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CDS restorative dentistry > 16. treatment planning > Flashcards

16. treatment planning Flashcards

1
Q

what is the definition of periodontal diseases?

A

group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent microbial plaque

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2
Q

what is the definition of periodontal health?

A

the outcome of the balance between bacteria of the dental plaque and the host immune system

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3
Q

what are 3 treatment strategies of periodontal diseases?

A

I. mechanical disruption
II. systemic antibiotics or local antimicrobials
III. host modulation therapy

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4
Q

what is the main goal of treatment of periodontal disease?

A

plaque control
removal of plaque retention factors

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5
Q

what does a BPE score of 0 mean?

A

no calculus or overhangs
no bleeding on probing
black band entirely visible

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6
Q

what does a BPE score of 1 mean?

A

no calculus or overhangs
bleeding on probing
blackboard entirely visible

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7
Q

what does a BPE score of 2 mean?

A

supra or sub gingival calculus or overhangs
black band entirely visible

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8
Q

what does a BPE score of 3 mean?

A

black band partially visible indicating a probing depth of 4-5mm

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9
Q

what does a BPE score of 4 mean?

A

black band disappears indicating pocket of 6mm or more

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10
Q

what does a BPE score of * mean?

A

furcation involvement

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11
Q

what does PMPR stand for?

A

professional mechanical plaque removal

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12
Q

what is supra gingival PMPR?

A

targeting the biofilm formed above the gingival line
first step of PMPR treatment

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13
Q

what is sub gingival PMPR?

A

biofilm that causes problems, indicates inflammation, hidden pockets below gingiva

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14
Q

if we remove the thin cementum during PMPR what does it cause?

A

exposed dentine

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15
Q

what is calculus?

A

calcified plaque

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16
Q

what is step 1 of the treatment plan?

A

control of local and systemic risk factors

17
Q

what are local risk factors to the oral environment?

A

calculus
overhangs

18
Q

what are systemic risk factors to the oral environment?

A

diabetes
smoking

19
Q

what would be additional steps only done if required in the first step if the treatment plan?

A

extracting teeth with bag prognosis
endodontic treatment
initial occlusal corrections

20
Q

what oral hygiene instructions should you give to a patient?

A

tooth brushing techniques
flossing
interdental brushes

21
Q

how powerful are sonic scalers? what are their vibrations like?

A

2000 to 8000 Hz
- vibrations caused by flow of compressed air
- circular vibrations with large amplitude of 60-100 um

22
Q

how powerful are ultrasonic scalers? what extra effect do they have?

A

20000 to 45000 Hz
additional cavitation effect

23
Q

what are piezoelectric ultrasonic scalers vibrations like?

A

vibrations caused by changes in size of quartz crystals subjected to alternating current
Linear vibration with small amplitude 20-72 um

24
Q

what are magnetostrictive ultrasonic scalar vibrations like?

A

vibrations caused by movement between iron/steel nickel allow plates in alternating magnetic field
Ellipsoidal vibrations with large amplitude 100um

25
Q

how much of an ultrasonic solar tip should be used on the tooth?

A

2-3 mm of tip

26
Q

what should the angle be between the working edge of an ultrasonic scalar and the tooth surface?

A

0-15 degree angle

27
Q

how much pressure should be applied when using an ultrasonic scalar on the tooth?

A

slight pressure

28
Q

what motions should you move the ultrasonic scaling tip in?

A

overlapping zig zag motions starting from occlusal part of crown and moving apically towards gum line

29
Q

what can we do to counter act the fact when using an ultrasonic tip it gets very hot due to the lots of energy?

A

use constant water spray and keep it moving

30
Q

what are some contradictions for ultrasonic scalers?

A

oral infectious diseases
dysphagia
acute leukemias and lymphomas
pregnancy
heart pacemaker

31
Q

what is step 2 in the treatment plan?

A

sub gingival instrumentation

32
Q

what instruments are used in sub gingival PMPR?

A

both hand instruments and sonic/ultrasonic scalers

33
Q

give an example of local antimicrobials?

A

chlorhexidine

34
Q

what happens if there is no improvement in the oral health 8 weeks after step 2?

A

repeat the treatment from the beginning

35
Q

what happens if there is some improvement but still some residual pockets in the oral health 8 weeks after step 2?

A

targeted PMPR
then go to step 3 = surgery

36
Q

what happens if there is complete improvement in the oral health after 8 weeks of step 2 treatment?

A

step 4 = maintenance

37
Q

give an example of a host modulation therapy?

A

anticytokine and biological therapies
- biological disease modifying anti-rheumatic drug like infliximab-anti-TNF-alfa

CDS restorative dentistry (6 decks)

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