Non-surgical Flashcards
How does pocket reduction effect microbial community?
Mombelli 1995
Pocket reduction resulted in significant and lasting decrease in anaerobic bacteria
How does calculus form?
Theilade 1964
By mineralization of dental plaque
Does calculus alone prevent attachment?
No
Listgarten and Ellegaard 1973
Sterilized Calc with chlorohexidine allows normal hemidesmosomal attachment (JE)
Allen and Kerr 1965
Steralized calc did not cause marked inflammation or granulation tissue when inserted into tissue of guinea pigs
What are the critical probing depths?
Lindhe & Socransky 1982
2.9mm and 4.2mm
Heitz-Mayfield & Lang 2013
5.4mm
What is curette efficiency and instrumentation limit?
Stambaugh 1981
- 7 +/- 0.97mm efficiency
- 21 Limit
How does pocket depth effect % calc removal?
Caffesse 86
Scaling
86% 1-3
43% 4-6
32% >6
OFD
86% 1-3
76% 4-6
50% >6
How does manual scaling compare to ultrasonic?
Wennstrom, Tomasi et al.
4Quad
SRP: 66% Calc removed
Ultrasonic: 58%
Time:
- 3min/closed pocket Ultrasonic
- 8min/closed pocket curette
How hard is it to remove endotoxin?
Moore 1986
39% removed via washing with water for 1min
60% via brushing for 1min w/ rotating brush
Do we have to curette extra after removing calculus to remove endotoxin?
NO
Cadosch 2003
9.3 strokes to remove all calc - minimal levels of endotoxin after calc removal
How does root irregularity effect perio?
Waerhaug 1956
Does not cause periodontal disease - Normal tissue attachment histologically observed in roughened areas
Querynen
Irregularities can increase plaque accumulation
Is healing after SRP sufficient to stop plaque?
Magnusson 1983
JE exhibits similar plaque resistance as regular attachment
Why should we not just do another SRP if there are residual pockets?
Badersten 1984
3 consecutive SRPs 3mo apart - no significant benefit over 1 SRP
Should you use non surgical for peri-implantitis?
NO
Elena Figuero 2014
Non-surgical shows little efficacy for treating peri-implantitis
Does well for peri-implant mucositis
Cochrane Systematic review says that theres inconclusive evidence though
What is endotoxin?
A heat stable lipid polysaccharide in the cell wall of many gram - bacteria. Causes inflammation - part of the etiology of perio
Is calculus detection accurate?
Sherman 1990
Periodontists did calc detection
EXT teeth
- 7% had calc
- 8% was detected
Why did we root plane before?
Theorized that the endotoxin is trapped in the root surface and needs to be removed
Why dont we need to root plane?
Moore et al. 1986
Looked at periodontally involved single rooted teeth
Found 39% of endotoxin could be removed by water spray
60% of endotoxin was removed by light brushing
How much calculus do we remove in non-surgical and surgical?
Waerhaug NSurg
Shallow: 83%
Mod: 38% (flip 83)
Deep: 11%
Cafesse 1986 NSurg
Shallow: 86%
Mod: 43% (86/2)
Deep: 32% (-11)
Cafesse 1986 Surg
Shallow: 86%
Mod: 75% (-11)
Deep: 50%
What challenges are there in cleaning molars?
Bower 1979
Average instrument 0.75mm
81% of furcations are = 1mm
58% are = 0.75mm
85% of Buccal Max 1st are = 0.75mm
How can we improve molar furcation debridement?
Matia 1986
Using US will aid in narrow furcation cleaning
Which is better, ultrasonic or hand scaling?
Baderstein et al. 1981
RCT split mouth
NSSD between clinical results
Cobb 2002
Ultrasonic was faster
What kind of healing occurs after SRP?
Long junctional epithelium
Caton & Zander 1979
What kind of healing occurs after OFD?
Long Junctional Epithelium
Caton 1980
How much PD reduction can you expect from non-surgical?
Cobb 1996
Review of longitudingal/RCT/Cohorts
1-3mm: 0.03mm
4-6mm: 1.3mm
>6mm: 2.1mm
