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perio 3rd yr > lecture 1 > Flashcards

lecture 1 Flashcards

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1
Q

should you ask open or closed end questions

A

open

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2
Q

3 steps of motivational interviewing

A

elicit patients readiness and interest in hearing info, provide info in neutral manner and then elicit patients rxn to info

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3
Q

what brushing technique do we want to use?

A

modified brass technique

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4
Q

explain modified brass technique

A

hold bursh horizontal to tooth surface with it touching slightly on gingiva, then tild 45 degress so that brissles are under the gingiva area and use back and forth or small circles

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5
Q

what level of plaque index is acceptable?

A

15%

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6
Q

when it comes to tooth brushes, which is more effective and which is more efficient.

A

both can be effective, however electric would be more efficient because it can do more in a certain amount of time vs manual. if someone has ortho, or hard time brushing properly than electric is better. also the more expensive, usually the better it is.

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7
Q

tips for flossing for patients

A

correct placement into sulcus, wrapping proximal area, and correct controlled motion

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8
Q

how effective is floss at removing plaque?

A

80%’

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9
Q

what percent of adults reguarly floss?

A

18%

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10
Q

types of floss used for wider emrasures?

A

super floss, ultra floss and butler weave

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11
Q

interdental or proxa brushes good for what uses?

A

large embrasures, around pontics, distal to last molars, orthodontic appliance and implant abutments

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12
Q

interdental rubber tips good for what

A

exposed furcations, concavities and massaging gingival tissue

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13
Q

interdental stimulators?

A

triangular shape, made of balsa wood, moisten before using

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14
Q

rationale for SRP

A

disrupts subgingival microbial flora, delaying repopulation of pathogenic microbes

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15
Q

measurable endpoints for SRP

A

loss or gain of attachment levels, BOP, gingival inflammation, probings, change in microflora

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16
Q

keratinized tissue minus probing depth is what

A

attached gingiva

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17
Q

how do you measure keratinized tissue?

A

from mucogingival jxn to the free gingival marin

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18
Q

explain what clinical attachment levels mean

A

CEJ to the depth of clinical pocket (recession + pocket depth)

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19
Q

after SRP what happens to shallow pockets vs deeper pockets?

A

shallow tend to lose attachment and recession occurs. deeper pockets tend to show a gain in attachment and therefor decreased probing depths

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20
Q

why do shallow pockets tend to lose attachment loss?

A

mechanical trauma from instrumentaion or aggresive oral hygiene procedures

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21
Q

is gingival inflammation and BOP a reliable indictor of future breakdown?

A

no

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22
Q

absence of BOP and inflammation tells us what

A

somewhat reliable indicator of heatlh

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23
Q

SRP reduces what kind of bacteria

A

motile microbes and spirochetes

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24
Q

in intial pocket depths of ____mm or greater have been shown to inadequately debride roots 65% of the time

