non surgical periodontal treatment 2

Question 1

PCP vs WHO probe

Answer 1

WHO - ball at end (0.5mm) then 2 bands - 1st = 3.5-5.5mm , 2nd = 8.5-11.5mm
PCP doesnt have ball on end

Question 2

what probe is used when assessing furcation involvement

Answer 2

nabers furcation probe

Question 3

furcation involvement grades

Answer 3

1 - initial involvement - furcation felt but less than 1/3 tooth width
2 - partial involvement - exceeds 1/3 tooth width but not total
3 - through and through involvement , probe can pass through entire furcation

Question 4

Grading Mobility

Answer 4

assessed using 2 instruments or a finger and instruments
grade 0 - physiological mobility (0.1-0.2mm)
grade 1 - 1mm horizontal movement of crown
grade 2 - visually increased horizontal movement of crown more than 1mm
grade 3 - severe mobility horizontally and vertically impinging tooth function

Question 5

probing depth

Answer 5

gingival margin to the base of pocket

Question 6

disclosing tablets

Answer 6

used to show where plaque is on teeth
darker colour = older plaque
good tool for oral hygiene instruction

Question 7

what are single tufted brushed good for

Answer 7

good for maligned teeth, localised gingival recession , distal surfaces of molars

Question 8

what should be used when cleaning interdental areas at sights with attachment loss

Answer 8

interdental brushes

Question 9

when should chlorhexidine mouthwashes be used

Answer 9

in ptx in which pain limits their ability to mechanically brush

Question 10

what type of mouthwashes are best for the majority of ptx

Answer 10

alcohol free and fluorodated

Question 11

cavitation bubbles

Answer 11

form when using water coolant with powered scalers , collapsing bubbles cause cavitation and coolant acts to flush pocket

Question 12

manual vs powered scalers

Answer 12

no difference in effectiveness
manual - no aerosols, greater tactile sensation
powered - quicker, easier, less fatigue

Question 13

effect of scaling and RSD on microflora

Answer 13

significantly reduces levels and prevalence of pathogenic species e.g p.gingivalis

Question 14

effect of scaling and RSD on hard and soft tissues

Answer 14

decreased inflammation
potential gingival recession
increased collagen fibres in junctional epithelium beneath pocket seeing increased attachment and therefore decreased pocket depth

Question 15

plaque retentive factor examples

Answer 15

restorations - overhanging margins, overcontoured crown s, subgingival margins
RPDs - gingival coverage, trauma
Orthodontics - compromised interdental cleaning, bands close to gingival margin

Question 16

what do attachment levels tell us pre and post treatment

Answer 16

pre treatment - measure tissue destruction

post treatment - extent of repair

Question 17

why might periodontal treatment plans fail

Answer 17

inadequate ptx plaque control - lack of compliance or dexterity?
residual subgingival deposits - deep pockets, inexperienced operator/ rushed RSD, furcation lesions / root grooves etc
systemic risks e.g smoking/ uncontrolled diabetes