Initial Therapy Flashcards
What are the three objectives of initial therapy
reduce or eliminate gingival inflammation by removing plaque retentive features
reduce or eliminate periodontal pockets produced by edematous enlargement of inflamed gingiva
achieve surgical manageability
This is a vital stage in the treatment plan which is a method of evaluation of the periodontal status after non-surgical (initial) therapy
periodontal re-evaluation (PR-E)
What are the three objectives of re-evaluation
response to initial therapy
reassess the prognosis or residual problems
treatment plan to improve health for “areas of concern”
What five things can be performed in the initial therapy stages
SRP OHI prophy occlusal therapy possible anti-microbial, antibiotic, or anti-inflammatory Rx
SRP will not remove plaque retentive features such as what
poor restorations or overhangs
This, if present, is a moderate predictor of future attachment loss
bleeding on probing
What does it mean if BOP is absent in a non-smoker
useful indicator of health
Why does a short term comparison of pre-treatment and PR-E probing depths have a limited predictive value
lack of reproducibility because variable examiner probing force, angulation, and probe position
Deep residual pockets (comparing pre-treatment and PR-E) are indicative of what
of further attachment loss particularly if combined with BOP
Sites greater than what are directly related to future periodontal breakdown
6mm
In which two ways may initial therapy reduce pockets
gingival recession
clinical gain in attachment
Reduction in tooth mobility following initial therapy may occur due to which two things
reduction in inflammation (CT healing, more collagen, less cellularity)
occlusal therapy
What are the times for re-evaluation for gingivitis and periodontitis
gingivitis - 2 weeks
periodontitis - 4 weeks minimum 3 months maximum
re-evaluate at this time from the last appointment
Why are the re-evaluation times what they are
if less time is allowed, the tissues may not have sufficiently healed
if too much time lapses, return on plaque and deposits may prevent evaluation at the time of optimal response
What is assessed and how when analyzing the degree of resolution of gingival inflammation
assessing the soft tissue response
done by recording color, contour, consistency, and BOP
Data obtained when will form the basis for future therapeutic measures
at the PR-E
What is the periodontal treatment option for a patient at PR-E with adequate plaque control, inflammation and probing depths of ≥5mm
referral for surgery in grad perio
What is the periodontal treatment option for a patient at PR-E with inadequate plaque control, inflammation and probing depths of ≥5mm
reinforcement of OHI and referral to grad perio
What is the periodontal treatment option for a patient at PR-E with adequate plaque control, no inflammation and probing depths of ≤ 5mm
perio maintenance
What is the periodontal treatment option for a patient at PR-E with inadequate plaque control, inflammation and probing depths of ≤5mm
reinforcement of OHI and perio maintenance
This is a prediction as to the progress, course, and outcome
prognosis
What is the primary goal of a periodontal treatment plan
elimination of gingival inflammation and correction of the condition that cause and/or perpetuate it; includes local as well as systemic conditions
What type of decisions are made about tooth retention in a treatment plan
periodontal condition
restorative needs if any; teeth that can be retained with minimal doubt and maximal margin of safety
removal, retention or temporary interim retention of one or more teeth
What three things can influence a decision about tooth extraction
mobility
abscess with an already severe CAL
position