A

5

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25
removal of soft and hard deposits adhering to tooth surface is called what
scaling
26
removal of diseased root surfaces to create a smooth non-contaminated root surface- not the removal of calculus alone
root planning, removing infected cementum
27
technical term for root planning is _______ but clinical is what?
removal of cementum, deep pockets and recession
28
effective instrumentation (4 steps)
adaption, angulation, motion activation and handle roll
29
if instrument is under the light and it is reflecting light what does this mean?
needs to be sharpened, flat and sharp edge does not reflect the light
30
definition of adaption
placing leading 3rd of cutting edge in contact with tooth surface. In this position, the cutting edge is correctly adapted to the tooth. we enter in closed fasion and at base of pocket we put into working angle where the lower shank is parallel to surface youre tyring to clean
31
angulation for gracey curette which has 1 cutting edge
less than 90 and greater then 45
32
motion activation refers to what
moving instrument in order to produce instrumentation stroke
33
finger rest while SRP goes in order from most recomended to least as:
close to area working, cross arch, opposite arch, or extraoral arch
34
what type of pressure should be used while scaling?
firm lateral pressure, should see the instrument moving.
35
should you use hand instruments of ultrasonic?
always finish with hands bc will end with smoother surface. Ultrasonic only used in addition to hand
36
benefit of using ultrasonic?
furcation involvement
37
sub G calculus appears what color?
black
38
light touch should be used when using which instrument?
11/12 explorer
39
11/12 explorer moved in what direction
vertical and horizontal
40
feeling pebbles with explorer is what
diseased cementum
41
two most common places for calculus to remain after trt
depth of pocket greater than 5 and at the CEJ bc we mistake this for CEJ
42
Injection site for SRP with hand instruments only
pulpal not needed, just injection in mucosal tissue just apical to MGJ using mepivacaine 3%. and then subsequent injection in keratinized tissue using lido
43
reason for injecting mucosal tissue first when injection for hand instrumentation SRP
keratinized injection can be uncomrortable. start with a site other then papilla and follow the blanching of the tissue
44
what type of injection should you use on the mandible if youre not using ultrasonic?
local infiltration
45
what is oraqix?
topical local anisthetic- non injectable
46
contents of oraqix
2.5%lidocaine and 2.5%prilocaine | same as emla which is not for oral use
47
oraqix is a viscous material and lasts for how long/?
14-31 min for an average of 20min
48
instructions for oraqix
place on gingival margin and wait 30 sec, place in pocket and fill until gel visible, wait 30 sec. should only do few teeth at a time due to short action
49
oraqix is only for what?
soft tissue anesthesia, if root calculus, may not help a lot
50
chemotherapetics can be what two kinds?
systemic (antibiotics and periostat) or local administration
51
what is periostat?
systemic chemotherapeutic, 20mg doxycycline 2x/day. need higher dose for antimicrobial effect, anticoagulation at lower dose.
52
periostat works how?
inhibits enzymatic breakdown of collagen. periostate works on MMPs and SRP works at bacterial byproducts. prevents ct from actually breaking down
53
explain results of periostate
statistically significant but not clinically significant
54
why do we use periostate if results no clinical significant?
prevents future breakdown
55
53% of periodontitis is attributable to what?
smoking, 11% formee
56
what is the major preventable risk factor for periodontitis in the US?
smoking
57
current smokers are how many times more likely to have disease? and former?
4x 2x
58
former smokers who smoked 11 or more years ago have what risk?
same as non smokers
59
smoking increases levels of what? which increases what?
pro inflammatory mediators, increses release of destructuuve collagenase
60
periostat decreases levels of what? leadint o what
decreases levels of pro inflammatory mediators and collagenase, which leads to better chance of periodontal health
61
those at risk for developing periodontal disease are disease that affect what?
onset, rate, severity and response
62
who should use periostat?
those resistant to trt, those who cant afford to lose more attachment, and those that show signs of brakdown after being stable for a long time and smokers
63
4 types of local administration
actisite, atridox, periochip and arestin
64
periochip content is what
2.5mg chlorohexidine gluconate
65
acitisite is no longer used what
was tube that was inserted and leached out, but had to be removed 7-10days after
66
second generation local administration is what
periochip
67
explain periochip
wafer placed sub G. can be hard to place, need to giet it down fast bc can stick to the root surface. hard in narrow pockets to get to base. chlorohexidine not the strongest.
68
atridox content
42mg doxycycline
69
explain atridox
mixed in tube and injected into sulcus. hard to keep in place once injected
70
arestin contents
minocycline HCL microsperes
71
explain arestin
microspheres are bioadhesivem bioresorbable polymer in powder form
72
minocycline effective aginst what periodontal pathogens
p. gingivalis, P intermedia, and A actinomycetemcomitans
73
is minocyline broad or narrow narrow spectrum?
broad
74
characteristics of microspheres found in arestin?
sustain release, easy to use, 2 yr stability
75
explain research results of arestin?
scientifically significant but not clinically. but reduced pathogenic bacteria. less than 1.3mm of increase
76
arestin is indicated as what?
an adjunct to SRP
77
arestin should not be used in what?
prego, nursing or children due to tertacycline derivative (minocycline). cholorohexidine can be used
78
agents accepted by ADA as chemical inhibitors of plaque and calculus
chlorohexidine (peridex and periogard) and essential oils (listerine) and decapinol to reduce gingivitis
79
adverse effects of cholorhexidine
staining, unpleasant taste and interaction with dentrifaces
80
explain why cholorohexidine and dentrifaces are a problem
chlorohexidine has cations, which react with anions found in dentrifaces such as sodium lauryl sulfate reducing the effect of both
81
how long should you wait in between cholorohexidine and tooth paste?
2 hrs
82
listerine is a what
anitseptic
83
how does listerine work?
disrupting cell wall and inhibits enzymes. reduces gingival inflammation
84
only which type of listerine is ADA accepted?
cool mint listerine
85
are listerine and chlorohexidine safe for enhancement of postsurgical wound healing?
yes. listerine for periodonaly flap surgery and chlorohexidne for gingivectomies
86
what is used to reduce perimplantitis by decreasing inflammation
listerine and chlorohexidine
87
listerine was shown to be effective as_______ in trt of oral candidiasis in pts with ________.
nystatin, prosthetic appliances
88
peridex made of what
chlorohexidine hibitane

perio 3rd yr (7 decks)

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