Non-Surgical Periodontal Treatment Flashcards
(15 cards)
What is the rationale for periodontal treatment?
To reduce the bacterial burden, to reduce inflammation, to in turn cause pocket closure via reducing PPD <4mm, recession and CAL gain
What were the findings of the systematic review by Yaacob et al in 2014 regarding manual toothbrushes?
Concluded that greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points compared to manual toothbrushes
What were the findings of the systematic review by Poklepovic et al in 2013 regarding interdental cleaning?
There was insufficient evidence to determine whether interdental brushing reduced or increased levels of plaque when compared to flossing.
State some methods for assessing oral cleanliness
- Questionnaires
- Plaque scores
- Gingival index
- Bleeding index
Describe an oral hygiene prescription
- Interdental cleaning
- Lingual and posterior teeth with interspace brush
- Electric toothbrush
How did the 1st European workshop in periodontology in 1993 describe non-surgical management?
Selective removal of supragingival plaque and 1-3mm subgingivally, from all tooth surfaces, using mechanically driven instruments and fluoride prophy paste
Discuss the main findings of the Baderstan 1984 study ‘Effect of nonsurgical periodontal therapy’
- No differences in results could be observed when comparing hand versus ultrasonic instrumentation
- Shows to not instrument subgingivally for healthy pockets as it will cause loss of attachment
What were the finding of the systematic review by Tunkel et al, 2002 ‘Systematic review comparing hand versus machine driven instruments’
- No evidence for difference in efficacy
- Machine-driven suggested to be faster
State the advantages of an ultrasonic
- Remove less root substance vs manual and other power-driven devices
- A thin periodontal probe-like tip has advantage in accessing deep periodontal pockets vs conventional tips and hand instruments
- Less appointments and less chair time treatment required
State the disadvantages of an ultrasonic
- Can create heat without irrigant
- Contaminated aerosols
- Vibration to operator?
- Magnetostrictive ultrasonic scalers and pacemakers
- Less tactile sensation
- Some patients dislike ultrasonics
Describe the 4 main approaches to infection control in non-surgical management
- Quadrant SRP ( 4 1 hour sessions)
- One stage full mouth scaling (2 sessions in 24 hours)
- One stage full-mouth disinfection (2 sessions in 24 hours + CHX)
- Full mouth ultrasonic debridement ( 1 hour session with US thin tip)
Describe what is involved in the one stage full mouth disinfection regime
- Brush dorsum of tongue with CHX
- Rinse twice a day with CHX
- Spray pharynx and tonsils with CHX
- Repeated subgingival application of CHX
- Rinse and spray tonsils with CHX for next 2 months
What have been study findings regarding different infection control regimes?
- Full Mouth resulted in significantly higher pain than Quadrant
- Failed to show that FM‐SRP is a more efficacious periodontal treatment modality compared to Q‐SRP
- Single‐visit full‐mouth mechanical debridement can be completed in a shorter time.
- No significant difference in incidence of recurrence of disease between the two approaches
What have been the study findings regarding Er:YAG lasers for NSM?
- The results of the present trial failed to demonstrate any apparent advantage of the use of Er:YAG laser for subgingival debridement during maintenance therapy, besides less treatment discomfort perceived by the patients
What have been the study findings regarding subgingival air polishing?
- There were no statistically significant differences between the treatment procedures at any of the examinations intervals.
- Perceived treatment discomfort was lower for air polishing than ultrasonic debridement.
