clinical management of PDD

Question 1

goals of periodontal therapy

Answer 1

1) restore health/eliminate disease
2) improve patients quality of life
3) clinical goals

Question 2

what is health

Answer 2

• complete state of physical, mental and social wellbeing, not merely the absence of disease

Question 3

oral health

Answer 3

• such a state of health of the teeth and supporting tissues and of efficiency, as is reasonable to safeguard general health (general dental services regulations)

Question 4

disease

Answer 4

• medically defined abnormalities in anatomical structures and/or physiological/biochemical processes

Question 5

clincicla goals for PD therapry

Answer 5

• no progression
• reduction in probing depths
• no probing depths greater than 5mm
• no bleeding on probing
• no smoking
• plaque score on less than 20% of surfaces

Question 6

factors which may affect outcome of treatment

Answer 6

• susceptibility to disease genetic factors
• plaque control
• previous periodontal disease
• smoking
• stress
• some systemic diseases eg diabetes
• diet

Question 7

treatment strategy

Answer 7

1) initial treatment
2) cause related therapy
3) non surgical treatment
4) surgical treatment occasionally

Question 8

inital treatment should be based on

Answer 8

• emergency treatment/relief of pain (where necessary)
• extraction of teeth having a hopeless prognosis
• oral health education/OH advice
• plaque control including correlation of plaque retention factors
• root surface debridement
• initial occlusal adjustment (where necessary)
• reassessment and monitoring

Question 9

positive ledges

Answer 9

plaque retentive features

- replace all or part of the restoration or place an indirect restoration

Question 10

when do you perform RSD

Answer 10

• pockets equal or more than 4mm
• removal of subgingival plaque and calculus
• removal of surface toxins (endotoxin)
• under LA usually
• predominantly ultrasonic

Question 11

non surgical treatment strategey

Answer 11

Deliver treatment as a quadrant or full mouth RSD
• Removal of plaque retention factors (includes scaling and correction of restoration margins)
• Root surface debridement of periodontal pockets ≥4mm) under LA
• 1 month oral health check
• Review 3 months following the completion of treatment (review oral hygiene at 1 month)
• Further treatment of non-responding sites

Question 12

when do you review

Answer 12

1 month

3 months

Question 13

1 month review

Answer 13

symtoms
risk factors
plaque score

Question 14

3 month

Answer 14

• plaque score
• probing depth
• mobility
• bleeding
• recession
• furcation

Question 15

root surface debridement

Answer 15

• reduced probing depth
• less bleeding
• no suppuration
• improved tissue contour
  will also see
• more recession
• increased sensitivity (due to the recession)
• other complications

Question 16

when is PD therapy complete

Answer 16

• residual probing depths above or equal to 6mm show incomplete periodontal treatment and further therapy is required
• residual probing depths greater than 6mm and BOP on over 3-% represent risk of further tooth loss
• need to keep checking to ensure progress

Question 17

what should you monitor for further treatment

Answer 17

Monitor

• probing depths
• recession
• plaque control
• inflammation (BOP)
• mobility
• drifting/migration
• dentine sensitivity

Question 18

Implant care

Answer 18

• Must combine efforts to have build-up of biofilm under control during maintenance and to reduce the influence that risk factors may play in plaque accumulation as well as in the tissue inflammatory response.

Question 19

limitations of clinical measurement

Answer 19

errors in probing depth measurements
Bleeding on probing
- smoking
- low sensitivity
- medication
- flow between sights

Question 20

limitations of radiographs

Answer 20

• show hard/calcified tissue only
• inter/intra operator variance, angulation
• patient factors/tolerance

Question 21

role of systemic antimicobials when to used them

Answer 21

1) severe rapidly progressive forms of disease
2) refractory disease
3) necrotising forms of periodontal diseases
4) abscesses

Question 22

what has use in PDD antimicrobials wise

Answer 22

amoxicillin

metronsazole

Question 23

side effect of azithromycin

Answer 23

can prolong QT inerval

risk of abnormal hear rhytm

Question 24

peripdontl surgert types

Answer 24

flap surgeyr

gingivectomy

Question 25

flap surgery

Answer 25

rasie a flap

can clean direcrly into root

Question 26

gingivectomy

Answer 26

cut back the gignival tissues