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Perio > Exam 3 Lecture 1 > Flashcards

Exam 3 Lecture 1 Flashcards

1
Q

What 3 things must we do first before we treat a patient?

A

Diagnosis
Prognosis
Get permission for Treatment

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2
Q

What phase is non-surgical in nature?

A

Phase I

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3
Q

What phase is surgical in nature?

A

Phase II

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4
Q

Patient with superficial inflammation, BOP, PD 1-4 mm, but no CAL, no bone loss, no tooth mobility or furcation involvement? What’s the diagnosis?

A

Gingivitis

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5
Q

Patient presents with superficial inflammation, BOP, PD 1-4 mm, but no CAL, no radiographic bone loss, no tooth mobility or furcation involvement? What’s the prognosis?

A 
Medical consult
OHI
Full-mouth scale and polish
Re-Evaluation in 4-6 weeks
Prophylaxis every 6 months
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6
Q

What phase is for emergencies where we review their medical condition and history?

A

Urgent Phase

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7
Q

What’s the initial phase called?

A

Control Phase

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8
Q

What the phase when they come back?

A

Re-evaluation Phase

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9
Q

What’s the corrective phase called?

A

Definitive Phase

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10
Q

What do we do in the corrective phase?

A

restore function if disease controlled

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11
Q

What’s the most critical phase in treatment?

A

Maintenance phase

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12
Q

When performing SRP, what instrument do we use first?

A

cavitron

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13
Q

With mild chronic periodontitis and treating with SRP, what might we prescribe for smokers?

A

Doxycycline

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14
Q

What does Doxycycline inhibit and why do we prescribe it?

A

Host Immuno-Inflammatory response for limiting connective tissue and bone metabolism

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15
Q

What’s the goal for SRP?

A

Decrease PD and change CAL

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16
Q

What’s the average PD and change in CAL with SRP?

A 
PD = 1.23 mm
CAL = 0.81 mm
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17
Q

SRP is most likely a prognosis when PD is how large?

A

PD greater than 5 mm

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18
Q

What are some problems we may encounter with SRP depth?

A

PD > 5mm, can’t reach bottom of pocket

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19
Q

What are some problems with SRP when it comes to tooth roots?

A

Root Proximity
Root Furcations
Root Flutings

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20
Q

What are 2 other problems we may encounter with SRP that don’t have to do with pocket depth or roots?

A

Irregular CEJ

Restorations

21
Q

What are limitations to SRP?

A

Intrabony lesions (SRP can’t get rid of these on its own)

22
Q

Patient presents with inflammation extending to bone, BOP, CAL 3-4 mm from CEJ, PD of 5-6 mm, bone loss 20-40%, Class I and II furcation involvement, and Class I and II tooth mobility? What’s the prognosis?

A 
Medical consult (Seeing a pattern yet)
OHI
Quadrant or half-mouth SRP w/anesthesia
Requires 2-4 appointments
Re-Evaluation 4-6 weeks
Local antimicrobial in 5-6 mm RESIDUAL pockets
Refer to Periodontist
23
Q

So when do we use SRP + local delivery of antimicrobials in PD?

A

residual > 5 mm PD

Maintenance Pt’s with ISOLATED PD’s of 5-6 mm

24
Q

What are some other reasons to use SRP + local antimicrobials besides PD?

A 
For Moderate Chronic Periodontitis
EARLY period abscesses
Extracted 3rd molars
Ailing implants
Furcations
25
Q

Where do we place local antimicrobials in Pt’s that have lost 3rd molars?

A

DF line angle of 2nd molars

26
Q

Name the 3 medications used in local antimicrobial prescriptions?

A

PerioChip
Atradox
Arestin

27
Q

PerioChip is AKA?

A

CHX

28
Q

Atradox is AKA?

A

Doxycycline

29
Q

Arestin is AKA?

