1. Non-Surgical Perio Re-evaluation Flashcards
What are the phases of perio therapy
- 1= Initial therapy-OHI, address the plaque retentive features (close open contacts, overhangs,etc), and SRP
- 2=Re-evaluate, determine the need for perio surgery
- 3= Perio surgery when needed
- 4= Re-eval and Maintenance (3 mo. recall)
Initial therapy addresses….
etiology of perio disease (which is mainly plaque)
Plaque on more than _% of surfaces is a contraindication for perio surgery
10%
Smoking can be a contraindication for what perio surgeries
- Implants
- Mucogingival surgery
- NOT flap surgery (usually)
What medical disease may also be a contraindication for implants and mucogingival surgery
Poorly controlled DM
Poorly controlled DM has an A1C greater than _ is a contraindication for perio surgeries
7
Different plaque retentive areas in the mouth are
-Interproximal regions
-Calculus
-Overhanging restorations
-Open contacts
-Open margins/overbulked crowns
-Cracked teeth
-
How is calculus detected
- X-rays (interproximal calculus only)
- 11/12 explorer
T/F Initial therapy (Phase I) includes treatment of pathogenic bacteria with systemic (antibiotics) and local (arrestin) factors
t
What systemic antibiotics are typically used to fight perio pathogenic bacteria
amoxicillin and metronidazole
Describe the difference between primary and secondary occlusal trauma
Primary= excessive forces on teeth with normal amounts of perio support
Secondary= normal or excessive forces on teeth with less than normal amounts of perio support
What can be done for patients with occlusal trauma to prevent the exacerbation of perio disease
occlusal equilibrium or splint
How long after intitial therapy should the re-eval be performed
Usually 3 months (the longer the better- but at the school it is 4-6 weeks)
What procedures are performed at the re-eval after initial therapy
- Measure plaque (disclosing solution)– is it <10% surfaces?
- Evaluate gingival inflammation and BOP
- Measure pocket depths
- Look for calculus
- X-rays
More recovery of pocket depths are seen with (larger/smaller) pockets
larger (and they have greater attachment gain)
If you notice pockets got deeper at the re-eval what may be the reason
may have gotten inaccurate readings the first time you probe due to obstruction of calculus
T/F Absence of BOP means absence of gingival inflammation
F- But absence of gingival inflammation means absence of BOP
Confused by slide 27?
ok
What is the non-surgical treatment for aggressive periodontitis
-SRP + systemic antibiotics (amoxicillin and metronidazole)
Why are antibiotics essential for treating aggressive periodontitis
Aggregatibacter actinomycetemcomitans invades the CT in the pocket (can’t be removed with SRP
What is the name of the pathogenic variant of AA that causes LAP
JP2
Describe the difference between JP2 and other AA
JP2 makes more leukotoxin
Most of the improvement in Clinical attachment levels after SRP and antibiotic therapy in LAP patients occurs when
3 months after tx- then hits a plateau
How do you decide on treatment following initial therapy
probing depths
-Greater than 5 mm is indication for perio surgery because 5 mm and greater the patient can’t clean on their own
