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BDS2 CLINICAL Periodontology > Non-surgical management of plaque-related periodontal diseases > Flashcards

Non-surgical management of plaque-related periodontal diseases Flashcards

1
Q

what is option 1 on action on recording BPE 3 (BSP)

A

if a sextant scores 3, this sextant should be reviewed and a 6 point pocket completed for that sextant only (and only after treatment)

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2
Q

what is option 2 on action on recording BPE 3 (SDCEP)

A

if a sextant scores 3, a 6 point pocket chart should be completed for that sextant before treatment and after.
where code 3 is observed in only one sextant, carry out full periodontal examination and root surface instrumentation of affected teeth in that sextant only

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3
Q

what is non surgical management also known as

A

cause related therapy

hygiene phase therapy

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4
Q

what is the aim of periodontal therapy

A

to arrest the disease process
ideally to regernate lost tissue
to maintain periodontal health long term

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5
Q

what is the disease control phase

A 
extraction of hopeless teeth
hygiene phase therapy
caries management
endodontic therapy 
provisional prostheses
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6
Q

what is periodontal therapy

A

supra gingival plaque control including scaling

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7
Q

what is periodontitis

A

loss of attachment and true pocket formation

colonization of the root surface - importance of removing this

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8
Q

what is hygiene phase therapy

A 
dental health education 
oral hygiene instruction 
scaling and root surface debridement
removal of other plaque retention factors 
reevaluation
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9
Q

how should dental health education be individualized

A

evaluate patients reasons for attendance, attitudes to health care, motivation tc
explain the natures of disease using diagrams, photographs, models ect
discuss findings of examination

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10
Q

what does dental health education consist of

A

demonstrate health and disease in the patients mouth
explain the nature and consequences of treatment
use language the patient will understand

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11
Q

what happens in oral hygiene instruction

A

talk about tooth brushing
interdental cleaning
disclosing agent

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12
Q

what is scaling

A

the removal of plaque and calculus from tooth surfaces

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13
Q

what is root surface debridement

A

encompasses the process of scaling and removal of supra gingival calculus

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14
Q

what are the scaling instruments

A

hand instruments

powered instruments

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15
Q

what are the powered scaling instruments

A

ultrasonic and sonic instruments

rotating and reciprocating instruments

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16
Q

what does the ultrasonic/sonic tip do better

A

may allow access to furcations
may be faster and less demanding on the operator
may result in less unwanted tooth tissue removal

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17
Q

how do the powered instruments work

A

the vibrations against calculus removes it

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18
Q

where can ultra sonic instruments be used

A

supra and sub gingival

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19
Q

what is the advantage of hand instruments

A

they have greater tactile sensitivity

can tell when you are at the base of the pocket

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20
Q

what is the disadvantages of powered instruments

A

the water coolant may produce cavitation
powered instruments produce aerosols
powered instruments may leave a rougher surface

21
Q

what are problems with restorations

A

their margins (location and adaptation)
restoration contour
partial dentures

22
Q

what are the problems seen with partial dentures

A

gingival coverage
direct trauma
uncontrolled loads

23
Q

how is success of periodontal therapy treatment measured

A

inflammation (bleeding on probing indices)
reduction in probing depth
gain in probing attachment level

24
Q

what does probing depth indicate

A

the difficulty of treatment and the likelihood of recurrence

25
Q

what do attachment levels indicate

A

they are a measure of tissue destruction (pretreatment) and the extent of repair (post treatment)

26
Q

what may manual probing measurements be influenced by

A

the resistance of the tissues
size, shape and tip diameter of the probe
site and angle of probe insertion
pressure applied
presence of obstructions such as calculus
patient discomfort

27
Q

what is the effect of supra gingival plaque control alone

A

decreased gingival inflammation
limited effect on probing depth
no change in attachment levels
no alteration in sub gingival microflora in deep pockets

28
Q

what is the effect of RSD alone

A

initial reduction in inflammation and pocket depth
pockets are recolonized by bacteria from supra gingival plaque
disease recurs

29
Q

what are the effects of RSD with supra gingival plaque control

A

decreased gingival inflammation
reduction in proving depth
gain in probing attachment level
marked changes in the sub gingival microbial flora

30
Q

what is the gain in attachment due to

A

long junctional epithelium formation and improved tissue tone (inflammatory infiltrate is replaced by collagen)

31
Q

when is the greatest changes observed

A

4-6 weeks after therapy

32
Q

when does gradual repair and maturation of tissues occur

A

over 9-12 months

33
Q

what are the 2 ways treatment can be organized

A

quadrant approach or full mouth disinfection approach

34
Q

what is the objective of the full mouth disinfection

A

prevent treated pockets being decolonized by intra oral translocation of bacteria

35
Q

what happens in full mouth disinfection

A

full mouth RSD at one or more sittings on the same day

use of chlorhexidine for sub gingival irrigation, tongue brushing and mouth rinsing

36
Q

what is the effect of debridement

A

reduces microbial challenge - decreased inflammation

inoculation with plaque organisms, boosts immune response

37
Q

what is revaluation

A

what has been the response to the initial therapy

38
Q

what do you look at in reevaluation

A

patient plaque control
bleeding on probing
residual probing depths and attachment levels
tooth mobility

39
Q

what are the factors that determine the success of treatment

A 
good oral hygeine
no bleeding on probing
no pockets > 4mm
no increasing tooth mobility
a functional and comfortable dentition
40
Q

what are the 3 categories of the reevaluations age

A 
poor OH (persistent inflammation) 
good OH (inflammation resolved) 
good OH (persistent deep pockets)
41
Q

what should be done if there is poor OH and persistent inflammation

A

identify the reason for poor OH then supportive care or repeat cause related therapy

42
Q

what should be done if there is good oral hygiene and the inflammation is resolved

A

support care and proceed with treatment plan

43
Q

what should be done if there is good oral hygiene but persistent deep pockets

A

surgical access or repeat RSD then reevaluate

44
Q

why does treatment fail

A

poor compliance
inadequate debridement
host factors (mainly smoking)

45
Q

what are the limitations of non surgical therapy

A 
root morphology
furcation involvement
deep pockets
skill level 
time
46
Q

what is the maintenance in supportive periodontal care

A

maintain periodontal health
detect and treat recurrence
maintain an accepted level of disease
manage tooth loss

47
Q

what are the intervals for supportive periodontal care

A

3months for most

48
Q

what happens in the supportive periodontal care

A

OH must be reinforced
examine for signs of recurrent disease
scaling: RSD, polishing and other treatment as necessary

49
Q

What is the treatment plan for periodontal therapy

A 
emergency care
disease control
re-evaluation
reconstruction
supportive care

BDS2 CLINICAL Periodontology (17 decks)

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