SRP Flashcards
(35 cards)
1
Q
When should periodontal charting be done?
A
- Initial exam- all new adult patients
- Pediatric patients if:
- Radiographic bone loss
- irritated gingiva
- suppuration
- abnormal mobility
- Patient hasn’t been seen in over 1 year
- Periodontal Maintenance patients
- every 3 months
- Periodontal re-evaluation
- 4-6 weeks after scaling and root planing
- Non-periodontal patient
- every periodic eval-6 months
2
Q
Periodontal charting contraindications
A
- High risk of abscess
- complete dentures
- heavy deposits prevent accurate readings
- need debridement first
- full exam at later appointment
- Did not take antibioitic prophylaxis
- delay appointment
3
Q
Why are the Handles of instruments made small and thick?
A
Prevents Carpal Tunnel Syndrome
- Large diamter lightens grasp–> less stress
4
Q
Shank
A
- Connects working end with handle
- Functional Shank
- working end to bend closest to handle
- Lower Shank
- aka terminal shank
- working end to first bend
5
Q
Explorers
A
- locate subgingival deposits and carious areas
- Check smoothness of root surfaces after SRP
- Pointed end detects calculus
- ODU 11-12
6
Q
SRP Instruments: Define
Face, Bac k, Lateral surfaces
A
- Face-area between cutting edges
- Back-area opposite the face
- lateral-area between cutting edges and back
7
Q
Sickle Scalers
A
- Triangular Cross section
- Pointed tip and back
- 2 cutting edges
- Face 90 degress to terminal shank
- functions at 70 degrees to tooth surface
- removes supra-gingival calculus from enamel
8
Q
Universal Currettes
A
- Rounded back & toe
- 2 cutting edges
- Face 90 degrees to lower shqank
- functions at 70 degrees to tooth surface
- Removes both supra-gingival and sub-gingival calculus from enamel/cemtentum
9
Q
Gracy Curettes
A
- Aka Area Specific Curettes
- 1 cutting edge
- face 70 degrees to terminal shank
- Supra and Subgingival
- remove calc from enamel and cementum
- Best instrument for debridement of complex root anatomy
- area specific currette so better access
10
Q
What is scaling?
A
- Instrumentation of the crown and root surfaces
- Removal bacterial biofilm, calculus, and stain from these surfaces
11
Q
What is root planing?
A
- Removal of diseased cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms
- ONLY on root surface
12
Q
What is the goal of root planing?
A
- reattachment of periodontal structures to the tooth
- restore gingival health that has been lost due to inflammation
13
Q
What is the Rationale for SRP?
A
- Restore gingival health
- remove elements that provoke gingival inflammation
- plaque (Bacterial biofilm)
- calculus
- endotoxin
- Shift composition of subgingival plaque
- gram - anaerobes to gram + falcultative
- reduce spirochetes and motile rods
- Increase in coccoid cells
- remove elements that provoke gingival inflammation
- Arrest the progression of further periodontal disease destruction
- create an enviorment conductive to fiber repair
14
Q
Therapeutic outcomes of SR?
A
- Securing biologically acceptable root surface
- reduce bacterial burden
- resolving inflammation
- decreasing pocket depth
- improving or maintaining attachment level
- preparing the tissues for surgical procedures
15
Q
How can I prevent plaque buildup?
