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Perio II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

3 differences between LAP and GAP

A

LAP –> puberty, GAP –> older pt
GAP associated with other systemic diseases and risk factors
LAP –> no clinical inflammation and little/no calculus build-up, GAP –> soft tissue response, calculus present

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2
Q

VSCs such as hydrogen sulfide, dimethyl sulfide, and methyl mercaptan cause …

A

oral malodor

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3
Q

anti-calculus products: pt can anticipate…

A

30% reduction in calculus

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4
Q

abx for acute perio. infections (e.g. abscess)

A

amoxicillin

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5
Q

what would you recommend first for pt with bad breath?

A

clean tongue

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6
Q

half of a subgingivally delivered drug is cleared in …

A

12.5 min

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7
Q

1 pre-disposing factor for dentin hypersensitivity

A

gingival recession

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8
Q

what % of population will test positive with periodontal susceptibility test meaning increased rxn to bacteria?

A

30%

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9
Q

which curette for distal of posterior teeth?

A

Gracey 13/14

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10
Q

which curette for mesial of posterior teeth

A

Gracey 11/12

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11
Q

which curette for anterior teeth

A

Gracey 7/8 universal

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12
Q

which 2 scalers we use

A

SIU FW 204, SIU 13/14 (?) McCall 17/18 (?)

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13
Q

what are stabilizers in toothpaste

A

carageenan –> jelly-like
lye/sodium hydroxide –> pH stabilizer
xantham gum, cellulose gum –> hold it together

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14
Q

ingredient for anti-caries

A

sodium fluoride

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15
Q

ingredient for anti-gingivitis

A

stannous fluoride

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16
Q

instrumentation for root planing

A

rapid, multidirectional strokes, less pressure, longer strokes

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17
Q

instrumentation for scaling

A

slower, unidirectional, shorter strokes, more pressure

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18
Q

which mouth rinse recommended for pt with erosion?

A

cetylpyridinium (CPC, Scope) because it has a higher pH

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19
Q

used for supragingival irrigation at home

A

waterpik

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20
Q

ADA acceptance of chemotherapeutic product for gingivitis control requires a min of 15% reduction in gingivitis, that oral soft tissues and teeth are not affected, opportunistic organisms are not selected for, but …

A

anti-gingivitis agents do NOT have to reduce plaque!

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21
Q

prevalence of gingivitis in US

A

86%

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22
Q

gingivitis defined as…

A

> /= 10% sites have BOP

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23
Q

Bacteremia from oral irrigation rages from ___ to ___ in pt with perio

A

7% to 50%

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24
Q

% ppl lacking cementum below CEJ

A

5-10%

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25
Q

% ppl with overlapping cementum and CEJ

A

60-65%

26
Q

% ppl with cementum = to CEJ

A

30%

27
Q

what are pyrophosphates?

A

water-softening agents which are an ingredient in anti-calculus chemotherapeutic agents. They bind to calcium and magnesium in saliva and form a soluble compound which doesn’t accumulate on teeth.

28
Q

oral B brushes action:

A

pulsation
rotation
oscillation
(only brush which pulsates)

29
Q

adaptation of scalers and curettes:

A

lower 3rd of blade must remain in contact with tooth

30
Q

which abx has best pt compliance?

A

doxycycline (100 mg 1XD)

31
Q

which abx has highest risk of C. diff. infection?

A

clindamycin (has black box warning –> careful if a pt calls within with diarrhea, could be sign of C. diff., usually short-term tx about 7 days isn’t a concern)

32
Q

define Miller class 2 mobility

A

up to 1 mm in any direction

33
Q

Miller class 1 mobility

A

first distinguishable sign of movement greater than “normal

34
Q

Miller class 3 mobility

A

more than 1 mm in any direction

35
Q

sodium lauryl sulfate

A

detergent, surfactant, foaming agent, dec effectiveness of CHX

36
Q

Interproximal brushes are good bc…

A

surface irregularities and concavities are exposed with gingival recession, making floss less effective.
IPB are superior for interproximal cleansing when there is space
larger the space –> larger the brush
IPB inserted from facial and lingual is more effective

37
Q

what is the deal with statins?

