localized chemotherapeutics in perio therapy

Question 1

chemotherapeutic agent is a general term for

Answer 1

achemical substance that provides clinical therapeutic benefit

Question 2

clinical benefits of chemotherapeutic agent

Answer 2

• antimicrobial actions

- ability to increase the host’s resistance

Question 3

chemotherapeutic in periodontal treatment management

Answer 3

• systemic antibiotics
• drugs that modulate host respnse(periostat, NSAIDS
• topical antimicrobial agents( mouth rinses, dentifrices)
• drug delivery systems (controlled)

Question 4

desirable characteristics of local chemotherapeutic

Answer 4

• substantivity
• low toxictity
• high potency
• good permeability
• intrinsic efficacy

Question 5

localized chemotherapeutics

Answer 5

• topical antimicrobials

- site specific local drug delivery by professionals

Question 6

def. of substantivity

Answer 6

Persistence of effect of a topically applied drug or cosmetic, determined by the degree of physical and chemical bonding to the surface; resistance to removal or inactivation by sweating, swimming, bathing, and friction, among other factors

Question 7

topical antimicrobials

Answer 7

• chlorhexidine
• essential oils
• povidine iodine
• quarternary ammonium chloride
• sanguinarine
• sodium hypochlorite
• stannous fluoride
• triclosan

Question 8

chlorhexidine is

Answer 8

• considered the gold standard
• cationic bisbiguanide
• mech. of action (MOA) - ruptures cell membranes
• good substantivity (adheres and releases for 6+ hours)

Question 9

side effects of chlorhexidine

Answer 9

• staining
• calculus formation
• taste alteration (less useful for long term treatment)

Question 10

chlohexidine concentration in

Answer 10

US-.12 with 11.6 alcohol

outside us-.2

Question 11

chlohexidine reduces plaque

Answer 11

by 50-55%

Question 12

chlohexidine reduces gingivitis by

Answer 12

45%

Question 13

use of chlohexidine

Answer 13

• 15 ml rinise for 30 seconds twice a day
• no rinsing or brushing for 30 minutes
• sodium lauryl sulfate and fluoride may decreses effectiveness
• effective as a pre-rinse to decrease bacterial load
• enhances wound healing

Question 14

Essential oil MOA

Answer 14

cell wall disruption and inhibition of bacterial enzymes

Question 15

essential oil contains

Answer 15

thymol
eucalyptol
menthol
methylsalicylate

Question 16

essential oils contain

Answer 16

21.6-26.9% alcohol

Question 17

essential oils reduces plaque and gingivitis by

Answer 17

34% when used twice a day

Question 18

for essential oil, 91% reduction in bacteria

Answer 18

when used as a prerinse before Sc/Rp

Question 19

Povidine iodine is a

Answer 19

• water soluble antimicrobialeffective against bacteria, viruses and fungi
• presurgical scrub for skin disinfection

Question 20

avoid Povidine iodine in

Answer 20

• pats with allergies to shellfish or iodine
• thyroid dysfunction
• pregnant or lactating women

Question 21

Quartenary ammonium compounds

Answer 21

• cetylpyridinium chloride alone
• combination domophenbromide
• MOA-rupture cell walls
• cationic surface active
• they bind but release rapidly, limits substantivity
• 14% and 24% reduction in plaque and ging

Question 22

Sanguinarine

Answer 22

• herbal alkaloid extract
• studied in mouthwash and dentrifices
• most effectivewhen agents are used together
• reduces plaque 17-42%
• reduces ging 18-57%

Question 23

Sodium Hypochlortie

Answer 23

• bleach
• endodontic irrigant for years
• corrosive effects on metals and bleaching if spilled on surfaces

Question 24

sodium hypochlorite is effective

Answer 24

• against bacteria, virus and fungi
• cheap
• ease of access

Question 25

Stannous fluoride

Answer 25

- ada seal in 1960 for prevention of decay | - exhibits effects on plaque and gingivitis

Question 26

stannous fluoride MOA

Answer 26

- promotes remineralization of decalcified enamel - inhbitsthe cariogenic microbial process in dental plaque - increases tooth resistance to acid dissolution

Question 27

Triclosan is

Answer 27

- bisphenol with broad spectrum antimicrobial activity - found in several different oral products - 20% reduction in gingivitis - 25 % reduction in plaque formation

Question 28

triclosan combined with

Answer 28

- zinc citrate, antiplaque and calculus effect - polyvinylmethyl and maleic acid to increase substantivity and anticalculus - pyrophosphates, anti calculus

Question 29

variety of products that combineagents with vectors or devices that can be placed directly into

Answer 29

periodontally diseased pocket

Question 30

goal of local or controlled delivery systems

Answer 30

ability to release up to 14 days at fractions of the systemic dose