Intro Lec 1 Flashcards
Phases of perio therapy.
1) Initial Therapy
2) Re-evaluation
3) Perio Surgery
4) Re-evaluation
5) Maintenance
What do you address during initial therapy?
OHI Plaque control Calculus Overhanging Restorations Open contacts
Time between initial therapy and Re-evaluation.
3 months
What does initial therapy address?
Etiology
Contraindications to perio surgery.
1) More than 10% of surfaces covered with plaque.
2) Uncontrolled diabetes
3) Possibly smoking
What does darkness at the gingival margin indicate?
Subgingival calculus
Used to detect subgingival calculus.
1) Blow air at the gingival margin and you’ll see the calculus.
2) Radiographs
3) 11/12 explorer
How to remove amalgam overhangs?
Purple tip cavitron.
Indicates if you have a good contact.
Floss
How will a weak contact look on a radiograph?
Closed- used floss to check.
This can accumulate at the gingival margin on overbulked crowns.
Plaque
Cause of a localized deep pocket.
Cracked tooth.
The cause of localized aggressive periodontitis.
Aggregatibacter actinomycetoconcomitans
Type of occlusal trauma where there’s excess forces on the tooth, but periodontal support is normal.
Primary occlusal trauma
Therapy for occlusal trauma.
Occlusal equilibration, splint to equally distribute the occlusal forces.
Therapy for pathogenic bacteria (like AA) that cause periodontitis.
Antibiotics like Amoxicillin.
Color of the cavitron tip you should be using for cleanings.
GP
Green or Purple
What procedures are performed during a re-evaluation?
- Measure pocket depths.
- Measure plaque with disclosing solution.
- Record BOP.
- Look for calculus
What does BOP indicate?
Inflammation
Absence of BOP does NOT mean that there’s absence of this.
Inflammation
Reasons for continued BOP after initial therapy?
- Pt has bad oral hygiene
- Could be a crack
- Left calculus behind during initial therapy.
An indication for perio surgery?
Pockets don’t resolve after initial therapy.
What pockets depths have the most reduction after initial therapy?
DEEPEST pockets
Probing depths > 7 mm have ____ mm as the average probing depth reductions, and gain ____ mm in clinical attachment.
- 2
1. 2
Surgical perio therapy had a lot less pocket depth reduction and a lot more clinical attachment loss when done in _____ pocket depths compared to just scaling and root planing the pocket.
Shallow
We always do these two things as treatment for aggressive periodontitis.
SCRP, and antibiotics
Most epithelial reattachment takes place how long after perio therapy?
First 3 months
A bad variant of AA
JP2
Non-surgical therapy in aggressive periodontitis.
SCRP and Antibiotics
Used to determine what tx to do following initial therapy.
Probing depths
Indications for perio surgery.
1) To reduce deep pockets
2) Provide access to root surfaces and furcations.
3) Correct gingival and osseous defects
4) Regenerate new CT attachment and alveolar bone
Two approaches to perio surgery.
1) Excisional
2) Regenerative
Types of excisional perio surgery.
1) Gingivectomy
2) Flap surgery
“Cutting pockets away”
Removes tissues
Reduces pocket depth
Excisional approach
“Putting things back”
Increase attachment and alveolar bone
Regenerative therapy
Types of regenerative perio surgery
Guided Tissue Regeneration - use resorbable membrane and maybe grafts.
Osseous grafting
Healing seen following perio therapy
1) Long epithelial attachment
2) New CT attachment
3) Perio regeneration
Bad thing about the long epithelial attachment that forms after perio tx.
It’s weak
Which is stronger?
Long epithelial attachment OR
Connective Tissue Attachment
CT attachment
Types of Incisions
1) External beveled
2) Internal beveled
This incisions is used in gingivectomies
External beveled
This incision is used in flap surgery
Internal beveled
The width of this kind of tissue is reduced in a gingivectomy.
Keratinized
The width of the keratinized tissue is preserved in what type of procedure?
Flap surgery
This incision preserves the width of the keratinized tissue.
Internal beveled
This surgery removes and recontours the bone after reflecting a flap.
Resective Therapy
Flap in which you:
1) Make a scalloped internal beveled incision.
2) Root Plane
3) Cut away the collar of gingival tissue.
4) Suture the flap back together.
Modified Widman Flap
Procedure where you:
1) Place an osseous (bone) graft.
2) Cover the graft with barrier membrane.
3) Suture flap over the barrier membrane-covered graft.
Regenerative therapy
