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Introduction to Periodontics and Prevention > Lectures 9 & 10 > Flashcards

Lectures 9 & 10 Flashcards

1
Q

Phase 1 perio therapy:

A

remove issues that accumulate plaque

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2
Q

Phases of Periodontal Therapy:

A

Phase I, Reevaluation, Phase II (perio surgery), Phase IIII (restorative), Phase IV (maintenance)

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3
Q

Phase II perio therapy?

A

perio surgery

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4
Q

Phase III perio therapy:

A

restorative

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5
Q

Phase IV perio therapy:

A

maintenance

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6
Q

During maintenance of perio therapy, how often should the recall visits be?

A

every 3 mo

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7
Q

Why is restorative work after Phase II?

A

bc the gingival margin location will change

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8
Q

TF? Root planing has to be subgingival.

A

F. does not need to be

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9
Q

Instruments for root planing:

A

curettes

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10
Q

what is required to get healing after perio therapy?

A

eliminate biofilm, calculus, and altered cementum

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11
Q

Microbial Reservoirs:

A

calculus, biofilm, planktonic plaque, scratches from insturmunets, resorption lacunae, accessory root canals and dentinal tubuli, pocket epithelium, intercellular and intracellular, within and upon cementum

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12
Q

Scaling is instrumentation of:

A

crown and root surfaces to remove plaque, calculus, and stain

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13
Q

Root planing is instrumentation of:

A

root surfaces,remove rough cementum or surface dentin impregnated with calculus, toxins or microorganisms. A.k.a. root surface instrumentation or root debridement.

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14
Q

Instrument to remove biofilm, calculus, and infected/contaminated cementum and dentin:

A

Gracey curette

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15
Q

TF? It is easier to remove plaque from a smooth surface.

A

T

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16
Q

What is the only clinical indicator of calculus removal?

A

root smoothness

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17
Q

TF Less plaque accumulates on smooth surfaces.

A

T

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18
Q

Why Remove Cementum?

A

Calculus is frequently embedded, Scaling can’t remove it, Root debridement is needed to remove cementum with embedded calculus

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19
Q

Goal of removal of cementum:

A

creation of a biologically compatible surface

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20
Q

How do we want oral microflora to change after SRP, antibiotics, and flossing?

A

Shift microflora back to gram positive cocci and rods

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21
Q

Plaque takes about ___ weeks to form to final conclusion

A

8 weeks

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22
Q

Effects of removing gram negative oral bacteria:

A

resolve inflammation, reduce pocket depth (2mm on average), increase clinical attachment

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23
Q

TF? Movement (?) of pocket from bottom up is histologic change.

A

F. Clinical attachment, not histologic, tissue gets tighter and can not push probe as deep

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24
Q

How long does bacteremia last after dental extraction

A

10 min

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25
Q

What type of immune response is there to bacteremia?

A

both local and systemic host response

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26
Q

% of pts with bacteremia, dental extraction:

A

100

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27
Q

% of pts with bacteremia, SRP

A

70%

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28
Q

% of pts with bacteremia, third molar surgery:

A

55%

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29
Q

% of pts with bacteremia, endodontic treatment:

A

20%

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30
Q

% viridans group steptococci, dental extraction:

A

85%

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31
Q

% viridans group steptococci, SRP:

A

55%

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32
Q

% viridans group steptococci, third molar surgery:

A

40%

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33
Q

% viridans group steptococci, endodontic treatment:

A

20%

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34
Q

% anaerobes, dental extractions:

A

75%

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35
Q

% anaerobes, SRP:

A

65%

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36
Q

% anaerobes, third molar extraction:

A

45%

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37
Q

% anaerobes, endo treatment:

A

5%

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38
Q

Driving bacteria into __here__ leads to bacteremia.

A

tissue

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39
Q

TF A pt may have constant bacteremia if they have loose teeth.

A

T, movement of teeth while chewing

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40
Q

How do you measure the level of bacteremia:

A

draw blood from arm

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41
Q

When to Rx antibiotics before SRP:

A

prosthetic heart valves (any prosthesis, right?)

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42
Q

Where is removing calculus harder?

A

posterior, interproximals, and deeper pockets

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43
Q

If pockets are too deep to clean out effectively during dental cleaning this may need to be done:

A

Open flap debridement (surgery)

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44
Q

TF? Calculus can form on dentures and fixed bridges

A

T

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45
Q

What fraction of the surfaces can be cleaned for pockets greater than 8mm?

