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Periodontology > chemical agents in plaque biofilm control > Flashcards

chemical agents in plaque biofilm control Flashcards

1
Q

define systemic delivery

A

administering chemical agents such as antibiotic, in the form of tablet or capsule

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2
Q

define local delivery? example?

A

placing a chemical agent into the mouth or even into a perio pocket
example is toothpaste that contains a chemical agent that can kill bacteria such as stannous fluoride

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3
Q

what inhibits calculus formation

A

pyrophosphates

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4
Q

examples of chemical agents used in perio patients

A
  1. therapeutic mouth rinses
  2. therapeutic dentifrices
  3. subgingival irrigation
  4. controlled-release delivery devices
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5
Q

what could cause resistance of biofilm to delivery of chemical agents

A
  1. surface of plaque biofilm is covered by an extracellular slime layer
  2. slime layer acts as a natural barrier to protect organized bacterial colonies living in plaque biofilm
  3. slime layer prevents chemical from contacting and killing bacteria
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6
Q

what is a microbial reservoir

A

secure place that allows periodontal pathogens to live undisturbed during routine periodontal therapy and subsequently repopulate periodontal pockets quickly.

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7
Q

is there a chemical agent that can control perio?

A

no

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8
Q

examples of chemical agents

A

antibiotics, fluorides, metal salts, antimicrobial, phenolic compounds, and antiseptics

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9
Q

examples of antibiotics studied for use in perio care

A
  1. penicillin and amoxicillin
  2. tetracyclines
  3. clindamycin
  4. erythromycin
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10
Q

T/F: routine use of systemic antibiotics for plaque-induced gingivitis and chronic perio is recommended

A

false; not recommended

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11
Q

why is antibiotics not recommended

A

bacterial antibiotic resistance and good response to plaque-induced gingivitis and chronic perio can come from NSPT

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12
Q

how often would antibiotics need to be taken to control bactiera in mouth?

A

many many years

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13
Q

when is antibiotics indicated?

A

for patients with aggressive perio and other rarer forms of perio

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14
Q

what is microbiologic analysis used for?

A

used to identify the antibiotic that is effective against the bacterial pathogens present in patient’s biofilm

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15
Q

use of tetracyclines

A
  1. higher concentrations of the drug concentrate
  2. effective against A.A.
  3. inhibit action of collegenase
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16
Q

how is controlled-release delivery device used in the mouth

A
  1. an antibacterial chemical embedded in a carrier material
  2. device is placed directly into perio pockets
  3. material dissolves slowing producing a steady release of antimicrobial agent over a period of several days within the perio pocket
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17
Q

benefits of controlled-release delivery device

A
  1. result in a small increase in attachment level in perio pocket
  2. when used with perio instrumentation they can result in both an improvement in probing depth reduction and a clinical attachment gain
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18
Q

mechanisms of controlled-release delivery

A
  1. tetracyclin hydrochloride-containing fibers
  2. minocycline hydrochloride microspheres
  3. doxycycline hyclate gel
  4. chlorhexidine gluconate chip
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19
Q

features of tetracycline fibers

A
  • no longer available in US
  • gingival retraction cord impregnated with tetracyclin
  • fiber laid back and forth all around tooth
20
Q

minocyclin hydrochloride microspheres features

A
  • cannula tip is used to expel microsphere into perio pocket

- within 5-7 days the microspheres dissolve so nothing to remove from pocket

21
Q

reactions from minocyclin

A
  • oral candidiasis
  • allergic reaction
  • don’t use in women who are pregnant or nursing
22
Q

doxycycline gel features

A
  • tetracycline derivate
  • antibiotic is delivered in a gel to perio pocket with cannula
  • gel solidifies into a waxlike substance
  • gel dissolves
23
Q

reactions from doxycycline

A
  • oral candidiasis
  • allergic reactions
  • do not use in pregnant or nursing mothers
24
Q

chlorhexidine gluconate chip features

A
  • tiny gelatin chip containing the antiseptic chlorhexidine
  • can be used in pockets with 5 mm or greater in depth
  • chip dissolves
  • no risk of antibiotic resistance with the use of gelatin chip
25
Q

what must you have to use gluconate chip? why?

A

5 mm pocket because if not then the chip will fall out of the pocket

26
Q

uses of cosmetic mouth rinses

A

used to cover up or mask odors of halitosis

-do not control oral disease such as gingivitis

27
Q

therapeutic mouth rinse purposes

A
  • decrease dental plaque enough to also decrease the severity of gingivitis
  • can decrease the risk of dental caries
28
Q

characteristics of an ideal mouth rinse

A

efficacy, stability, substantivity, safety

29
Q

define efficacy

A

inhibits or kills perio pathogens

30
Q

define stability

A

stable at room temp and have a reasonable shelf life

31
Q

define substantivity

A

retained in the oral cavity and released slowly over several hours with continued effect

32
Q

define safety

A

does not produce any harmful effects on local tissues

33
Q

define active ingredient

A

component that produces a benefit for the patient

34
Q

define inactive ingredient

A

component added to give color or taste, preserve, or keep in a liquid state

35
Q

3 ingredients that have some effect on gingivitis are….

A
  1. chlorhexidine gluconate
  2. essential oils
  3. cetylpyridinium chloride
36
Q

how much can chlorhexidine reduce the overall severeity of gingivitis by?

A

by 50 % when used as directed

37
Q

what is chlorhexidine effective against?

A

gram positive and negative bacteria, very low level of toxicity and shows no permanent retention in the body

38
Q

why is the primary mechanism of action for chlorhexidine

A

disruption of the integrity of the cell walls of bacteria

39
Q

patients who would benefit from using chlorhexidine

A

special needs, patients with dental caries, oral piercings, candida infections, and patients in nursing homes

40
Q

chemical agents included in essential oils

A

thymol, menthol, and methyl salicylate

41
Q

features of mouth rinses containing essential oils

A

reduces gingivitis by 35%

  • less effective than chlorhexidine
  • less expensive than chlorhexidine
  • pre-procedural rinses reduces bacteria in aerosols by more than 90%
42
Q

quaternary ammonium compounds features

A
  • released so rapidly that is has very little substantivity, limiting its effectiveness
  • less effective than chlorhexidine and essential oils
43
Q

povidone iodine as a mouth rinse features. who shouldn’t use this?

A
  • used in medical practice as a presurgical scrub for skin disinfection
  • safety concerns
  • shouldn’t be used with patients who have sensitivity to iodine, allergies to shellfish, thyroid dysfunction, or women who are lactating or pregnant
44
Q

what ingredient inactivates chlorhexidine

A

sodium laurel sulfate

45
Q

side effects of essential oils

A

burning sensation in mouth, bitter taste, drying out mucous membranes

46
Q

ADA classificiation of dentifrices

A

-antitartar activity, caries prevention, whitening, gingivitis reduction, plaque formation reduction, tooth sensitivity reduction

47
Q

what ingredients reduce supragingival calculus

A

pyrophosphates, triclosan, and zinc citrate

Periodontology (28 decks)

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