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Perio - Exam 2 > ABX - Part II > Flashcards

ABX - Part II Flashcards

1
Q

What are some implications of oxygenating products for the control of plaque and gingivitis?

A

MOA: Inhibits anaerobic bacteria, short term anti-inflammatory properties

Safety?

  • Black, hairy tongue
  • Tissue injury
  • Co-carcinogen
  • Delayed wound healing

*Research does NOT support its use

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2
Q

What are some oxygenating products?

A

OxyFresh
-Peroxide, Peroxyl

Plax

  • Na benzoate, Na lauryl sulfate, Na salicylate
  • 8.7% alcohol
  • Pre-brush rinse

Sanguinarine

  • Bloodroot plant
  • Questionable results, no longer available

Povidone iodine (Betadyne)

  • Broad-spec
  • Pre-procedural rinse
  • Good outcomes when used with SRP

Sodium Hypochlorite

  • Bleach
  • Broad spec
  • Low cost, easy to use
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3
Q

Tell me about SnF2.

A

Anticarogenic effect

Reduces gingivitis, but not plaque scores

Limited benefits as subgingival irritant

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4
Q

Tell me about baking soda + NaCl + H2O2.

A

Can be used as an antimicrobial

  • Associated with Keyes’ technique
  • Put bacteria on slide
  • Add the formulation and it kills the bacteria
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5
Q

What is Triclosan?

A

Broad spec antimicrobial

MOA: Bacterial cytoplasmic membrane

  • Colgate is the ONLY toothpaste w/ ADA seal for plaque/gingivitis reduction
  • Not used much here in US
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6
Q

T/F - Studies have NOT documented effectiveness of topical chemical plaque control agents in the tx of periodontitis.

A

TRUE

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7
Q

T/F - Studies have documented that Biotene DOES have an effect on periodontal disease.

A

TRUE

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8
Q

What are the 3 areas for irrigation?

A

Supragingival
-Coronal to the gingival margin

Marginal
-Angled apically to FGM

Subgingival
-Into sulcus

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9
Q

3 rationales for irrigation.

A

Flush away bacteria

LPS is loosely adherent

Non-specific reduction of microbes

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10
Q

T/F - Subgingival irrigation can get 75-93% of the pocket depth, NOT all of it.

A

TRUE

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11
Q

What angle should the tip be at for supragingival irrigation?

A

90 degrees

IF doing marginal irrigation
—45 degrees

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12
Q

T/F - There is a strong relationship b/t plaque accumulation and gingivitis.

A

TRUE

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13
Q

What is hydrokinetics?

A

Pulsating water w/ compression and decompression phases

Displaces debris and bacteria

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14
Q

What are the results of supragingival irrigation as a mono therapy?

A

Varied results

Do NOT use in lieu of tooth brushing

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15
Q

Irrigation plus oral hygiene does what for mild or moderate periodontitis?

A

Significant reduction of proinflammatory cytokines (IL-1, PGE2)

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16
Q

What is the greatest pt benefit with gingivitis in using supragingival irrigation?

A

Interproximal cleaning is improved

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17
Q

T/F - 0.2% CHX in irrigation systems slightly reduced probing depths (Improved PERIODONTITIS slightly)

A

TRUE

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18
Q

How is subgingival penetration of solutions after supragingival irrigation?

A

3 mm subg

Beneficial in treating gingivitis not periodontitis

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19
Q

T/F - Suprag irrigation appears to similar levels of bacteremia as toothbrushing, floss, perio dressing changes, SRP and chewing.

A

TRUE

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20
Q

3 pt groups that are good candidates for suprag irrigation?

A

Inadequate oral hygiene

Ortho pts

Gingivitis pts

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21
Q

Methods of subg irrigation?

A

Syringe

Jet irrigator

Ultrasonic

*Should be preceded by SRP

**Limited by calculus, lateral dispersion

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22
Q

How far into the pocket should the syringe tip be inserted?

A

3 mm

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23
Q

T/F - Subg irrigation resulted in a reduction of pathogens, but then a return to baseline at 1-8 weeks.

24
Q

T/F - Subg irrigation should be used as an adjunct to SRP.

25
Q

T/F - Currently insufficient data to indicate routine use to augment SRP.