A

about half of the surfaces

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46
Q

Where will the biggest reduction in

pocket depth be seen?

A

deep pockets

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47
Q

Typical Sequence of Instrumentation:

A

probe, explorer, ultrasonic, scaler, curette, polisher

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48
Q

Scalers are used for:

A

large supragingival calculus

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49
Q

Curettes are used for:

A

smaller deposits and subgingival debridement

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50
Q

Stains are removed via this process:

A

polishing

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51
Q

Instrument to locate calculus and caries:

A

explorers

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52
Q

__ is a combination of #23 and #17:

A

5

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53
Q

This is the Old Dominion University explorer:

A

11/12

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54
Q

Explorer with three angles:

A

17

55
Q

Typical looking explorer with a slightly longer tip:

A

23

56
Q

Straightest explorer:

A

11/12

57
Q

Explorer with a slight curve at end, not a full hook:

A

3

58
Q

Angled, hook explorer:

A

3CH Pigtail

59
Q

What are ultrasonic and sonic instruments used for?

A

scaling and root debridement – large deposits

60
Q

5 scalers for supragingival calculus and stain removal:

A

curette, sickle, file, chisel, and hoe

61
Q

Sickle scalers are for:

A

large calculus deposits, 2 cutting edges

62
Q

Which aspects of the tooth can sickles be used on?

A

all aspects

63
Q

Which instrument is triangular in cross section, double-cutting edge, and pointed tip?

A

sickle scaler

64
Q

lateral surface should meet face of the sickle scaler at an internal angle of:

A

70 to 80 degrees

65
Q

What type of area is the Jacquette scaler good for reaching?

A

interproximals, pointed tip, especially mandibular anteriors

66
Q

3 parts to a perio instrument:

A

handle, shank, blade

67
Q

Instruments with 2 cutting edges:

A

scalers

68
Q

Instruments with 1 cutting edge:

A

curettes

69
Q

TF? The lower shank includes the tip of the explorer.

A

F. area just proximal to tip

70
Q

The lower shank is aka:

A

terminal shank

71
Q

This scaler is good to flick off big chunks of calculus in the mandibular linguals

A

Towner scaler, facial of mandibular as well? Yes

72
Q

Curettes are fine instruments for:

A

subgingival removal of calcified deposits, altered cementum from root surfaces, and debride soft tissue lining the pocket

73
Q

Numbers for anterior, posterior, mini anterior, and mini posterior explorer:

A

5530, 5532, 5534, 5536

74
Q

These remove tenacious subgingival calculus and altered cementum. Limited to certain situations:

A

hoe, chisel, and file

75
Q

Cleansing and polishing instruments:

A

rubber cups, brushes, and dental tape

76
Q

Oral (Dental) Prophylaxis:

A

Procedures to remove plaque, calculus, materia alba and extrinsic stain from the crowns and roots of teeth using hand instruments or ultrasonic instruments or electric polishers.

77
Q

TF Both adults and children get oral prophylaxis.

A

T

78
Q

What kind of a shank does a right-angle have?

A

a straight shank

79
Q

What type of right-angles are reusable?

A

metal

80
Q

Webbed cups:

A

flexible, less abrasive paste than ribbed cups

81
Q

Ribbed interior cup

A

flexes and follows tooth contour

82
Q

What is used to remove stains from the pits and fissures of occlusal surfaces?

A

Bristle brush attachments

83
Q

TF Bristle brush attachments can be used on facial, lingual, mesial, distal, or occlusal surfaces.

A

F. only oclusal

84
Q

What is used to remove extrinsic stains from the crowns of the teeth?

A

rubber cup filled with polishing agent

85
Q

Universal curettes:

A

2 cutting edges, blade 90 degree angle to terminal shank

86
Q

Degree angulation for curettes:

A

70 degrees

87
Q

Numbering for Gracey curettes:

A

5-6, 7-8, 11-12, 13-14

88
Q

Scalers are angled at __ d’s and curettes are angled at __ d’s:

A

90 (remember: double edged, makes sense to be at 90d), 70

89
Q

Which are narrower, scalers or curettes?

