advanced perio quiz

Question 1

What assessment is suitable for an implant?

Answer 1

6PPC / periodontal assessment

Question 2

You assess and implant, the radiograph shows no bone loss but you notice bleeding and mild marginal inflammation. What would your diagnosis be?

Answer 2

Peri-implant mucositis

Question 3

True or False - ‘normal’ probing depths around anterior implants can be deeper than expected around teeth.

Answer 3

True

Question 4

A 60 year old patient presents with gingival swelling and suppuration around an implant supported crown in region of 46.
Periodontal charting shows PPD of 8mm and bleeding on probing with suppuration.

What would this indicate?

Answer 4

Peri-implantitis.

Question 5

OHI/discussion delivered to pts with an implant:

Answer 5

1. Toothbrushing instruction - demonstrating to brush 45º into margins
2. Interdental cleaning instruction - interdental brushes, super floss, floss
3. Subgingival or difficult access cleaning - single tuft brush, electric single tuft brush +/- adjuncts if required.
4. Discussion regarding signs / symptoms of healthy implant vs unhealthy implant. eg/ bleeding, mobility. suppuration presence
5. Discuss diagnosis
6. Advise PMPR and regular maintenance

Question 6

OHI/discussion for a patient with peri-implantitis.

Answer 6

1. Toothbrushing instruction - demonstrating to brush 45º into margins.
2. Interdental cleaning instruction - interdental brushes, super floss, floss
3. EMPHASIS on Subgingival or difficult access cleaning - single tuft brush, electric single tuft brush +/- adjuncts if required.
4. Discussion regarding signs / symptoms of healthy implant vs unhealthy implant. eg/ bleeding, mobility. suppuration presence
5. Advise PMPR and regular maintenance with referral
6. Discuss risk of implant failure/ progression of disease and diagnosis
7. Risk of bone loss and risk of more complicated procedure if implant replacement is requested.

Question 7

2 surgeries for the management of periodontitis:

Answer 7

1. Regenerative Periodontal Surgery
2. Open Flap Debridement

Question 8

What document guides you through the most effective steps for the treatment of periodontal disease?

Answer 8

1. BSP S3 guidelines
2. S3 guidelines.
3. BSP guidelines.

Question 9

Marie, a 52 year old female has attended for NSPT. You have completed steps 1, 2 and 3 which has taken 1 year.
The outcome is: BoP >10%, pocketing of 4mm with no BoP, no pockets above 4mm.

Is this pt stable, in remission or unstable?

Answer 9

Currently in Remission

Question 10

55 y/o female who smokes 5 CPD and doesn’t take medication.
BPE 4s in all sextants, mild calculus supragingival and subgingivally.
PAs show >30% bone loss with the worst site being UL6; 53%.
FPA shows >30% with pocketing over 4mm with BoP.

What is the diagnosis?

Answer 10

Generalised Periodontitis, Stage 3, Grade B, currently unstable with risk factor of smoking.

Question 11

4 principles of supportive therapy:

Answer 11

1. Supportive periodontal care strongly encouraged.
2. Reinforce OHI, risk factor control and behaviour change.
3. Targeted PMPR as required to limit tooth loss.
4. Consider evidence based adjunctive toothpaste/mouthwash to control gingival inflammation.

Question 12

3As of subgingival PMPR:

Answer 12

1. Adaptation
2. Angulation
3. Activation

Question 13

What type of instrument would be most suitable to access the distal surfaces of molars and premolars in subgingival pocketing?

Answer 13

Gracey 13/14.

Question 14

What type is most suitable for assessment of periodontal pocketing?

Answer 14

UNC15

Question 15

What type of probe is most suitable for assessment of periodontal pocketing?

Answer 15

UNC15

Question 16

What type of probe is most suitable for assessment of periodontal pocketing?

Answer 16

UNC15

Question 17

What are the tx outcomes of advanced instrumentation?

Answer 17

• reduced pocket probing
• maintaining / improve attachment loss
• reduce bleeding on probing