Non-Surgical Periodontal Management Flashcards
(39 cards)
Non surgical management is also called…..
cause related therapy
hygiene phase therapy
3 aims of periodontal treatment
to arrest the disease process
ideally, to regenerate lost tissue
to maintain periodontal health long term
result = keep teeth
treatment plan stages
emergency care
disease control
re- evaluation
periodontal surgery
reconstruction
supportive care
parts of disease control phase in Tx plan
extraction of hopeless teeth
hygiene phase therapy
caries management
endodontic therapy (RCT)
provisional prostheses
periodontitis
Loss of attachment and true pocket formation colonisation of the root surface
parts of hygiene phase therapy
Dental health education
Oral hygiene instruction
Scaling and root surface debridement
Removal of other plaque-retention factors
- E.g. defective restoration margins
Re-evaluation
- Establish if worked, if not figure out why
how to carry out dental health education for periodontal management
Evaluate patients’ reasons for attendance, attitudes to health care, motivation etc
Explain the nature of disease using diagrams, photographs, models etc.
Discuss findings of examination
- Demonstrate health and disease in the patients mouth
- Explain the nature and consequences of treatment
Why maintenance and commitment needed
- Use language the patient will understand
Booklets on clinics – ask for them to show pt
- Importance of interdental cleaning
3 components of oral hygiene instruction to cover
Tooth brushing – modified bass technique
Interdental cleaning
- Floss and tape
- Interdental sticks
- Interdental brushes
Why they don’t use regularly? -show how to use effectively
Many on market – make sure pt knows which they are to use and the right size
Fits but isn’t tight, displace the bristle but not touch the wire
Give them a few sizes to try but not to many to overwhelm
Disclosing agents
scaling
removal of plaque and calculus from the tooth surfaces
root surface debridement (RSD)
The act of removing dead, contaminated or adherent tissue or foreign material
Encompasses the process of
- Scaling and
- Removal of supragingival calculus
- removal of subgingival plaque in true pocket
progressive alveolar bone loss per year if sub-gingival plaque impregnate pocket
1mm/year
2 types of scaling instruments
Hand instruments
Powered instruments
- Ultrasonic (predominate)
- Sonic
- Rotating
- Reciprocating
All equal effective if used correctly and mastered (not damaging teeth)
where can ultrasonic instruments be used
supra and sub-gingivally
3 possible problems in restorations that can contribute to periodontal disease
Restoration margins
- Location
- Adaptation (fit)
Restoration contour
- Contour emergence can make plaque trap
- Shelves at gingival margin
- Square, plaque trap
Partial dentures
- Gingival convergence
- Direct trauma
- Uncontrolled loads
3 ways to measure success in periodontal treatment
Inflammation (bleeding on probing indices)
Reduction in probing depth
Gain in probing attachment level
how far apart are the bands on a PCP 12 probe
3mm
what probe is used for 6PPC
PCP 12 probe
coronal gingival overgrowth is
negative
gingival recession is
positive
probing depth indicates
the difficulty of treatment and the likelihood of recurrence
attachment levels are
measure of tissue destruction (pre-treatment) and the extent of repair (post-treatment)
6 factors which influence manual probing measurements/depths
the resistance of the tissues
size, shape and tip diameter of the probe
site and angle of the probe insertion
pressure applied
presence of obstructions such as calculus
patient discomfort
- pt complains
what does successful periodontal therapy require
both supra and sub gingival plaque control
effect of supra-gingival plaque control alone
decreased gingival inflammation
limited effect on probing depth
no change in attachment levels
- stabilisation
no alteration in subgingival microflora in deep pockets (>6mm)
reduction in inflammation but still pocket – root surface debridement wrong