A

curettes

90
Q

Flat surface of the curette is called:

A

the face

91
Q

Surfaces of a curette starting from the cutting end and working around to the face as the last side:

A

cutting edge, side, back, non-cutting edge, face

92
Q

Purpose of the exploratory stroke:

A

detect calculus and irregularitites

93
Q

Working stroke:

A

remove calculus and altered cementum

94
Q

3 basic strokes:

A

vertical, oblique, horizontal

95
Q

TF The cavitron is typically used subgingivally.

A

F

96
Q

Gross superficial debridement is done with:

A

ultrasonic

97
Q

Are curettes ever used supragingivally or only sub?

A

can be used for both

98
Q

Adverse Effects of Scaling and Root Debridement:

A

Gingival recession (“black triangle”), increased clinical crown length, poor esthetics, root sensitivity, toothbrush abrasion, root surface caries

99
Q

TF The size of the anatomical crown can increase after SRP.

A

F. clinical crown, not anatomical

100
Q

Will root sensitivity go away after SRP?

A

usually, if they clean

101
Q

Calculus will be visible as:

A

chalky deposits, need to dry teeth completely

102
Q

Subgingival calculus is visible at the gingival margin as:

A

a dark shadow

103
Q

What explorer should we use to detect subgingival calculus?

A

11/12

104
Q

Most common locations of calculus:

A

buccal of maxillary molars (Stenson’s duct) and lingual of lower anterior (Wharton’s duct), mineral deposition

105
Q

Patterns of subgingival calculus:

A

spicules, ledge, ring, veneer

106
Q

Start scaling with this type of motion:

A

vertical motion

107
Q

What would happen if you use a downward stroke when trying to remove calculus?

A

Impact gingiva, swollen mouth, calculus lodged subgingivally

108
Q

Why is subgingival calculus dark?

A

iron deposits in calculus from blood, tobacco, and red wine

109
Q

What will happen if you cut off circulation in one area of the mouth?

A

collateral circulation will form

110
Q

What is the nutrient base for biofilm to form?

A

calculus

111
Q

Which mouthwash should I use?

A

Look for the ADA seal

112
Q

What mouthwashes can stain teeth?

A

chlorhexidine or cetyl pyridinium chloride (CPC – Crest procare mouth rinse, CPC: abbreviation for both)

113
Q

What instrument should you start with to remove calculus?

A

Towner/Jacquette, McCalls then Gracey’s

114
Q

Is Gracey’s a scaler or curette?

A

most often in reference to curette, but can also be scaler

115
Q

What is the Towner OR Jacquette used for?

A

big chunks, supragingivally only

116
Q

This explorer looks like Cpt. hooks hook:

A

U15 Towner

117
Q

McCall 17/18 is used for:

A

Distal posterior

118
Q

Where might we remove tooth structure when scaling?

A

subgingivally

119
Q

What is McCall 13/14 used for?

A

Bicuspids, mesial posterior:

120
Q

Scaler that is in the shape of half of a benzene ring

A

jacquette

121
Q

TF We can remove enamel when scaling.

A

F

122
Q

TF The Towner U15 can be used for subgingival calculus.

A

F

123
Q

What is the pointed tip of the Towner U15 used for?

A

interproximals

124
Q

Blade width of the Towner U15:

A

1mm

125
Q

Sickle scaler with a straight, flat face and two cutting edges that come to a point, removes calculus supragingivally and interproximally, not for subgingival calculus

A

30 Jacquette

126
Q

Scalers are for ___ calculus while curettes are for ____ calculus.

A

breaking, shaving

127
Q

This instrument is used for medium to heavy calculus, not for use on root surfaces, 80° angulation fractures calculus from tooth, breaks chunks of calculus, not shaving calculus as when using a curette

A

U15 Towner / 30 Jacquette

128
Q

TF. The scaler should be at a 90 degree angle to the long axis of the tooth.

A

F, 80 degrees

129
Q

All __ facing surfaces, then all __ facing surfaces

A

Rt, Lt

130
Q

Designed for most areas by changing finger rest, fulcrum,and hand position, parallel cutting edges on either side of the face:

A

McCalls 13/14 and 17/18

131
Q

McCalls #13/14 bestfor ____and #17/18 best for ___.

A

bicuspids and mesial surfaces, molars and distal surfaces

132
Q

Shank parallel to distal surface when correct working-end is selected?

A

lower shank

133
Q

What shank goes up and over the tooth?

A

functional shank

134
Q

How to know which shank is the lower shank?

A

ask

Introduction to Periodontics and Prevention (8 decks)

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