Nonsurgical Periodontal Therapy

Question 1

define NSPT

Answer 1

all nonsurgical treatment and education measures used to help control gingivitis and periodontitis

Question 2

the goal is to plan a treatment that controls or eliminates what?

Answer 2

1. primary etiologic factors-bacteria
2. local risk factors-calculus
3. systemic risk factors-diabetes

Question 3

Periodontal surgery is ______ part of nonsurgical therapy

Answer 3

not

Question 4

the objective of NSPT is to eliminate disease and what?

Answer 4

1. return periodontium to health

2. maintain health with professional and patient self-care

Question 5

other names of NSPT

Answer 5

initial periodontal therapy, anti-infective phase, root debridement, or root planning and scaling

Question 6

what are removing with NSPT?

Answer 6

removing calculus and plaque with scalers and curetts

Question 7

what is root debridement

Answer 7

advanced instrumentation/therapy designated for patients with perio for AAP 2 and above

Question 8

indications for NSPT?

Answer 8

1. all patients with plaque-associated gingivitis or chronic perio

Question 9

even those patients with advanced perio go through NSPT first because NSPT may _____ the extent of surgery needed

Answer 9

minimize

Question 10

T/F: NSPT is the best therapy for aggressive perio?

Answer 10

false; it is not

Question 11

goals of NSPT

Answer 11

1. minimize bacterial challenges to patient
2. eliminate or control local risk factors for periodontal disease
3. minimize impact of systemic risk factors for perio disease
4. stabilize attachment level

Question 12

what is the ultimate number one goal of NSPT?

Answer 12

stabilize attachment level by controlling local and systemic factors

Question 13

components of NSPT

Answer 13

1. customized treatment plan
2. patient takes charge of self care
3. dental team provides routine professional care
4. correction of local and systemic risk factors
5. periodontal debridement

Question 14

____ removal of microorganisms and byproducts to prevent and treat periodontal infection

Answer 14

physical

Question 15

physical removal of bacteria plaque is the most _____ mechanism of control

Answer 15

effective

Question 16

pockets must be instrumented to _____ bacterial colonies

Answer 16

disrupted

Question 17

what are some rationals for instrumentation?

Answer 17

1. arrest progress of perio disease
2. eliminate bleeding
3. increase effectiveness of patient self-care
4. prevent recurrence of disease through periodic maintenance
5. induce positive changes in subgingival bacterial flora

Question 18

define scaling

Answer 18

removes plaque calculus and stains

instrumentation of crown and root surfaces

Question 19

define root planning

Answer 19

removes cementum and rough dentin impregnated with calculus toxins

Question 20

what can root planning lead to?

Answer 20

endodontic lesions

Question 21

define periodontal debridement

Answer 21

removes or disrupts bacterial plaque byproducts and calculus from crown and root within pocket space
doesn’t include deliberate aggressive removal of cementum

Question 22

what system do insurance’s use for coding

Answer 22

ADA system

Question 23

advantages of ultrasonic instrumentation

Answer 23

1. flushes debris, bacteria, and unattached plaque from pocket
2. tip is thinner and smaller than a Gracey and can reach the furcas better
3. optimum choice over hand instruments for perio debridement
4. shorter instrumentation time
5. low to medium power setting for less root surface damage

Question 24

endpoint for instrumentation is simply a return to what?

Answer 24

soft tissue health and free from inflammation

Question 25

what is the primary pattern of healing after instrumentation as far as the JE goes?

Answer 25

it is through formation of a long junctional epithelium which results in reduced probing depths

Question 26

what are we lacking when there is a long JE formation?

Answer 26

no formation of bone, cementum, or pdl fibers

Question 27

what time frame should we use to evaluate tissue healing?

Answer 27

4-6 weeks after completion of instrumentation

Question 28

what if healing doesn't occur---what do we do?

Answer 28

consider host factors , surgery or re-explore and remove calculus if still present

Question 29

what factors cause sensitivity

Answer 29

mechanical, thermal, or chemical stimuli

Question 30

what layer prevents sensitivity

Answer 30

Smear layer

Question 31

how do we treat sensitivity?

Answer 31

keep surface plaque free, apply fluoride, calcium hydroxide, and use potassium nitrate toothpaste

Question 32

what must the patient do in order to prevent from getting sensitivity again?

Answer 32

keep the tooth surfaces free of plaque

Question 33

hypersensitivity pain is ____

Answer 33

sporadic

Question 34

what does MI paste do?

Answer 34

helps remineralize areas and helps with sensitivity

Question 35

thorough daily ____ removal prevents and controls sensitivity

Answer 35

plaque

Question 36

will treatment immediately stop sensitivity?

Answer 36

no