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perio 3rd yr > lecture 1 > Flashcards

lecture 1 Flashcards

1
Q

should you ask open or closed end questions

A

open

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2
Q

3 steps of motivational interviewing

A

elicit patients readiness and interest in hearing info, provide info in neutral manner and then elicit patients rxn to info

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3
Q

what brushing technique do we want to use?

A

modified brass technique

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4
Q

explain modified brass technique

A

hold bursh horizontal to tooth surface with it touching slightly on gingiva, then tild 45 degress so that brissles are under the gingiva area and use back and forth or small circles

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5
Q

what level of plaque index is acceptable?

A

15%

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6
Q

when it comes to tooth brushes, which is more effective and which is more efficient.

A

both can be effective, however electric would be more efficient because it can do more in a certain amount of time vs manual. if someone has ortho, or hard time brushing properly than electric is better. also the more expensive, usually the better it is.

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7
Q

tips for flossing for patients

A

correct placement into sulcus, wrapping proximal area, and correct controlled motion

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8
Q

how effective is floss at removing plaque?

A

80%’

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9
Q

what percent of adults reguarly floss?

A

18%

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10
Q

types of floss used for wider emrasures?

A

super floss, ultra floss and butler weave

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11
Q

interdental or proxa brushes good for what uses?

A

large embrasures, around pontics, distal to last molars, orthodontic appliance and implant abutments

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12
Q

interdental rubber tips good for what

A

exposed furcations, concavities and massaging gingival tissue

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13
Q

interdental stimulators?

A

triangular shape, made of balsa wood, moisten before using

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14
Q

rationale for SRP

A

disrupts subgingival microbial flora, delaying repopulation of pathogenic microbes

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15
Q

measurable endpoints for SRP

A

loss or gain of attachment levels, BOP, gingival inflammation, probings, change in microflora

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16
Q

keratinized tissue minus probing depth is what

A

attached gingiva

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17
Q

how do you measure keratinized tissue?

A

from mucogingival jxn to the free gingival marin

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18
Q

explain what clinical attachment levels mean

A

CEJ to the depth of clinical pocket (recession + pocket depth)

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19
Q

after SRP what happens to shallow pockets vs deeper pockets?

A

shallow tend to lose attachment and recession occurs. deeper pockets tend to show a gain in attachment and therefor decreased probing depths

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20
Q

why do shallow pockets tend to lose attachment loss?

A

mechanical trauma from instrumentaion or aggresive oral hygiene procedures

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21
Q

is gingival inflammation and BOP a reliable indictor of future breakdown?

A

no

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22
Q

absence of BOP and inflammation tells us what

A

somewhat reliable indicator of heatlh

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23
Q

SRP reduces what kind of bacteria

A

motile microbes and spirochetes

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24
Q

in intial pocket depths of ____mm or greater have been shown to inadequately debride roots 65% of the time

A

5

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25
Q

removal of soft and hard deposits adhering to tooth surface is called what

A

scaling

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26
Q

removal of diseased root surfaces to create a smooth non-contaminated root surface- not the removal of calculus alone

A

root planning, removing infected cementum

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27
Q

technical term for root planning is _______ but clinical is what?

A

removal of cementum, deep pockets and recession

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28
Q

effective instrumentation (4 steps)

A

adaption, angulation, motion activation and handle roll

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29
Q

if instrument is under the light and it is reflecting light what does this mean?

A

needs to be sharpened, flat and sharp edge does not reflect the light

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30
Q

definition of adaption

A

placing leading 3rd of cutting edge in contact with tooth surface. In this position, the cutting edge is correctly adapted to the tooth. we enter in closed fasion and at base of pocket we put into working angle where the lower shank is parallel to surface youre tyring to clean

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31
Q

angulation for gracey curette which has 1 cutting edge

A

less than 90 and greater then 45

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32
Q

motion activation refers to what

A

moving instrument in order to produce instrumentation stroke

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33
Q

finger rest while SRP goes in order from most recomended to least as:

A

close to area working, cross arch, opposite arch, or extraoral arch

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34
Q

what type of pressure should be used while scaling?

A

firm lateral pressure, should see the instrument moving.

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35
Q

should you use hand instruments of ultrasonic?

A

always finish with hands bc will end with smoother surface. Ultrasonic only used in addition to hand

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36
Q

benefit of using ultrasonic?

A

furcation involvement

37
Q

sub G calculus appears what color?

A

black

38
Q

light touch should be used when using which instrument?

A

11/12 explorer

39
Q

11/12 explorer moved in what direction

A

vertical and horizontal

40
Q

feeling pebbles with explorer is what

A

diseased cementum

41
Q

two most common places for calculus to remain after trt

A

depth of pocket greater than 5 and at the CEJ bc we mistake this for CEJ

42
Q

Injection site for SRP with hand instruments only

A

pulpal not needed, just injection in mucosal tissue just apical to MGJ using mepivacaine 3%. and then subsequent injection in keratinized tissue using lido

43
Q

reason for injecting mucosal tissue first when injection for hand instrumentation SRP

A

keratinized injection can be uncomrortable. start with a site other then papilla and follow the blanching of the tissue

44
Q

what type of injection should you use on the mandible if youre not using ultrasonic?

