Periodontal Treatment Flashcards
(45 cards)
What is excessive occlusal force?
Occlusal force that exceeds the reparative capacity of the periodontal attachment apparatus. This can result in trauma or tooth wear.
What is occlusal trauma?
Injury to attachment apparatus, including bone, PDL, and cementum.
What factors impact tooth mobility?
- Width of PDL
- Height of PDL
- Inflammation
- Number, shape, and length of roots.
In what cases can tooth mobility NOT be accepted?
- If it is progressive
- It gives rise to symptoms
- It creates difficulty with restorative treatment
What treatments are available to reduce tooth mobility?
- Reduce plaque induced inflammation.
- Correction of occlusal relations
- Splinting
What is primary occlusal trauma?
Excessive force on a tooth with normal bone support, resulting in injury of tissue.
How is the PDL suited to handle occlusal forces?
It has the ability to increase its width so forces can be adequately dissipated, and can then return to normal width and stabilise the tooth.
What is secondary occlusal trauma?
Injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced support.
What is fremitus?
A palpable or visible movement of tooth when subjected to occlusal forces.
What may cause a tooth to migrate?
- Loss of periodontal attachment
- Unfavourable occlusal forces
- Unfavourable soft tissue profile
How do you manage tooth migration?
- Treat periodontitis
- Correct occlusal relations
- Accept position of teeth and stabilise
- Consider orthodontic treatment
What impact does abnormal occlusal contact have on periodontal tissues?
Significantly deeper probing depths, and greater attachment loss - ultimately leading to less favourable tooth prognosis.
What is the benefit of occlusal therapy as part of periodontal disease treatment?
- It can help in situations where abnormal occlusal load is being placed on teeth
- It should not be used routinely
- In cases where occlusal trauma is present, it may slow progression of periodontitis.
What is a gingival abcess?
An infection localised to the gingival margin.
What is a periodontal abscess?
A localised infection related to a pre-existing deep pocket, assosiated with food packing and tightening of gingival margin post HPT.
What is a pericoronal abcess?
Associated with partially erupted teeth and 8s.
What is an endodontic-periodontal lesion?
A pathological communication between the endodontic and periodontal tissues of a given tooth.
What is the guidance for treatment of acute periodontal abscess?
- Careful PMPR under LA
- Drain pocket via incision
- Recommend optimal analgesia
- Recommend 0.2% CHX mouthwash
When should antibiotics be given for periodontal abscess?
- Pen V 250mg for 5 days
- Amoxicillin 500mg 5 days
-Metronidazole 400mg 5 days
Each have a TID dose.
What are the signs/symptoms of a periodontal abscess?
- Swelling
- Pain
- Tooth TTP
- Bleeding
- Enlarged lymph nodes
- Fever
- Tooth usually vital
- Pre-existing PD
What causes acute periodontal-endodontic lesions?
Trauma or perforation of canal
What causes chronic periodontal-endodontic lesions?
Pre-existing periodontitis, and may not have evident symptoms.
What are the signs and symptoms of a periodontal-endodontic lesion?
- Deep pocketing, reaching apex
- Negative response to vitality tests
- Bone resorption at apex/furcation
- Spontaneous pain
- Pain on palpation/percussion
- Tooth mobility
- Sinus tract
What are the possible routes of communication from periodontal/endodontic lesions?
- Exposed dentinal tubules
- Lateral/accessory canals
- Furcal canals
