Case defense Flashcards
Why is it not PTM?
According BURNSVOLD 2005
ther’s No teeth elongation (defying Thielman’s Law), no increased overjet (is in accordance, with the lower) no biprotusion of both of them, patient is going to do orthodontic ttm and it is reversible after perio-ttm.
Root trunk length?
OSCHENBEIN 1986 (upper 3, 4, 5; Lower 2, 3, 4)
PDL widening?
LINDHE & ERICSSON 1976 presented that PDL widening is an early indicator of perio breakdown when EP is combined with Occ.Trauma
Root proximity?
VERMYLEN 2005: <0,3, 0,3-0,5, 0-8. OR 3.6. , In Perio pt +prevalent coronal third, frequently symmetical, worsens tooth prognosis.
Open contacts?
HANCOCK 1980: Open contacts per se are not a factor, only when there’s food impaction leading to an increase of PPD, loose contacts are the worst.
Calculus?
MENDEL & GAFFAR 1986, indirect and direct way: Porosity increase retention of toxic products, ATB without debridement limited efficacy, Subgingival calculus has a pathogenic effect, Frequent removal to prevent progression, Calculus cause periodontal disease. JEPSEN 2011: Calculus is a retentive facto for plaque accumulation.
Restorations and EP/PPD?
Overhanging restaurations: HIGHFIELD & POWELL 1978, overhanging restauration, trappes more plque, therefore worse periodontal parameters
BOP
LANG 1990, 1986. Low+predictive value 6% (90) for AL predictability and 30% (86). Lang 1990 says Absence of BOP has high+predictive value 98% for perio status stability.
MATULIENE 2008: (in SPT) Sites with BOP+PPD>=5mm had +probability TL and OR 44 for EP progression.
Furcation involvement?
McGUIRE 1996, DONNEWITZ 2016, NIBALI 2016 demonstrated a worst prognosis for F.I., but mostly with F.I. 3&2.
Salvi 2014 OR 2.9 FI-2, type-3 OR 6.8
Tonetti 2017 FI-2 10y survival was 52%. Subclass A-90% (9.5-10y), B-70%, C-23%
Nibali 2016: RR of 1.7 (type II vs I), 1.8 (III vs II) and 3.1 (III vs I) with statistical significance
Why this staging and grading?
Pt presents PD>=6mm (stage III) and %BL/age<0.25 (grade A)
Crowding / malpositon?
ERCOLI 2018: Harder to maintain a good IHO.
Why wait 8 weeks?
SEGELNICK 2006 4-8w C.Tx repair and 4-8w recolonization (mobility 1m to 6-12m); MAGNUSON 1984 also 4-8w recolonization, MOUSQUES 1980 Spirochette to baseline ~42d (6w)
Calculus elimination?
BRAYER 1989: Experienced vs non experienced operator, (remove less calculus), RATEISCHAK plus 1992: calculus is present at the base of 75% of the PPD.
Mobility?
KERRY 1982: After nst, there’s an increase of movility, due to the reorganization of the collagen fibers, that later mobility will reduce.
SPT based on PRA
TONETTI & LANG 2003
LANG 2015: Validated PRA