26
Q

Subg irrigation: CHX vs. Betadine

A

CHX
-No significant difference than with H2O
—Possible difference in pockets 4-6 mm, but not more than 6

Betadine
-Possible enhanced effect in depths >7mm

27
Q

What are some limitations to Subg irrigation with medicaments?

A

Short half life

Minimal dispersion

Blood contact inactivates CHX

GCF flows outward

28
Q

T/F - A single episode of in-office subg irrigation to enhance SRP does NOT improve clinical healing.

29
Q

What should be used at home for irrigation?

A

CHX, Listerine, Fluoride

Daily delivery benefit*

30
Q

Is Arestin a replacement for irrigation therapy?

31
Q

How are Arestin-type products effective?

A

Reach the base of the pocket

Must be high enough concentrations to destroy the bacteria

Drug must stick around

32
Q

What are advantages of Arestin-like products?

A

Sustained higher drug conc in GCF

Better pt compliance/acceptance

Drug resistance has not become a problem

Site specific

33
Q

What are the characteristics of minocycline?

A

Bioadhesive

Bioresorbable

Safe

34
Q

What is minocycline?

A

Broad spec

Semi-synthetic derivative of tetracycline

  • Effective against the RED COMPLEX*
  • MIC is high
  • pH is changed
35
Q

T/F - Minocycline achieves high local conc w/ minimal systemic levels.

36
Q

What does Arestin do?

A

Decreases pocket depths

Doesn’t do much to attachment level

37
Q

2 sites where Arestin and SRP delivered enhanced efficiency to difficult to treat sites and pts?

A

Molars

Furcation sites

38
Q

3 pt groups where Arestin and SRP enhance efficacy?

A

Smokers

Elderly

Pts with current CV disease or CV disease history

39
Q

Can Arestin be used to treat periodontitis?

A

NO

-B/c it does nothing to attachment loss, which is a hallmark of periodontitis

—It DOES decrease pocket depth by decreasing the swelling in the pocket by killing the bugs

40
Q

T/F - Arestin + SRP are significantly more fertile in reducing pocket depth than SRP alone.

41
Q

T/F - Repeated therapy w/ minocycline prolongs efficacy and minocycline is easy to use, well-tolerated, and safe.

42
Q

What are pt instructions after Arestin application?

A

No brushing for 12 hours

Avoid eating hard, crunchy, or sticky foods for 1 week

Postpone use in interproximal cleaning devises for 10 days (including floss)

*Maintains therapeutic conc for up to 14 days

43
Q

What is Atridox?

A

Doxycycline gel

Must be removed after 7-10 days via flossing or toothbrushing

44
Q

What is Atridox used for?

A

Tx of chronic adult periodontitis for a gain in clinical attachment, reduction in probing depth, and reduction in BOP

*It physically pushed the tissues away and required them to re-attach

45
Q

What are the contraindications for Atridox?

A

Pts hypersensitive to doxycycline or any other drug in the tetracycline class

46
Q

T/F - SRP results in increased attachment.

47
Q

T/F - Pt should avoid brushing, flossing, and eating at affected sites for one week.

48
Q

T/F - Approved as a mono therapy and should be used as an adjunct to mechanical tx.

49
Q

What is the chemical in PerioChip?

A

Chlorhexidine

50
Q

How deep should pockets be for PerioChip tx?

A

5 mm

Pt should not brush or floss for 7 days

51
Q

T/F - For a pt that received a locally delivered system, results should be seen 10 days to 14 days. If improvement, resume recalls. If no improvement, re-apply or refer.

52
Q

T/F - In the 70s, it was thought:

Treat PD as bacterial infection

Only few specific organisms that needed to be targeted

Thought to be exogenous and could eliminate from body indefinitely

Noteworthy successes

53
Q

What 3 groups should receive abx prophylaxis?

A

Uncontrolled diabetes

HIV with ANUG

Active chemotherapy tx

54
Q

T/F - ABx should be used as an adjunct to implants and guided bone regen/guided tissue regen

55
Q

Primary proteinases important to us?

A

Collagenase, gelatinase, elastase

56
Q

Arachidonic Acid metabolites result in what activities?

A

Increased vasopermeability and vasodilation leading to redness and edema

Potent induced of MMP secretion by monocytes and fibroblasts to trigger CT destruction

Perio - Exam 2 (8 decks)

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