1 - intro - EBD and clinic perio nonsurgical/surgical therapy

Question 1

what is “healthy” periodontium

Answer 1

PD 1-3mm
no history of attachment loss
no signs of inflammation

~patients who have no CURRENT disease and no history of attachment loss

~patients can still be healthy on a reduced periodontium

Question 2

Dx?

1-3mm probe depth
no history of attachment loss
clinical signs of inflammation

Answer 2

gingivitis

now we have to see what is causing it
~plaque-induced
~other forms (nonplaque induced)

Question 3

Dx?
<=3mm PD
BOP present
no gingival recession
red and edematous soft tissue

Answer 3

dental plaque-induced gingivitis

~other forms often difficult to Dx and Tx. involvment of systemic disorders/meds (non-plaque induced linear gingival erthema)

Question 4

_;severity and complexity of management

I. Initial periodontitis - 1-2mm attachment loss, RBL 15% or less coronal third - no tooth loss
II. Moderate - 3-4mm max 5, 15-33% coronal third RBL, no tooth loss
III. Severe with potentional for additional tooth loss - greater than 5, RBL 1/2 or more, less than 4 lost teeth, furcation 2/3, moderate ridge defects
IV. Severe with potential for loss of the dentition - greater than 5mm, RBL extending to middle third of root and beyond, less than or = 5 teeth lost, less than 20 teeth remaining

Answer 4

stages

first thing we look at is CAL (interdental at site of greatest loss)

then radiographic bone loss

extent (generalized/localized) added to stage

grading - rate of progression

Question 5

_; evidence or risk of rapid progression, anticipated treatment response)

A. Slow rate - no loss over 5 years, 0.25% bone loss/age, nonsmoker, no systemic disease
B. Moderate rate - <2mm over 5 years, less than 10 cigs/day, HbA1c <7%
C. Rapid rate - >2mm over 5 years, >1% progression, more than 10 cigs/day, greater than 7%HbA1c

Answer 5

grades

rate of progression

Question 6

_ attachment loss - gingival recession

not specifically due to bacteria/disease, could be tooth brush trauma, not chronic periodontal disease

Answer 6

incidental attachment loss-gingival recession

Question 7

general approach to periodontal care

1. perform an _
2. make an initial _
3. ID the risk factors for _
4. establish a Px.
5. present tx alternatives
6. obtain informed consent
7. treat the patient

Answer 7

1. examination
2. clinical Dx
3. for future progression

*initial non-surgical therapy, reevaluation, periodontal maintenance

Prophy - everyone who doesn’t have disease

Perio maintenance - have to be in recovery from disease and maintaining disease or previously had it

Question 8

one perio disease we refer to periodontitis everytime

Answer 8

NUP

necrotizing ulcerative periodontitis

Question 9

periodontal Tx planning

list in order the basic steps to recovery of the periodontium

Answer 9

non-surgical therapy
reevaluation
surgical therapy
perio maintenance

Bring back for revaluation
Patient has responded in some areas and not in others
Sometimes works

Reval and no response - either miss Dx
	Or missed medication, why it is or isn't working 

Have to have very good charting - start at basic and work your way up