A
- Easy to prevent buildup with proper care
- Brush at least twice a day to remove plaque from all surfaces of your teeth
- Floss daily to remove plaque between your teeth and under gumline where toothbrush may not reach
- Limit sugary or starchy foods
- Schedule regular dental cleanings and exams
16
Q
Plaque index
A
of surfaces with plaque/ total # of surfaces x100
- Excellent hygiene: 0-20%
- Good hygiene: 21-40%
- Fair Hygiene: 41-60%
- Poor Hygiene: 61%-100%
17
Q
Brushing techniques:
A
- Bass or Sulcus cleaning method
- Modified Bass technique
- Modified Stillmann’s technique
- Fones or circular or scrub method
- Vertical or Leonard’s method
- Charter’s method
- Scrub brush mehtod
- Roll technique
- Physiologic or Smith method
18
Q
Flossing
A
- Guide the floss between your teeth using a gentle rubing motiion
- Never snap the floss into the gums
- When the floss reaches the gum line, curve it into a C shape against one tooth
- Gently Slide it into the space between the gum and tooth
19
Q
6 ways to prevent Gum Disease
A
- Brush thoroughly at least twice a day
- use a toothpaste like CREST Pro-health
- Rinse Thoroughly with Crest Pro-Health Multi-Protection
- Use Soft Bristled Tooth brush
- Floss Daily
- Visit a Dentist regularly
20
Q
What is Endotoxin?
A
- heat stable, lipid polysaccharide (LPS) complex found in the cell wall of many gram negative microorganisms
- Can be cytotoxic, progenitor, and have been shown to induce/amplify inflammation
- Bacteria shed endotoxins when broken down or growing/dividing.
- Superficially attach to the root surface meaning that extensive removal of root structure is not necessary
- found in plaque, calculus, cementum
- associated with bone resorption
21
Q
What brushing technique is used on periodontist patient?
A
Modified Bass technique
- Place the toothbrush at 45 degree angle toward the gingiva to get under the sulcus
- Small vibrational circles followed by a downward sweeping motion
22
Q
What is difference between bass and modified bass?
A
Modified Bass includes a sweeping motion
23
Q
What is the shape of the interdental area?
A
“Col” is pyramidal-shaped
24
Q
What is granulation tissue?
A
- New vascularized tissue that has a lot of neutrophils
- The result of the inflammatory tissue
25
What is the difference between long junctional epithelium and junctional epithelium?
* Long junctional epithelium has more epithelial cells on the apical surface than normal JE
26
What kind of attachment is made when the junctional epithelium is reattaching?
* Junctional epithelium forms a tight connection to afibrillar cementum and root cementum via a hemidesmosome attachment within the interal basal lamina
27
What is plaque?
* aka Dental biofilm
* Sticky, colorless film of bacteria and other microorganisms
* causes:
* immune response
* cavities
* gum disease
* constantly forms on our teeth and along gum line
* Can harden into tartar/calculus if not removed daily
28
What is LPS?
* Outer membrane of gram negative bacteria
* induces inflammation
* it is an endotoxin
* composed of lipid A an dpolysaccharide components
* recognized by host toll-like receptors
29
What is the extracellular matrix and what are the components?
* Polysaccharides, lipids, and proteins
* Involved in the formation of biofilm because secreted by bacteria
30
What is biofilm?
* Nonmineralized microbial accumulation
* Adheres firmly to tooth surfaces, dental restorations, and prosthetic appliances
* Exhibits structural organization with predominance of filamentous forms
* composed of organic matrix
* derived from salivary glycoproteins and extracellular microbial products
* cannot be removed by rinsing or water spray
31
What is the difference between biofilm and microbiome?
* Microbiome
* all genetic material of microorgniams inside or on body
* Biofilm
* microorganisms adhering to hard surfaces
* ex: catheter, tooth
32
What else in plaque besides bacteria?
* Food, endotoxin, LPS, extracellular matrix
* Associated microorganisms
* viruses, protozoa, fungi
33
Difference between gracey and universal curettes?
* Universal
* 2 cutting edges
* blade is 90 degrees to the shank
* need to work with the blade 70 degrees to the tooth surface
* Gracey
* 1 cutting edge
* blade is 70 degrees to the shank
* Terminal shank should be parallel to the long axis of the tooth when working bc the blade is already at 70 degrees
34
How do you treat disease granulation tissue?
soft tissue curretage
* uses a currette to remove the soft tissue lining in the pocket
35
Modified Bass technique:
Advantages vs disadvantages
* Advantages
* excellent sulcus cleaning
* good interproximall and gingival clenaing
* good gingival stimulation
* Disadvantage
* dexterity
