PERIO Flashcards
(30 cards)
smoking effect P
- vasoconstriction = ↓bf+heal
- impair NP funct = ↓IS bac
- ↑PIC (IL-6, TNF-a) = t destruct
- accelerate ABL
interleukin
cytokine mediate immune response
-anti
-pro
is plaque/calc a risk factor
- plaque yes = 1° cause plaque-induced P
–> progress depend host response + risk fac (biofilm induced inflam) - calc indirect 2° PRF, not causative
OPT benefit, limits, vs PA
+ variety concerns (RR,caries,cavity,path)
+ overall dentition 8s
- low res = poor detail alveolar crest + *
- inaccurate ant BL
- distort overlap post
= only if justified progressed NICE 3-5yr
= 4-5 PA cover 1 OPT
how can you tell sub working
- tactile = smooth, less res
- ging = inflam, BoP
- ↓ pt discomfort over repeated strokes
after ineffective sub
= PPD 5+ / 4 and BoP
- repeat s3 poor response localised
- antimicrobial adjunct CHX deep
- surgery flap access >6 compliance
engaging pt
- plaque 20% = dis control + risk reinf
- marginal bleed 30% = inflam plaque presence
(base = active P) - diet personal self-care RF
- inquisitive, attend
stable P sites / progressing
BoP < 10 STABLE
PPD ≤ 4 (no BoP)
BoP ≥10 REMISSION
PPD ≤ 4
PPD ≥ 5 UNSTABLE
PPD ≥ 4 + BoP
- progress ↑PPD, BoP, inflam
reflect improve
- tailored diet analysis + counsel
(verbal yes –> exercise, less snacks) - small modifications over visits ETB, TePe see results perfect OH longterm = increase + consistent
use RG to diagnose
gen hor BL (no defects accelerated sites)
widen PDL + RL apices indicate inflam
RL cavity/caries extent
RO root-filled
- measure, impact
nabers probe hor
- plaque+calc ret
- difficult clean px/dentist
- recurring inflam
- ↑ mobility
- bad heal poor blood supply
I <3mm
II >3mm
III through+through
AIGH vs losartan
= Ca-channel blocker hyperT
- ↑ fibroblast prolif (connect-t)
- ↓ collagen degradation
- xs ECM deposit = ging enlarge
(angiotensin II receptor antagonist BP remained high)1
- tailor OHI
- limited so may respond NSPT
- drug sub GP
- surgery ↓+recontour t
- check resolved
other risk fac
- ethnicity afro-caribbean
- genetic = gene PIC xs inflam, severe P runs family, NP funct, B met
diagnosis
- Historic P (interdental rec, papilla loss black∆, TL) + bleed,diabetes,amlodopine
- Exam OH /PRF (calc, crowd)
- Screen 4, RG diagnostic quality interproximal BL, P assess 6PPC 4+ bleed
= generalised >30% teeth
= stage III severe LR7 PBL 40% mid
= grade B Mod (40/46 0.5-1)
= Unstable ≥5/4+BoP
factors influence prognosis
- deeper>6 ↓longterm stable
- multi-root less accurate
- systemic health P progress
- OH, age, compliance
more accurate prognosis
McGuire & Nunn studies
- IL-1 genotype
- smoking status
= accurate actual outcome
= predict tooth survival
why just RG insufficient
retrospective past dis
- current dis activity
- inflam status
pre-diabetes
<6% 42mmol/mol
= HbA1c glycated Hg 42-47
D <6.5 48
= insulin res ≠respond
= β-cell dysfunct –>
hyperglycaemia
= ↑inflam + impair wound heal + ↑BL
- ↑inflam cytokine IL-6
- oxidative stress
= bi-directional inflam comp epi barrier –> ingress bac/p systemic circ
manage diabetes
OHI, diet, 3mth review, sub
–> stabilise blood sugar
NHS DPP lifestyle∆
(gen, sedentary, obese, hyperT, refined carbs/sugars)
why might PFS↓ but ↑BoP
- OH good, inflam bad
- residual plaque, microbial fac
- underlying systemic dis/control
bimaxillary proclination effect P
- plaque ret
- poor self cleansing
- localised trauma periodontium
why OPT and BW
FGDP balance diagnostic yield + radiation dose
- efficient + tolerated
- gen 4s full overview BL pattern+severity
- PAP, RR –> TP all teeth
- BW C+IBL unclear opt
1 OPT = 3 PAs
RCT success + xla
+ condensed obturation
+ sealed system
- pain, swell, abscess, sinus tract
- periapical RL
+ stable asympt no inf
+ good prognosis no comps monitor
- reinf exposed GP inadequate coronal seal bac contaminate fail
- compromised periodontium = BL/CAL
severe fluorosis
dean’s index
- brown widespread staining
- pitting / hypoplasia
- senegal high fl water
- since childhood
- no sensitivity or aesthetic
