Chemical Adjuncts to Periodontal therapy

Question 1

types of antimicrobial agents?

Answer 1

antiseptics

antibiotics

Question 2

chemical antimicrobials may cause?

Answer 2

sensitivity
resistance
super infections - MRSA/candida

Question 3

an alternative to an antibiotic could be an?

Answer 3

antiseptic

Question 4

drugs excreted by kidney?

Answer 4

amoxicillin
erythromycin
acyclovir

Question 5

drugs metabolised by liver?

Answer 5

clindamycin

metronidazole

Question 6

enzymes used for?

Answer 6

• to interfere with bacterial attachment

- potentitation of host defences to inhibit bacteria

Question 7

what type of antiseptics posses anti plaque activity?

Answer 7

Bisbigaunide

e.g - Chlorhexidine gluconate

Question 8

how does chlorhexidine work?

Answer 8

broad spec of killing

damage bacterial wall

Question 9

example of a quaternrary ammonium compound, what do they do?

Answer 9

cetylpyridinium chloride

mod plaque inhibitory activity - not retained for long

Question 10

what is a phenolic antiseptics?

Answer 10

used in high concs and decrease plaque accumulation
e.g Listerine - mod plaque inhibitory effects/anti gingivitis
poor oral retention

Question 11

what is Triclosan?

Answer 11

used in TP/MW
mod plaque inhibitory effecr
little substantivity
anti inflamm

Question 12

what metal ions have plaque inhibitory effects?

Answer 12

zinc,copper,tin - copper/tin cause extrinsic staining

zinc retained by plaque and inhibits regrowth

Question 13

natural products have any effect?

Answer 13

Sanguinarine chloride

mod reductions in plaque and gingivitis

Question 14

antiseptic mouthwashes replace mechanical brushing when?

Answer 14

after oral/perio surgery
during acute gingival conditions
mentally/physically handicapped

Question 15

all effective anti plaque mouthwashes cause?

Answer 15

staining

Question 16

what is Perio - Chip?

Answer 16

slow release decide - deliver theraputic agent directly to perio site
used as an adjunct in sites not responding to tx

Question 17

what does perio chip contain?

Answer 17

2.5mg Chx - prolonged exposure,
biodegradable
gelatine and water impregnanted with chx

Question 18

what type of release does perio chip have?

Answer 18

bisphasic release over 7 days

initially 40% released - 1000ppm GCF, then 60% over 7 days

Question 19

how is perio chip used?

Answer 19

placed in pocket after RSD and arrest of haemorrhage
chip swells in moisture and is retained
eliminates pathogenic bac - levels decreased for up to 100 days

Question 20

perio chip supposed to promote?

Answer 20

decreased probing depths
decreased BOP
poss reattachement
use 3/12 as no.of bac decreaased for up to 100 days

Question 21

what are the antibiotics most commonly used to treat periodontitis?

Answer 21

tetracyclines
metronidazole
= both are broad spec

Question 22

what is a course of tetracycline given along side of?

Answer 22

a course of non surgaical treatment in aggressive periodontitis to eliminate actinobacillus actinomycetemcomitans

Question 23

modes of action of antibiotics?

Answer 23

bacteriocidal - kill sensitive - penicillin and metronidazole
bacteriostatic - inhibit multiplication of sensitive bacteria - tetracycline and metronidazole

Question 24

advantages of local administration of antibiotics?

Answer 24

• local admin = much higher conc in the pocket
• much lower total dose of antibiotic
• very low systemic spill over - decreasing risk of hypersensitivity and resistance

Question 25

short term use of systemic or topical tetracycline and metronidazole produces a marked reduction in?

Answer 25

marked reduction in gram negative anaerobes and spirochetes and improvement in clinical condition

• decrease in probing depth
• decrease in BOP

Question 26

what is dentomycin?

Answer 26

semi synthetic tetracylcine
2% minocycline
for pockets over 5mm
as an adjunct to scaling/RSD
decrease in probing pocket depth and bop

Question 27

how to use dentomycin?

Answer 27

applied 2-3x weekly with 2 weeks between administration

Question 28

what is elyzol?

Answer 28

25% metronidazole - kills A.a
injected into pocket and becomes semi- solid
active for 24 hours
pockets over 5
decreased ppd/bop
adjunct only - careful in first 24 hours

Question 29

what is actisite?

Answer 29

25% tetracycline
active for 10 days
into pocket with flat plastic
fibre left in situ for 10 days then removed with scaler

Question 30

what is periostat and what is it used for?

Answer 30

subantimicrobial dose of doxycycline

collagenase inhibitor,