Mod 4 Flashcards
what is cavitation
- bubbles produced when water contacts tip
- bubbles implode and produces shock waves that destroy walls of perio pathogens
what is acoustic turbulence
agitation or swirling of the fluid around the tip, distrupts biofilm
what is acoustic microstreaming
flow of cavitating water that has ability to debride .5 mm past area where the tip is touching the root surface
what is frequency
number of times the tip vibrates per second
what is amplitude
distance tip moves during one cycle, controlled by power setting
what is an ultrasonic
converts electrical energy into mechanical energy
what are the 2 types of ultrasonics
magnetostrictive- ellipical motion- stacks
peizo- linear motion-ceramic rods
what is sonic scaling
converts air pressure into mechanical energy- elliptical motion
what are the advantages of power scalers
removal of biofilm furcation access access to deeper pockets conservation of tooth structure operator ergonomics less fatigue shorter instrumentation time
what are concerns for ultrasonics
aerosols
visibility
restorations
what are contraindications for ultrasonics
- respiratory problems
- demineralized areas
- communicable diseases
- immunosupressed
- swallowing difficulty
- cardiac pacemakers
- newly erupted or primary teeth
- implants
- exposed dentinand hypersensitivity
what is the technique for ultrasonics
-pen grasp
light touch
start coronal and move apically
what are the 3 strokes for ultrasonics
vertical-interproximal
oblique- around corners
horizontal- facial
what should the water control be like
- mist- stain, light calc, low power
- droplets- heavier calc, medium deposits
what is the triple bend design for
gross removal of moderate-heavy tenacious calc
what does the curved shank of the triple bend facilitate
- access to line angles and interproximal surfaces
- supragingival use, some sub
what a slim straigt used for
light calc, pockets less than 4 mm
what is the slim curved used for
enhances adaptation to posterior root surfaces, concavities and furcations, pockets greater than 4 mm
what are symptoms of perio seen by the clinician
erythema, edema, bleeding on probing, increase in probe depths, loss of attachment, mobility, loss of alveolar bone
what are symptoms observed by the patient in perio
difficulty chewing, bleeding with brushing, blood on pillow, disomfort in gums, bad taste in mouth, bad breath
what is the silent disease like HBP
perio… very few visible signs
what is non surgical perio tx
all measures, non surgical and educational used to control gingivitis and periodontitis
what are examples of NSPT
dental biofilm removal and control,supra and sub scaling, root debridement, adjunctive therapies, pt education
what is needed in the treatment of perio disease
effective removal of plaque, calc and associated endotoxins so that perio healing can occur in the oral enviroment
what indicates NSPT
- plaque associated gingivitis
- slight perio
- moderate perio (for most patients)
- severe chronic perio (for a few patietns)
what are goals in perio therapy
control bacterial challenge (remove calc, plaque, homecare)
minimize impact of systemic risk factors
minimize local risk factors
stabilize attachment level
what is scaling
instrumentation of the crown or root surfaces to remove plaque calc or stain
what is root planing
removing cementum or surface dentin that is rough impregnated with calc or contaminated with toxins or microorganisms
what is SC/RP
-complete removal of plaque and calc
-smooth glassy root
-often resulted in overinstrumentation
-
what does root debridement do
treats preio as an infection or disease- is theraputic
what does SRP do
mechanical removal focued on plaque and calc
what is debridement
removal of disruption of bacterial plaque needed to reestablish perio health and restore balance
what is gross scaling
aka gross debridement or preliminary partial scaling
removal of most accessable calc
what is the code for perio scaling and root planing for 4 or more teeth? 1-3 teeth?
4341
4342
is SRP prophylactic or theraputic
theraputic
what is full mouth debridement
gross removal of plaque and calc that interferes with ability of dentist to do a eval
what are the 3 steps of NSPD tx
- full mouth disinfection or partial mouth
- re eval appt
- perio maintenance
what is full mouth disinfection? partial?
- 2, 2 hr appts. 24-48 hrs apart
- 2-4, 1 hr appts in a 2 week time span
when should the reevaluation appointment be
4-6 weeks after instrumentation has been completed
What are signs of non reponsive sites
continued loss of attachment
clinical signs of inflammation
bleeding on probing
when should you refer
- moderate perio if cant be controlled with NSPT
- severe or agressive perio
- perio conditions that continue to decline
What is as important as intial therapy
homecare, talk to pt at every appointment
what is informed consent
patients voluntary consent to treatment after they have been informed of perio disease, tx, risks benefits ect
what is written consent
- formal consent form to document consent process
- pt dates and signs form
- dentist and witness sign
- copy in chart, copy to pt
in verbal consent what do you do
record in chart
what stroke is used for a hoe? chisel
pulling, pushing
what is not a goal fo rNSPT
customize homecare instructions for pt
successful perio debride always results in complete removal of cementum from exposed root surface
false
full mouth disinfection is
perio debride completed in 2 appts within 24 hr period
what is the end point of instrumentation in NSPT
the root surface and pocket are in a state that healing can take place
when should the re-eval appt occur
4-6 weeks from end of NSPT
what is the active tip area of ultrasonic
last 2-4 mm
1 mm of wear on ultrasonic results in
____ loss of efficency
