Bioresorbable Safe
34
What is minocycline?
Broad spec Semi-synthetic derivative of tetracycline * Effective against the RED COMPLEX* - MIC is high - pH is changed
35
T/F - Minocycline achieves high local conc w/ minimal systemic levels.
TRUE
36
What does Arestin do?
Decreases pocket depths Doesn’t do much to attachment level
37
2 sites where Arestin and SRP delivered enhanced efficiency to difficult to treat sites and pts?
Molars Furcation sites
38
3 pt groups where Arestin and SRP enhance efficacy?
Smokers Elderly Pts with current CV disease or CV disease history
39
Can Arestin be used to treat periodontitis?
NO -B/c it does nothing to attachment loss, which is a hallmark of periodontitis —It DOES decrease pocket depth by decreasing the swelling in the pocket by killing the bugs
40
T/F - Arestin + SRP are significantly more fertile in reducing pocket depth than SRP alone.
TRUE
41
T/F - Repeated therapy w/ minocycline prolongs efficacy and minocycline is easy to use, well-tolerated, and safe.
TRUE
42
What are pt instructions after Arestin application?
No brushing for 12 hours Avoid eating hard, crunchy, or sticky foods for 1 week Postpone use in interproximal cleaning devises for 10 days (including floss) *Maintains therapeutic conc for up to 14 days
43
What is Atridox?
Doxycycline gel Must be removed after 7-10 days via flossing or toothbrushing
44
What is Atridox used for?
Tx of chronic adult periodontitis for a gain in clinical attachment, reduction in probing depth, and reduction in BOP *It physically pushed the tissues away and required them to re-attach
45
What are the contraindications for Atridox?
Pts hypersensitive to doxycycline or any other drug in the tetracycline class
46
T/F - SRP results in increased attachment.
TRUE
47
T/F - Pt should avoid brushing, flossing, and eating at affected sites for one week.
TRUE
48
T/F - Approved as a mono therapy and should be used as an adjunct to mechanical tx.
TRUE
49
What is the chemical in PerioChip?
Chlorhexidine
50
How deep should pockets be for PerioChip tx?
5 mm Pt should not brush or floss for 7 days
51
T/F - For a pt that received a locally delivered system, results should be seen 10 days to 14 days. If improvement, resume recalls. If no improvement, re-apply or refer.
TRUE
52
T/F - In the 70s, it was thought: Treat PD as bacterial infection Only few specific organisms that needed to be targeted Thought to be exogenous and could eliminate from body indefinitely Noteworthy successes
TRUE
53
What 3 groups should receive abx prophylaxis?
Uncontrolled diabetes HIV with ANUG Active chemotherapy tx
54
T/F - ABx should be used as an adjunct to implants and guided bone regen/guided tissue regen
TRUE
55
Primary proteinases important to us?
Collagenase, gelatinase, elastase
56
Arachidonic Acid metabolites result in what activities?
Increased vasopermeability and vasodilation leading to redness and edema Potent induced of MMP secretion by monocytes and fibroblasts to trigger CT destruction

Perio - Exam 2 (8 decks)

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