CSA local antimicrobials in perio Flashcards
what is mechanical therapy to remove perio. pathogens?
- scraping near roots
- patients cleaning their teeth
Limitations of mechanical therapy?
- ## teeth with furcation involvement show poor treatment outcome
Why mechanical therapy may fail to remove pathogens?
- microbes trapped
Where can microbes get trapped?
- sub epithelial gingival tissue
- crevicular epithelial cells
- within CONNECTIVE tissue
- altered cementum and dentinal tubules
- sub gingival calculus
- DEEP grooves
- tongue, tonsils and oral mucosa
what is a locally delivered antimicrobial?
0.2% chlorhexidine gluconate:
In perio. disease is there a high volume of GCF?
Yes
Are all local delivery devices degradable?
YES apart from Actisite
How to measure treatment outcomes?
PPD
Gingival recession
Clinical attachment level
BOP
why can there be a change in pocket depth after treatment?
attachment tissue being reformed or inflammation of gingivae is resolving
what is a reliable tool to indicate perio. stability?
absence of BOP
WHAT IF patient has pockets > 3mm with NO BOP
OHI and scaling
WHAT IF patient has pockets > 3mm with BOP
scaling and RSD
What is actisite?
long ethylene vinyl acetate fibre loaded wit 25% tetrracycline
how does actisite work?
bactericidal, layered within pocket and adhesive placed around tooth neck
when is acitisite removed?
after 10 days, its difficult to place
what does actisite increase?
0.5 MM more CAL on aver.
What is a Periochip?
2.5mg chlorhexidine digluconate in biodegradable gelatine chip
where is periochip placed?
• placed in a spot with as much calculus removed and is as clean as possible >disrupts the microflora biofilm >easier to kill
what does a periochip improve?
pocket depths and CAL
What is Dentomycin?
2% minocyline in lipid gel
where is denotmycin placed?
base of pocket
what does dentomycin improve?
PD and CAL
What is Elyzol?
• 25% metronidazole in a monoglyceride and triglyceride gel
- quick administer
What is Atridox ?
• 8.5% doxyclyine gel
what is atridox used for?
guided tissue regeneration
when Is full mouth debridement more effective with atridox?
after three months of scaling and root planing under LA
What is Arestin?
• 1mg of minocycline HCL in encapsulated microspheres
What are indicators for local antimcirobials?
- Pocket depths >5mm with BOP after review
- Adjunctive to mechanical therapy
- Non-responding sites after initial therapy
What is the choice of product influenced by?
number of pockets to be treated
What are the locally delivered antimicrobials?
0.2% chlorhexidine gluconate: Actisite Periochip Dentomycin Elyzol Atridox Arestin
