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Classic Literature > 23 - Nonsurgical Therapy Mike COPY > Flashcards

23 - Nonsurgical Therapy Mike COPY Flashcards

1
Q

Bacteremia and SRP

A

Lafaurie 2007

BL: SRP induced anaerobic bacteremia in patients w/ severe ChP

  • 81% w/ bacteremia after SRP
  • P. gingivalis, Actinomcyces, M. micros
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2
Q

Endoscopy and SRP

A

Michaud 2007

BL: Endoscopy does not provide a statistically significant (SS) benefit to traditional SRP
-No difference between test and controls in total % residual calculus

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3
Q

Endotoxin and SRP

A

Jones & O’Leary 1978

BL: SRP renders root surfaces generally free of endotoxin. Scaling alone does not remove endotoxin.

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4
Q

Endotoxin and Curette/Ultrasonic

A

Nishmine 1979

BL: Root planing resulted in 8X less endotoxin compared to ultrasonic scaling

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5
Q

Full mouth disinfection: systematic review

A

Eberhard 2008

Compare: 1) Full mouth scaling in 24 hours + antiseptic 2) Full mouth scaling in 24 hours 3) Quadrant scaling

BL: All treatment modalities offer benefits w/ minor differences between them (~0.5mm difference)

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6
Q

Most important name for full mouth disinfection

A

Quirynen

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7
Q

Are periodontal parameters useful for detecting residual calculus?

A

Sherman 1990

BL: NO! BOP/PD/CAL not useful for predicting residual calculus after SRP

  • <50% sensitivity
  • Still have improvement in periodontal parameters after SRP even w/ residual calculus
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8
Q

Root roughness relation to plaque accumulation and gingival inflammation

A

Rosenberg 1974

BL: Root surface roughness is not SS related to supragingival plaque accumulation or gingival inflammation
-Curette produces smoother surface than ultrasonic

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9
Q

Diamond bur for root planing

A

Leknes 1994

BL: Diamond bur causes roughness that promotes subgingival bacterial colonization
-Beagle dog study

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10
Q

Pathological pocket and SRP

A

Waerhaug 1978

BL: Pathological pocket is reversible with SRP/MWF
-Dento-epithelial junction reforms where subgingival calculus is removed

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11
Q

How often do we miss subgingival plaque?

***Know these numbers

A

Waerhaug 1978

90% of the time we miss subgingival plaque
<3mm PD: 89% plaque free
3-5mm PD: 63% plaque free
5mm+ PD: 11% plaque free

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12
Q

Do we need to remove infected cementum?

A

Nyman 1988

BL: Removal of infected cementum not necessary

  • Experimental group = remove cementum w/ bur
  • No difference in periodontal parameters compared to calculus removal alone
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13
Q

SRP effects on specific bacteria

A

Cugini 2000

BL: PG/TF/TD decreased w/ SRP
-Majority of changes during first 3 months

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14
Q

SRP in smokers

A

Renvert 1998

BL: SRP successful in smokers but they have a less favorable response at 6 months

  • BOP 37% S vs 23% Non-S
  • PD reduction 1.9mm S vs 2.5mm Non-S
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15
Q

How far down the root surface do we clean with curettes?

***Know these numbers

A

Stambaugh 1981

  1. 73 + 0.97mm = greatest pocket depth at which root surface hard/smooth/calculus free
  2. 52 + 1.94mm = maximum mean pocket depth in which evidence of instrumentation observed
  3. 21mm = absolute maximum PD curette cleans
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16
Q

What is the problem with the Stambaugh article?

A

“Most famous 7 teeth in all of perio”

  • 7 teeth only
  • 25-39 minutes SRP per tooth
17
Q

2 studies that looked at multiple rounds of SRP?

How was it performed?

A

Anderson 1996 - SRP 1X versus 3X (24 hours apart)

Badersten 1984 - Ultrasonic SRP 1X versus 3X (at baseline, 3, and 6 months)

18
Q

Multiple rounds of SRP study results

A

Anderson - no SS difference for single or multiple SRP

Badersten - full effect of treatment realized 6-9 months following instrumentation. Single episode of SRP is as effective as SRP q3months in patients w/ good hygiene

19
Q

How good are we at detecting residual calculus?

