Perio Treatment Step 3 Flashcards
how do you know if treatment has been successful
good oral hygiene
no BOP
no pockets >4mm
no increasing tooth mobility
functional and comfortable dentition
what is step 1 of periodontal treatment
build foundations for optimal treatment outcomes
educating the patient
reduction of risk factors
OHI
PMPR
what is step 2 of treatment
subgingival instrumentation
what is step 3 of treatment
managing non-responding sites and re-evaluation
why would you do step 3 of treatment
if the dentition is still unstable after step 2 (otherwise continue to step 4)
what is step 4 of treatment
maintenance
what would you do if patient had poor OH and persistent inflammation at re-evaluation
identify reason for poor OH, supportive care or repeat cause-related therapy
what would you do if patient had good OH and inflammation has resolved
supportive care and proceed with treatment plan
what would you do if patient had good OH but persistent deep pockets with BOP
surgical access or repeat RSD then re-evaluate
what do you do if pocket depth is 4-5mm
repeat subgingival instrumentation
what do you do if pocket depth is >6mm
consider surgery
why do you need to eliminate pockets
teeth with pockets >4mm are more likely to be lost in the future
deeper the pocket the more likely the tooth is to be lost
what factors influence decision for surgery
smoking
compliance
OH
systemic disease
suitability of site
prognosis of tooth and importance of tooth
availability of specialist treatment
patient preference
what would be the ideal endpoint for a patient to go to step 4 treatment
no pockets >4mm
no pockets at 4mm with BOP
BOP <10%
functional and comfortable dentition
plaque scores <20%
