Exam 3 Non-surgical Therapy Flashcards
The effect of 0.2 % CHX on undisturbed 6 hr plaque vs 24 and 48 hr plaque is…?
- CHX effect on 6 hr was significant
- CHX effect on 24 & 48 hr plaque was limited to the outer layer
CHX facilitates __________ calculus buildup.
supragingival
What is scaling?
Removal of accretions of the tooth
What is root planing?
Removal of accretions on the root
SRP (soft tissue management) reduces ________ this is considered _____ therapy.
- inflammation
- initial
Need a minimum of ______ , or greater to do a SRP.
4mm
PD less than 3 mm
- 0.34 (a loss in CAL)
0. 03 mm Mean Reduction in probing depth
PD 4-6 mm* showed a mean PD reduction of ______ and a _______mean gain in CAL
***1.29mm SRP
0.55mm
PD > 7 mm* showed a mean PD reduction of ______ and a _______ mean in gain in CAL
***2.16 mm SRP
1.19 mm
What are the problems of restricted access?
1) Probing depth
2) furcations
3) root proximity
4) root flutings
5) CEJ relationships
6) Restorations
What is the clinical protocol?
1) Electric power toothbrush
2) Interproximal cleaning (floss, waterpik)
3) Rinise w/ CHX twice daily
4) Rinse w/ CHX 2 X
5) SRP w/ local anesthesia
6) Low dose doxycycline, 20 mg., #180 tabs, q 12 h (smoker)
7) Re-evaluation 4-6 weeks post SRP (retreat if needed)
8) If desired response is not achieved than consider surgical TX
What was Low Dose (Subantimicrobial) Doxycycline (Host Modulation) originally marketed as? dose?
- Periostat
- 20 mg of doxycycline, # 180 tabs, q. 12 h.
Will SRP affect infra bony lesions like horizontal and vertical bone loss?
No, it will no treat bone defects, it will only reduce inflammation.
At 20 mg concentration of doxycycline, what is the effect?
There is no bacterial effect at this dose.
The tetracycline drugs, doxycycline has the ability to ____________ matrix metalloproteinases- specifically ________________ and __________ produced by PMNs and macrophages.
- INACTIVATES
- COLLAGENASE
- gelatinases
SRP and local delivery of antimicrobials occurs when ? (6)
1) Pockets are greater than 5 mm
2) Maintenance patients with isolated PD of 5-6 mm
3) Early stage of periodontal abscess
4) PD at the distal-facial line-angel of 2nd molars related to 3rd molar extractions
5) Ailing implants (peri-implantitis)
6) Furcations
What are the names of commercially available site specific antimicrobials?
1) PerioChip
2) Atradox
3) Arestin
What is the PerioChip?
Chlorhexidine gluconate in a polymerized polylactic acid disc
What is Atradox?
Doxycycline in a poly-lactide gel that polymerizes on contact with water
What is Arestin?
1 mg of minocycline micro encapsulated in a polyglycolide-co-lactide dry powder
Arresting bind to the ______ space
subgingival
_________ is the most common and simplest locally delivered antimicrobials.
Arestin
Arrestin is placed in __________, ___________ after initial treatments, if certain areas didn’t ________ to therapy.
-It will decrease size of __________, does not ______ bone.
- Periopockets
- furcations
- respond
- inflammation
- increase
SRP + Arestin can be given to a pt with _________ chronic ____________ of ________ severity with PD of _________. 1 pk/day cigarette smoker.
- localized
- periodontitis
- moderate
- 4-6 mm
To be effective a locally delivered antimicrobial must have what 5 things
1) Kill or inhibit appropriate target microbes
2) Reach the disease site
3) Achieve adequate concentration for effectiveness
4) Achieve appropriate duration of effect
5) Have few side effects and/or cause no harm to the patient
Which 3 delivery systems reaches the disease site well and which 1 thing has poor prognosis?
Good = Sub gingival irrigation, Systemic antibiotics, locally delivered antimicrobials
Poor= Mouth rinse
Which 3 delivery systems achieve adequate concentration and which 1 thing has a fair prognosis?
Good= Mouth rinse, Sub gingival irrigation, and Locally delivered antimicrobial
Fair= Systemic ABX