Case pres

Question 1

How do you define perio stability?

Answer 1

PPD <4mm with no BOP
Marginal bleeding scores <10%

Question 2

When can you move from step 1 perio?

Answer 2

When patient is engaging
Plaque score <20%
Bleeding score <30%
OR
more than 50% reduction in both
OR
patient meeting self care plan standards

Question 3

When can you move from step 2 to step 3?

Answer 3

Minimum 8 weeks but standard recommendation is 3 months - to allow for formation of long junctional epithelium and increase in tissue tone

Question 4

How do you manage your patient’s dental anxiety?

Answer 4

Ask them what their issue is - fear of the unknown
Explain all procedures as you go
Behavioural management technique
- Give stop and rest signals
- Positive reinforcement
- Distraction/ relaxation

Question 5

Why do you need a cuspal coverage restoration for an endo-treated tooth?

Answer 5

To reduce bacterial ingress - better coronal seal with cuspal coverage restoration that is luting cemented in than you do with a direct restoration
Helps prevent root fracture and prevent cusp/ restoration fracture.

Question 6

What is gingivitis vs. periodontitis?

Answer 6

Gingivitis - inflammation of the gingivae

Periodontitis - inflammation of the periodontium and destruction of supporting alveolar bone

Question 7

Why no lower denture?

Answer 7

Function will not hugely be improved/ impacted by addition of two teeth - small saddle areas
Mesial tiliting of 8’s would make path of insertion difficult
Patient ultimately did not want one anyway