A

Minocycline

30
Q

Patient presents with inflammation extending to bone, BOP, CAL >5 mm from CEJ, PD >7 mm, bone loss >40%, Class I, II, or III furcation involvement, and Class I, II, or III tooth mobility? What is the diagnosis?

A

Advanced Chronic Periodontitis

31
Q

Patient presents with inflammation extending to bone, BOP, CAL >5 mm from CEJ, PD >7 mm, bone loss >40%, Class I, II, or III furcation involvement, and Class I, II, or III tooth mobility? What is the prognosis?

A 
Medical consult
OHI
Quadrant or half-mouth SRP w/anesthesia
Requires 2-4 appointments
Re-evaluation in 4-6 weeks
Local antimicrobials in 5-6 mm RESIDUAL pockets
Refer to Periodontist
32
Q

Name the prognosis without treatment?

A

diagnostic prognosis

33
Q

Name the prognosis when determining the effect perio treatment will have on the course of the disease?

A

therapeutic prognosis

34
Q

Name the prognosis when given the anticipated results of periodontal treatment, you determine what the forecast is for the success of the prosthetic restoration?

A

prosthetic prognosis

35
Q

Name the prognosis given prior initial phase of treatment, it may change according to the patient/tooth response?

A

provisional prognosis

36
Q

Name the 5 factors of substantivity when prescribing local antimicrobials?

A

1) Kill
2) Reach
3) Appropriate concentration
4) Adequate duration
5) no harm

37
Q

When do we prescribe systemic antibiotics?

A

Aggressive Periodontitis

Severe & Progressive Chronic Periodontitis

38
Q

How long do we prescribe systemic antibiotics for?

A

7 day window

39
Q

What medications do we prescribe for systemic antibiotics?

A 
Amoxicillin
Metronidazole (don't if will consume alcohol)
40
Q

What can we prescribe if allergic to Amoxicillin?

A

Clindamycin

41
Q

What is so overly prescribed that we won’t prescribe it anymore?

A

Azithromycin

42
Q

What else can we prescribe for systemic antibiotics?

A

Tetracycline HCl

Doxycycline

43
Q

Name some advantages for using systemic antibiotics for chronic periodontitis?

A 
affects bacterial reservoirs
targets multiple sites
reduces Pt chair time
absorbs in adjacent soft tissue sites
penetrates base of pocket
wide choice of antibiotics
44
Q

Name some disadvantages for using systemic antibiotics for chronic periodontitis?

A 
Allergy
GI intolerance
Pt compliance
Drug interactions
Pt cost
inability to penetrate intact biofilm
45
Q

Name some reasons systemic antibiotics fail for use with chronic periodontitis?

A

Pt compliance
Pt cost
can’t penetrate infection and intact biofilm
can’t eradicate infection

46
Q

What is the average improvement in change of CAL for prescribing systemic antibiotics in aggressive and chronic periodontitis?

A

0.4 mm

47
Q

Patient presents with inflammation extending to bone, BOP, CAL 3-4 mm from CEJ, PD of 5-6 mm, bone loss 20-40%, Class I and II furcation involvement, and Class I and II tooth mobility? What’s the diagnosis?

A

Moderate Chronic Periodontitis?

48
Q

Patient presents with inflammation extending to bone, BOP, CAL 1-2 mm from CEJ, PD 3-4 mm, bone loss less than 20%, Class I or no furcation involvement, Class I or no tooth mobility. What’s the diagnosis?

A

mild chronic periodontitis

49
Q

Patient presents with inflammation extending to bone, BOP, CAL 1-2 mm from CEJ, PD 3-4 mm, bone loss less than 20%, Class I or no furcation involvement, Class I or no tooth mobility. What’s the prognosis?

A 
medical consult
OHI
quadrant or half-mouth SRP w/anesthesia
requires 2-4 appointments
re-evaluation 4-6 weeks
3-4 month maintenance interval

Perio (5 decks)

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