Corrective Therapy Flashcards
What are the 3 parts of periodontal treatment plan?
- Initial therapy
- Corrective therapy
- Supportive therapy
What is the definition of corrective therapy?
It is the stage following the initial “hygiene” therapy for a patient, where re-assessment and definitive treatment planning is undertaken
Corrective therapy may then include further periodontal, conservative, prosthetic and orthodontic treatment
What can corrective therapy include?
further periodontal, conservative, prosthetic and orthodontic treatment
What do you constantly need to do to the treatment plan
The plan requires constant review and reassessment of periodontal status
What is the aim of corrective therapy?
- To restore function and provide a stable occlusion for the patient
- To restore aesthetics after resolution of inflammation and healing following extractions
Why might initial therapy fail?
- Inadequate instrumentation
- Poor plaque control/motivation
- Confounding systemic factors
- Gross deposits
- Smoking habit changes
- Host factors
- Microbial factors
Why is harder to treat smokers with periodontitis?
They have a poorer response to treatment
Tissue healing is impacted by reduced vascularisation and altered host response
What should you do if your patient is not compliant with homecare?
- Think again
- Counsel patient
- Tailor OHI and education/motivation
- Keep full clinical record
How can you review how your treatment is going?
Check plaque levels, calculus, marginal bleeding free score
When should you return to the initial therapy phase?
If non surgical therapy has not succeeded
How can you check to see if your non surgical therapy has not succeeded ?
If there is:
- Residual Bleeding on Probing
- Residual pockets
- Residual calculus
- Ineffective self care oral hygiene regimen
- Ineffective instrumentation
If initial therapy is unsuccessful what should you look at to judge why it has been unsuccessful?
You should ensure response to the initial therapy is not affected by systemic (smoking diabetes) or local factors (occlusion, poor restorations).
What procedures and therapies are part of corrective therapy??
- Replacement of missing teeth
- Adjunctive treatments
- Periodontal surgery
- Endodontic surgery
- Orthodontics
- Root canal therapy
- Definitive restorative treatment and occlusal therapy
What treatment can me give someone who has lost a tooth?
Crowns
bridges
implant placement restoration
dentures
What is periodontal care dependant?
Patient availability
Operator experience
Correct equipment
How long can periodontal treatment take?
4-6 hours
When do you use adjunctive treatments?
If a patients has: 1. Deep pockets
2. Unresponsive sites or patients
Where no allergy known and make sure the patient is willing
What are some limitations of adjunctive therapy?
- Operator skill
- Allergy
- Patient comfort
- Patient availability for repeated applications
- Efficacy
- Cost
What might me place in non-responsive sits?
Locally placed antimicrobials
Locally placed disinfectants
In certain severe cases we may use Systemic antibiotics
Name some locally placed antimicrobials
Minocyline gel (Dentomycin) Metronidazole gel (Elyzol)