Periodontology and Orthodontics - an interface Flashcards
What resolves upon removal of fixed appliances?
Most plaque related acute gingival disease
How are gingivitis and fixed appliances linked?
Children and adolescence = if gingivitis due to ortho appliance develops it will rarely extend to perio
How to involve oral hygiene in ortho tx? (minimal perio involvement)
OHI before ortho
Extra care to clean teeth
Hygiene needs often needed
Where are the most difficult areas to clean with fixed appliances?
Mesial and distal area of each tooth between the brackets
Gingival margin below the bracket
How to control plaque during tx?
Special aids;
- interproximal brush
- standard interspace brush
- powered rotatory brush
- superfloss/floss threader
- Electric rotatory brush
- Floss
BUT a standard toothbrush is adequate
Can periodontally involved adult pts have ortho tx?
No contraindications as long as the disease is under control before and during ortho tx
Ortho tx for pts undergoing perio tx?
Periodontitis affects up to 40% of the adult population over 40yrs old
Increased no adults wanting ortho
= perio pts wanting ortho is increasing
- Combined perio and ortho tx can enhance perio health and dentofacial aesthetics
What are the most common orthodontic problems found in periodontally compromised patients?
Proclination of maxillary anterior teeth Irregular dental spacing Rotation of teeth Overeruption Migration/loss of teeth Traumatic occlusion
What occurs if the inflam, ortho forces and occlusal trauma are not under control?
More rapid destruction than inflam alone
How to identify active disease?
Persistent BOP
Classification of PD?
Chronic perio
- Localised <30% sites affected
- Generalised >30% sites affected
Aggressive perio
- Localised aggressive
- Generalised aggressive
Systemic forms of perio
Necrotising forms of perio
- NUG
- NUP
What groups are at risk?
Those with minimal disease and no progressive despite gingival inflam
Moderate progression
Rapid progression
How to control moderate perio involvement?
Remove supra and sub calculus RSD with and without surgical flaps Osseus surgery Observation period after tx to allow complete healing and ensure there is adequate control Increase freq of recall - 2-4 monthly = More cleaning and scaling
How to reduce microorgansims ?
Molar bonding = makes marginal cleaning easier than bands
Elastomeric rings have higher levels of microorganisms and wire ligatures or self ligating brackets may be preferred?
What can cause recession?
Enthusiastic arch expansion