A

Number Needed to Treat site says statins taken over 5 years for heart disease prevention in pt WITH HD would save 1/83 lives.
In pt WITHOUT KNOWN HD, NO LIFE SAVED.
ALL PTs –> 1/50 get diabetes, and 1/10 get muscle damage.

38
Q

What is the host modifying tx approved by ADA and what is its mechanism?

A

subantimicrobial dose doxycycline (formerly known as Periostat) suppresses MMP8 and MMP9 which reduces the collagenase activity that breaks down the soft tissues as part of an inflammatory response.

39
Q

gain in CAL with SDD

A

0.35 mm

40
Q

dose of SDD

A

20 mg doxycycline 2XD for AT LEAST 3 months

41
Q

how to take SDD

A

with full glass of water to prevent heart burn

42
Q

what to do if miss dose of abx?

A

don’t double dose, just pick up with the next dose

43
Q

what is problem with subgingival irrigation

A

site is reached with adequate cxn, but cannot penetrate biofilms

44
Q

tell me about tetracycline

A

systemic abx
concentrates in perio tissues 2-10X the serum cxn
effective against A.a.
decreases collagenase production by inhibiting MMPs

45
Q

tell me about ProArgin

A

contains amino acid arginine and calcium carbonate
binds to negatively charged dentin surface and attracts calcium into the dentin tubules to plug and seal them off
the tubules remain sealed even in acidic conditions helping to reduce sensitivity

46
Q

pt: why do I have to floss?? Department of Health took it off their health guidlines?

A

dentist: they removed flossing from guidelines because there has not been sufficient research trials to officially recommend it. HOWEVER, that doesn’t mean they don’t RECOMMEND it. All major dental organizations have confirmed their support for flossing to remove interproximal biofilms because dental health professionals see enough evidence in their practice that flossing works!

47
Q

what is most abrasive tooth cleanser?

A

tooth powders (5x more abrasive than paste)

48
Q

what is PASS score if all molars are positive for plaque on M and D surfaces?

A

40% (5% per surface if 5 teeth are evaluated)

49
Q

Harold Loe study:

A

students stopped oral hygiene for 10-21 days and all got gingivitis
reversed after 7 days of good POH

50
Q

tell me about Gly-oxide and Amosan used in short-term treatment of NUG and gingivitis as well as OTC “oxygenating mouthrinse” which produces fomaing and bubbling to remove debrise and create a more aerobic environment

A

Gly-oxide:
carbimide peroxide 10% is active ingredient in Gly-oxide
carbamide is an oxidizing agent made of ammonium compouned with urea
OTC products with peroxide can help oxidize stains off of teeth but are not as good as what dentists can provide
Amosan:
sodium perborate is active ingredient
hydrolyzes in contact with water and produces hydrogen peroxide and borate

51
Q

you see dark stuff on root of tooth supragingivally after an SRP: why??

A

probably subgingival calculus which is now supragingival after an SRP because the previously edematous soft tissue has shrunk a bit with reduced inflammation. It should simply be scaled off without removing too much cementum.

52
Q

dentin abrades ___ faster than enamel

A

25X

53
Q

t/f: the ring and middle fingers together achieve most stable finger rest

A

true

54
Q

how to tell if curette is in right place

A

terminal shank parallel to long axis of teeth

55
Q

Williams study with Arestin

A

differnece in Probing Depths between SRP and SRP+Arestein = 0.35 mm after Arestin applied 3X

56
Q

when is LDD best?

A

LDD is best when you have controlled all other etiologic factors and there are at most a couple localized areas which may respond to a LDD after multiple times of administration

57
Q

which is a universal curette?

A

McCall 17/18

58
Q

Marjorie Jeffcoat study on Periochip:

A

active ingredient: CHX
difference in SRP alone vs diff in SRP+Periochip: 0.30mm
time spent on initial SRP: 1 hour
no additional SRPs done
at 3 and 6 months, more chips were placed in pockets still 5mm or more

59
Q

ultimate evaluation of response to perio managment:

A

soft tissue response

60
Q

only about ___% of oral microbiota can be grown in lab

A

50%

61
Q

Bonito study:

A

follow-up and self-care affect the longterm perio status of pt as much/more than adjuncts to SRP
dentist must decide if adjuncts in research are clinically significant and worth $$ and effort

Perio II (1 decks)

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