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Periodontics > Lecture 10 > Flashcards

Lecture 10 Flashcards

1
Q

biologic equilibrium

A

a state of balance in the body between the bacterial plaque and the host

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2
Q

what happens if an individual’s immune system can effectively deal with a mouthful of periodontal pathogens

A

no destruction will occur

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3
Q

nature’s balancing act

A

the situation can be thought of as a balance scale, with disease-promoting factors on one side of the scale and health-promoting factors on the other side

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4
Q

periodontal disease results when

A

the balance tips between pathogenic bacteria and the hosts inflammatory and immune responses

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5
Q

the balance of periodontal disease can be affected by

A

differences in host response
risk factors: local/systemic risk factors, systemic illness, medications, smoking, poor diet, stress

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6
Q

risk assessment involves identifying elements that either

A

predispose a patient to developing periodontal disease or influence the progression of disease that already exists

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7
Q

in addition to an evaluation of the risk factors…

A

educate patients concerning their risk
implement suitable intervention strategies
eliminate/minimize the impact of contributing/risk factors

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8
Q

restoring balance: inadequate self-care

A

many patients are unable or unwilling
patient education/oral hygiene instruction
more frequent perio instrumentation

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9
Q

is it possible to eliminate local contributing factors to help restore balance

A

faulty restorations
ill-fitting dentures
caries

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10
Q

it is possible to compensate for local factors that cannot be eliminated

A

root concavities
palatal grooves
good home care around crowded teeth or anatomical challenges

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11
Q

systemic contributing factors

A

patients can work to eliminate systemic risk factors to restore balance
diabetes: control blood glucose
quit smoking: TDE for all smokers

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12
Q

genetic risk factors

A

at the present time, there are some risk factors that cannot be eliminated or controlled, such as genetic risk factors
frequent professional care can help to slow disease progression

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13
Q

why is it important to be aware of your patient’s risk factors

A

as a dental professional you want to: eliminate/minimize the impact of contributing factors to maximize the success of nonsurgical periodontal therapy

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14
Q

nonsurgical periodontal therapy

A

describes the many nonsurgical steps used to eliminate inflammation in the periodontium of a patient with periodontal disease and return the periodontium to a healthy state

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15
Q

nonsurgical periodontal therapy (NSPT) consists of a combination of both

A

professional care and patient self-care

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16
Q

types of procedures included in NSPT

A

patient education/individualized self-care instructions
home care recommendations
instrumentation of tooth surfaces
correction of local/systemic risk factors
evaluation of treatment

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17
Q

treatment plans for NSPT

A

a list of procedures or interventions that addresses a patient’s periodontal health needs as identified during the periodontal assessment

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18
Q

patient education/individualized self-care instructions

A

addressing all key concepts for patient education
individualized oral hygiene instruction/goals

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19
Q

home care recommendations

A

antimicrobial agents/xerostomia products
specific interdental/brushing aids

20
Q

instrumentation of tooth surfaces

A

2 units of scaling: ultrasonic, hand instrumentation
select polishing

21
Q

correction of local/systemic risk factors

A

defective restorations, food impaction, patient habits
smokers? (TDE)
caries risk? nutritional counseling/FL TX (varnish/gel)

22
Q

evaluation in axium: diagnostic summary tab

A

are the outcomes met and goals obtained?
is a re-evaluation appointment necessary?

23
Q

biofilm-induced gingivitis

A

NSPT primary type of care
periodontal surgery may be needed to correct other existing problems (gingival recession, gingival overgrowth)

24
Q

stage 1 and stage 2 periodontitis

A

NSPT can bring many cases under control
may require periodontal surgery to correct damage done by the disease

25
Q

stage 3 and stage 4 periodontitis

A

will require thorough NSPT as well as more advanced perio procedures such as perio surgery as severity of disease increases
document the possible need for more advanced treatment and inform patient when the need for such treatment appears likely
surgery is indicated for patients with more advanced periodontitis after NSPT is completed
NSPT may minimize the extent of surgery that is needed

26
Q

instrumentation during NSPT objective

A

physical removal of microorganisms and their products (calculus/biofilm) to prevent and treat periodontal infections

27
Q

why do we instrument during NSPT

A

physical removal/disruption is the most effective mechanism of control

28
Q

rationale for instrumentation

A

to eliminate inflammation in the periodontium
to arrest progress of periodontal disease
to induce positive changes in subgingival bacterial flora
to increase effectiveness of patient self-care
to prevent recurrence of periodontal disease during periodontal maintenance

29
Q

power instrumentation vs hand instrumentation for periodontal debridement

A

very effective in deplaquing tooth surfaces
more effective treatment of furcations
slim tips reach deeper into periodontal pockets
low/medium power setting less root surface damage
water irrigation removes toxins
reduced instrumentation time

30
Q

scaling

A

instrumentation of the crowns and root surfaces to remove plaque biofilm and calculus

31
Q

dental prophylaxis

A

includes scaling and polishing to remove coronal plaque biofilm, calculus and stain

32
Q

root planing

A

removes rough cementum or surface dentin and the associated calculus, toxins or microorganisms

33
Q

periodontal instrumentation/periodontal debridement

A

the removal or disruption of plaque biofilm, its by-products and calculus from coronal and root surfaces to the extent needed to reestablish periodontal health and restore a balance between the bacterial flora and the host’s immune responses

34
Q

periodontal instrumentation/periodontal debridement involves

A

thorough biofilm and calculus removal but does not include the deliberate, aggressive removal of cementum
root surfaces should be instrumented only to a level that results in resolution of tissue inflammation

35
Q

end point for instrumentation during NSPT

A

to return the periodontium to a state of soft tissue health that is free of inflammation

36
Q

the primary type of healing in a site of attachment loss after periodontal instrumentation is through the formation of

A

long junctional epithelium

37
Q

long junctional epithelium

A

as inflammation resolves, epithelial cells may readapt to the tooth surface
this adaptation of the epithelial cells to the root surface is referred to as the long junctional epithelium

38
Q

following periodontal instrumentation there is no formation of

A

new alveolar bone
cementum
periodontal ligament

39
Q

tissues responses to instrumentation

A

shrinkage of the soft tissue/resolution of inflammation resulting in a shallow pocket depth/reduction in probing depth
forming a long junctional epithelium: readaptation of the tissue to the root resulting in a shallow pocket depth/reduction in probing depth
little change in the level of soft tissues resulting in a residual periodontal pocket

40
Q

the re-evaluation appointment

A

occurs after the completion of NSPT
ideally 4-6 weeks after completion of NSPT (true tissue response will not occur for at least 1 month)
allows time for complete tissue healing

41
Q

steps in re-evaluation

A

medical status update
thorough periodontal assessment
compare results with initial assessment
decide on the next step in therapy
additional nonsurgical therapy
periodontal maintenance
possible referral for periodontal surgery

42
Q

options for treatment following re-evaluation

A

additional NSPT: revisit unresponsive sites
establish maintenance program
recognize the need for periodontal surgery/referral

43
Q

initial therapy

A

reduce the number of bacteria
remove calculus and biofilm accumulation
patient education: critical with perio patients

44
Q

maintenance therapy

A

Q 3 months
debridement
review patient education and goals: reinforce home care strategies

45
Q

periodontitis and its treatment may involve both

A

non-surgical therapy and surgical approaches

46
Q

goal of treating all of the periodontium’s problems

A

try to reduce the number of harmful bacteria, create architecture easier for the patient and hygienist to maintain

Periodontics (11 decks)

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