Nonsurgical Periodontal Therapy Flashcards
define NSPT
all nonsurgical treatment and education measures used to help control gingivitis and periodontitis
the goal is to plan a treatment that controls or eliminates what?
- primary etiologic factors-bacteria
- local risk factors-calculus
- systemic risk factors-diabetes
Periodontal surgery is ______ part of nonsurgical therapy
not
the objective of NSPT is to eliminate disease and what?
- return periodontium to health
2. maintain health with professional and patient self-care
other names of NSPT
initial periodontal therapy, anti-infective phase, root debridement, or root planning and scaling
what are removing with NSPT?
removing calculus and plaque with scalers and curetts
what is root debridement
advanced instrumentation/therapy designated for patients with perio for AAP 2 and above
indications for NSPT?
- all patients with plaque-associated gingivitis or chronic perio
even those patients with advanced perio go through NSPT first because NSPT may _____ the extent of surgery needed
minimize
T/F: NSPT is the best therapy for aggressive perio?
false; it is not
goals of NSPT
- minimize bacterial challenges to patient
- eliminate or control local risk factors for periodontal disease
- minimize impact of systemic risk factors for perio disease
- stabilize attachment level
what is the ultimate number one goal of NSPT?
stabilize attachment level by controlling local and systemic factors
components of NSPT
- customized treatment plan
- patient takes charge of self care
- dental team provides routine professional care
- correction of local and systemic risk factors
- periodontal debridement
____ removal of microorganisms and byproducts to prevent and treat periodontal infection
physical
physical removal of bacteria plaque is the most _____ mechanism of control
effective
pockets must be instrumented to _____ bacterial colonies
disrupted
what are some rationals for instrumentation?
- arrest progress of perio disease
- eliminate bleeding
- increase effectiveness of patient self-care
- prevent recurrence of disease through periodic maintenance
- induce positive changes in subgingival bacterial flora
define scaling
removes plaque calculus and stains
instrumentation of crown and root surfaces
define root planning
removes cementum and rough dentin impregnated with calculus toxins
what can root planning lead to?
endodontic lesions
define periodontal debridement
removes or disrupts bacterial plaque byproducts and calculus from crown and root within pocket space
doesn’t include deliberate aggressive removal of cementum
what system do insurance’s use for coding
ADA system
advantages of ultrasonic instrumentation
- flushes debris, bacteria, and unattached plaque from pocket
- tip is thinner and smaller than a Gracey and can reach the furcas better
- optimum choice over hand instruments for perio debridement
- shorter instrumentation time
- low to medium power setting for less root surface damage
endpoint for instrumentation is simply a return to what?
soft tissue health and free from inflammation
what is the primary pattern of healing after instrumentation as far as the JE goes?
it is through formation of a long junctional epithelium which results in reduced probing depths
what are we lacking when there is a long JE formation?
no formation of bone, cementum, or pdl fibers
what time frame should we use to evaluate tissue healing?
4-6 weeks after completion of instrumentation
what if healing doesn’t occur—what do we do?
consider host factors , surgery or re-explore and remove calculus if still present
what factors cause sensitivity
mechanical, thermal, or chemical stimuli
what layer prevents sensitivity
Smear layer
how do we treat sensitivity?
keep surface plaque free, apply fluoride, calcium hydroxide, and use potassium nitrate toothpaste
what must the patient do in order to prevent from getting sensitivity again?
keep the tooth surfaces free of plaque
hypersensitivity pain is ____
sporadic
what does MI paste do?
helps remineralize areas and helps with sensitivity
thorough daily ____ removal prevents and controls sensitivity
plaque
will treatment immediately stop sensitivity?
no