***Know these numbers

A

Sherman 1990

2 clinicians say calculus is present, we are 72% correct
2 clinicians say no calculus is present, we are 50% correct

20
Q

Site/tooth/patient level factors accounting for variance in PD reduction

A

D’Aiuto 2005

Site level: 80%
-M/D greater response than B/L
-Deeper sites greater PD reduction
Tooth level: 12%
-Mobile teeth decreased PD reduction
Anterior teeth greatest PD reduction
Patient level: 8%
-Bad for IL-6, smokers
21
Q

Curettes vs ultrasonics in moderate periodontitis

A

Badersten 1981

BL: 4-7.5mm PD in non-molars w/ excellent hygiene successfully treated w/ curettes OR ultrasonic
-SRP at 1/3/7 months

22
Q

SRP for severe periodontitis

A

Badersten 1984

BL: Wait longer for severe sites, repeated instrumentation is effective

23
Q

SRP in molar furcations compared to flat surfaces

A

Nordland 1987

BL: molar furcations w/ PD 4mm+ have poorer response to SRP compared to molar flat surfaces and non-molars
-Loss of attachment furcations (21%), molar flat surfaces (7%), non-molars (11%)

24
Q

Is there any difference in the amount of inflammation histologically after SRP?

***Rationale for NST for case presentation

A

Caton 1989

BL: OH + SRP more effective for reducing interproximal inflammation compared to OH alone
-Repair occurs within 4 weeks

25
Q

What are reliable predictors for CAL loss?

A

Claffey 1990

BL: Increased PD and BOP predictive for CAL loss over time

  • 1mm+ PD increase = PPV 68% and 87% when combined with BOP 75%+
  • 7mm+ residual PD = PPV 50% and 67% when combined with BOP 75%+
26
Q

SRP in a healthy periodontium

animal

A

Lindhe 1982

BL: Repeated SRP in a healthy periodontium leads to SS loss of CT of 0.39mm and alveolar bone
-2 rhesus monkeys, SRP q2weeks

27
Q

SRP in a healthy periodontium (human)

A

Claffey 1986

BL: Loss of attachment w/ thin healthy gingiva

  • No loss of attachment for thick and thin bleeding sites
  • No loss of attachment for thick non-bleeding sites
28
Q

Rationale for OFD in non-molar teeth

A

Brayer 1989

BL: In PD >4mm, OFD more effective than closed and is related to operator experience
-Compared resident to board certified periodontitis

29
Q

Where is residual calculus found?

A

Brayer 1989

CEJ
Root concavity
Line angle
Distal surfaces

30
Q

Rationale for OFD in all teeth

***Know numbers for residual calculus by pocket depth

A

Caffesse 1986

BL: OFD SS more effective for pockets >3mm.
-% residual calculus dependent on severity of PD

31
Q

Numbers for residual calculus by pocket depth for flapless/OFD

A

Caffesse 1986

1-3mm pockets, 86% calculus free surfaces for flapless AND OFD

4-6mm pockets, 76% calculus free surface w/ OFD

> 6mm pockets, 50% calculus free surface w/ OFD

32
Q

Rationale for OFD in molars

A

Fleischer 1989

BL: OFD and operator experience enhances calculus removal in molars w/ furcation invasion
-68% calculus free surfaces in 4mm+ sites with board certified periodontist

33
Q

Rationale for OFD in furcations

Most common site for residual calculus in this study?

A

Matia 1986

BL: OFD and ultrasonic indicated for debridement of furcations
-Residual calculus = furcal dome

34
Q

Matia 1986 - distinguish between wide and narrow furcations

A

Wide >2.3mm - most often calculus free

Narrow <2.3mm - ultrasonic better than curettes, but not perfect

35
Q

Diamond burs + OFD in molars

A

Parashis 1993

BL: OFD + diamond rotary burs for furcations
-5% residual calculus in furcation flutes and roof

Classic Literature (38 decks)

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