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4910 periodontal maintenance

Every 3 to 4 months

1

They can retain teeth and we can:

Stop attachment loss

2

Our three goals of periodontal maintenance

1. Control the information by controlling etiologic risk factors
2. Preserve attachment levels
3. Preserve bone around teeth

3

Procedures during periodontal maintenance

Health history, clinical assessment, evaluate home care and levels of plaque, Point out good things, periodontal instrumentation, other treatments needed

4

Periodontal instrumentation:

Thin ultrasonics on low-power, liberal use

5

Code 4341

SRP of up to three teeth per quad, used for recurrence in limited individual sites

6

Noncompliance

In study, 16% fully compliant, 49% erratic compliance, 34% never participate

7

Reasons for noncompliance

Fear, expense, low priority, denial, misunderstanding implications of noncompliance, perceived indifference of healthcare provider

8

Root caries

Demineralized at pH of 6.2, strip mutans and lactobacillus, discolored tan or brown areas that are soft and Shallow

9

Cambra

Caries management by risk assessment

10

Measurements for good candidate for implant

6.6 mm of bone, height of jaw bone 10 mm, diameter of implant 3 to 6 mm

11

Early implants

Endosseous root or blade, subperiosteal

12

Specific indications for implants

Gag reflex so no denture, long span bridge, free and removable partial denture's, alternative to bridge, hopeless periodontally involved teeth

13

Two-stage surgical procedure

First implant placed with cover on screw, then three months later abutment placed

14

One stage surgical procedure

Implant and abutment placed in one visit

15

Successful implant

Immobile, no inflammation, no discomfort or pain, no increased bone loss, no bone loss greater than one third of the implant, bone loss is less than .2 mm after year, no mechanical failure

16

Bacterial infection

Porphyromonas gingivalis, Prevotella intermedia, fusobacterium nucleatum

17

No probing necessary if Peri-implant tissue is healthy

True

18

Implant maintenance

Meticulous self-care, three-month recall, Watch for decrease in bone, inflammation, host response or systemic disease affecting implant

19

Debridement of implants

Use plastic or titanium, ultrasonic Piso tips with plastic tip, interdental brushes without wire, super floss