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Perio > 30.Treatment sequence > Flashcards

30.Treatment sequence Flashcards

1
Q

Aim of systemic phase

A
  1. Identify conditions, diseases and medications that contribute to periodontal disease
  2. Identify conditions, diseases and medications that can endanger the patient during treatment
  3. Diseases and conditions that are dangerous to medical staff
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2
Q

Number of groups of conditions, diseases and medications

A

3

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3
Q

Group 1 conditions

A
  • Puberty
  • Pregnancy
  • Menopause
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4
Q

Group 1 diseases

A
  • Diabetes
  • Vitamin C deficiency
  • Leukemia
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5
Q

Group 1 medications

A
  • Immunosuppressants-Cyclosporin
  • CCB-Nifidipine
  • Anticonvulsants-Phenytoin
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6
Q

Group 2 conditions

A

Allergies(latex/asthma)

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7
Q

Group 2 diseases

A

*Endocarditis=>
* Debridement may exacerbate condition

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8
Q

Group 2 medications

A

Anticoagulants(aspirin)

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9
Q

Group 3 conditions

A

Psychological

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10
Q

Group 3 diseases

A
  • All infectious diseases
  • Viral hepatitis
  • Covid
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11
Q

Aim of hygienic phase

A
  • To achieve a clean infection free oral cavity free of plaque and calculus
  • Removal of all plaque retentive factors
  • Extraction of irrational to treat teeth
  • Debridement-Scaling and root planing
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12
Q

Treatment sequence is according to

A

Ramfjord

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13
Q

Natural plaque retentive factors

A
  • Calculus
  • Deep fissures and equators
  • Variations in dental anatomy
  • Exogenous tooth discolouration
  • Caries
  • Crowding
  • Furcations
  • Malocclusion-crowding, rotations
  • Frenuli
  • Recession
  • Shallow vestibulum
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14
Q

Types of frenulum

A
  • Gingival
  • Mucosal
  • Papilla
  • Papilla penetrating
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15
Q

Iatrogenic plaque retentive factors

A
  • Poorly adapted restorations
  • Fixed orthodontic appliances
  • Mouth breathing-xerostomia/hyposalivation
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16
Q

Types of prognosis

A
  • Good
  • Doubtful
  • Irrational to treat
17
Q

Factors used in different types of prognosis

A
  • Periodontal
  • Endodontic
  • Dental
  • Functional
18
Q

Periodontal doubtful prognosis

A
  • Furcation involvement=1 or 2
  • Angular bony defects
  • Horizontal bone defect reaching 2/3 of root
19
Q

Periodontal irrational prognosis

A
  • Recurrent abcess
  • Combined endo and periodonal lesion
  • Attachment loss to apex
  • Furcation involvement= 3
20
Q

Endodontic doubtful prognosis

A
  • Large post or screw obturations
  • Incomplete root canal
  • Peri-apical pathology
21
Q

Endodontic irrational to treat prognosis

A

Perforations in apical half of root

22
Q

Dental doubtful prognosis

A
  • Extensive root caries that does not extend into root canal
23
Q

Dental irrational to treat prognosis

A
  • Extensive root caries extending into root canal
  • Verical root fractures 2/3 of root
  • Oblique fractures into middle third of tooth
24
Q

Functional irrational to treat prognosis

A
  • Third molars only without antagonist
  • Grade 3 mobility
  • Periodontitis and caries
25
Q

When re-evaluation done

A

6 week to 6 months

26
Q

What is done during re-evaluation

A
  • Periodontal risk assessment
  • Full periodontal status
27
Q

Information contained in periodontal risk assessment

A
  • Age
  • Number of implants
  • Number of sites per tooth/implant
  • No. of bop positive sites
  • No. of sites w/ pocket depths >5mm
  • No. of missing teeth
  • % alveolar bone loss
  • Systemic genetic diseases
  • Smoking(environmental factors)
28
Q

Environmental factors include

A
  • Non smoker
  • Former smoker
  • Occasional smoker
  • Smoker
  • Heavy smoker
29
Q

When epithelium regenerates

A

10-14 days

30
Q

When connective tissue regenerates

A

6 weeks

31
Q

When bone reforms

A

6 weeks to 3 months

32
Q

When periodontal healing takes place

A

up to 6 months

33
Q

Aim of corrective phase

A
  • Restore function and health of periodontium=>
  • Surgical treatment
  • Orthodontics
  • Prosthetic treatment
  • Conservative(RCT)
  • Periodontal surgery
  • Implant placement
  • Re-evaluation after surgery
34
Q

Aim of maintainence phase

A

Prevent re-infection and disease recurrence

35
Q

Maintainence phase includes

A
  • Anamnesis
  • Extra and intra-oral status
  • Indexes
  • Scaling
  • Periodontal status
  • Periodontal risk assessment
36
Q

How patient recall is dettermined

A
  • High risk-3 months
  • Medium risk- 6 months
  • Low risk- 12 months

Perio (61 decks)

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