Initial Therapy

Question 1

What are the three objectives of initial therapy

Answer 1

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

Question 2

This is a vital stage in the treatment plan which is a method of evaluation of the periodontal status after non-surgical (initial) therapy

Answer 2

periodontal re-evaluation (PR-E)

Question 3

What are the three objectives of re-evaluation

Answer 3

response to initial therapy
reassess the prognosis or residual problems
treatment plan to improve health for “areas of concern”

Question 4

What five things can be performed in the initial therapy stages

Answer 4

SRP
OHI
prophy
occlusal therapy
possible anti-microbial, antibiotic, or anti-inflammatory Rx

Question 5

SRP will not remove plaque retentive features such as what

Answer 5

poor restorations or overhangs

Question 6

This, if present, is a moderate predictor of future attachment loss

Answer 6

bleeding on probing

Question 7

What does it mean if BOP is absent in a non-smoker

Answer 7

useful indicator of health

Question 8

Why does a short term comparison of pre-treatment and PR-E probing depths have a limited predictive value

Answer 8

lack of reproducibility because variable examiner probing force, angulation, and probe position

Question 9

Deep residual pockets (comparing pre-treatment and PR-E) are indicative of what

Answer 9

of further attachment loss particularly if combined with BOP

Question 10

Sites greater than what are directly related to future periodontal breakdown

Answer 10

6mm

Question 11

In which two ways may initial therapy reduce pockets

Answer 11

gingival recession

clinical gain in attachment

Question 12

Reduction in tooth mobility following initial therapy may occur due to which two things

Answer 12

reduction in inflammation (CT healing, more collagen, less cellularity)
occlusal therapy

Question 13

What are the times for re-evaluation for gingivitis and periodontitis

Answer 13

gingivitis - 2 weeks
periodontitis - 4 weeks minimum 3 months maximum
re-evaluate at this time from the last appointment

Question 14

Why are the re-evaluation times what they are

Answer 14

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

Question 15

What is assessed and how when analyzing the degree of resolution of gingival inflammation

Answer 15

assessing the soft tissue response

done by recording color, contour, consistency, and BOP

Question 16

Data obtained when will form the basis for future therapeutic measures

Answer 16

at the PR-E

Question 17

What is the periodontal treatment option for a patient at PR-E with adequate plaque control, inflammation and probing depths of ≥5mm

Answer 17

referral for surgery in grad perio

Question 18

What is the periodontal treatment option for a patient at PR-E with inadequate plaque control, inflammation and probing depths of ≥5mm

Answer 18

reinforcement of OHI and referral to grad perio

Question 19

What is the periodontal treatment option for a patient at PR-E with adequate plaque control, no inflammation and probing depths of ≤ 5mm

Answer 19

perio maintenance

Question 20

What is the periodontal treatment option for a patient at PR-E with inadequate plaque control, inflammation and probing depths of ≤5mm

Answer 20

reinforcement of OHI and perio maintenance

Question 21

This is a prediction as to the progress, course, and outcome

Answer 21

prognosis

Question 22

What is the primary goal of a periodontal treatment plan

Answer 22

elimination of gingival inflammation and correction of the condition that cause and/or perpetuate it; includes local as well as systemic conditions

Question 23

What type of decisions are made about tooth retention in a treatment plan

Answer 23

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

Question 24

What three things can influence a decision about tooth extraction

Answer 24

mobility
abscess with an already severe CAL
position

Question 25

What are the five phases of therapy

Answer 25

initial preparation
re-evaluation
surgical phase
restorative phase
maintenance phase

Question 26

What are some components of initial preparation

Answer 26

diet control
SRP
removal of caries, ill-fitting restorations
antimicrobial therapy
occlusal adjustment
provisional splinting
prosthesis

Question 27

What four things should be considered regarding the presentation of the treatment plan

Answer 27

be specific
begin with a positive note
present the entire treatment plan as a unit
do not hole onto hopeless teeth

Question 28

True or False

The patient has the right to know difference treatment options

Answer 28

True

Question 29

What are the components of the active phase of treatment

Answer 29

evaluation and treatment plan
initial therapy (extractions/perio/caries control)
re-evaluation

Question 30

Do we need to refer the case for surgeries?

Answer 30

Yes! perio surgeries first, restorations second
No! start restorative phase of treatment and place patient into perio maintenance program but sometimes perio surgeries are needed for restorative needs