A

local infiltration

45
Q

what is oraqix?

A

topical local anisthetic- non injectable

46
Q

contents of oraqix

A

2.5%lidocaine and 2.5%prilocaine

same as emla which is not for oral use

47
Q

oraqix is a viscous material and lasts for how long/?

A

14-31 min for an average of 20min

48
Q

instructions for oraqix

A

place on gingival margin and wait 30 sec, place in pocket and fill until gel visible, wait 30 sec. should only do few teeth at a time due to short action

49
Q

oraqix is only for what?

A

soft tissue anesthesia, if root calculus, may not help a lot

50
Q

chemotherapetics can be what two kinds?

A

systemic (antibiotics and periostat) or local administration

51
Q

what is periostat?

A

systemic chemotherapeutic, 20mg doxycycline 2x/day. need higher dose for antimicrobial effect, anticoagulation at lower dose.

52
Q

periostat works how?

A

inhibits enzymatic breakdown of collagen. periostate works on MMPs and SRP works at bacterial byproducts. prevents ct from actually breaking down

53
Q

explain results of periostate

A

statistically significant but not clinically significant

54
Q

why do we use periostate if results no clinical significant?

A

prevents future breakdown

55
Q

53% of periodontitis is attributable to what?

A

smoking, 11% formee

56
Q

what is the major preventable risk factor for periodontitis in the US?

A

smoking

57
Q

current smokers are how many times more likely to have disease? and former?

A

4x 2x

58
Q

former smokers who smoked 11 or more years ago have what risk?

A

same as non smokers

59
Q

smoking increases levels of what? which increases what?

A

pro inflammatory mediators, increses release of destructuuve collagenase

60
Q

periostat decreases levels of what? leadint o what

A

decreases levels of pro inflammatory mediators and collagenase, which leads to better chance of periodontal health

61
Q

those at risk for developing periodontal disease are disease that affect what?

A

onset, rate, severity and response

62
Q

who should use periostat?

A

those resistant to trt, those who cant afford to lose more attachment, and those that show signs of brakdown after being stable for a long time and smokers

63
Q

4 types of local administration

A

actisite, atridox, periochip and arestin

64
Q

periochip content is what

A

2.5mg chlorohexidine gluconate

65
Q

acitisite is no longer used what

A

was tube that was inserted and leached out, but had to be removed 7-10days after

66
Q

second generation local administration is what

A

periochip

67
Q

explain periochip

A

wafer placed sub G. can be hard to place, need to giet it down fast bc can stick to the root surface. hard in narrow pockets to get to base. chlorohexidine not the strongest.

68
Q

atridox content

A

42mg doxycycline

69
Q

explain atridox

A

mixed in tube and injected into sulcus. hard to keep in place once injected

70
Q

arestin contents

A

minocycline HCL microsperes

71
Q

explain arestin

A

microspheres are bioadhesivem bioresorbable polymer in powder form

72
Q

minocycline effective aginst what periodontal pathogens

A

p. gingivalis, P intermedia, and A actinomycetemcomitans

73
Q

is minocyline broad or narrow narrow spectrum?

A

broad

74
Q

characteristics of microspheres found in arestin?

A

sustain release, easy to use, 2 yr stability

75
Q

explain research results of arestin?

A

scientifically significant but not clinically. but reduced pathogenic bacteria. less than 1.3mm of increase

76
Q

arestin is indicated as what?

A

an adjunct to SRP

77
Q

arestin should not be used in what?

A

prego, nursing or children due to tertacycline derivative (minocycline). cholorohexidine can be used

78
Q

agents accepted by ADA as chemical inhibitors of plaque and calculus

A

chlorohexidine (peridex and periogard) and essential oils (listerine) and decapinol to reduce gingivitis

79
Q

adverse effects of cholorhexidine

A

staining, unpleasant taste and interaction with dentrifaces

80
Q

explain why cholorohexidine and dentrifaces are a problem

A

chlorohexidine has cations, which react with anions found in dentrifaces such as sodium lauryl sulfate reducing the effect of both

81
Q

how long should you wait in between cholorohexidine and tooth paste?

A

2 hrs

82
Q

listerine is a what

A

anitseptic

83
Q

how does listerine work?

A

disrupting cell wall and inhibits enzymes. reduces gingival inflammation

84
Q

only which type of listerine is ADA accepted?

A

cool mint listerine

85
Q

are listerine and chlorohexidine safe for enhancement of postsurgical wound healing?

A

yes. listerine for periodonaly flap surgery and chlorohexidne for gingivectomies

86
Q

what is used to reduce perimplantitis by decreasing inflammation

A

listerine and chlorohexidine

87
Q

listerine was shown to be effective as_______ in trt of oral candidiasis in pts with ________.

A

nystatin, prosthetic appliances

88
Q

peridex made of what

A

chlorohexidine hibitane

perio 3rd yr (7 decks)

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