Perio in Children and Young Adults Flashcards
describe the stage and grading of periodontitis. how do you work these out?
stage I - initial
stage II - moderate
stage III - severe with pot. tooth loss
stage IV - severe with pot. dentition loss
grade A - slow rate
grade B - mid rate
grade C - rapid rate
work out the stage with bone loss using the worst site
- stage I - <15%
- stage II - coronal third of root
- stage III - mid third of root
- stage IV - apical third of root
work out grade based on the age
- % bone loss / patient age
- grade A - <0.5
- grade B - 0.5-1.0
- grade C - >0.5
describe stable perio and unstable perio
stable:
BoP - <10%
PPD <4mm
unstable:
PPD >5mm OR PPD >4mm and BoP
what does dental biofilm induced gingivitis (plaque induced) entail?
- inflamed gingiva
- false pocketing - base of pocket may be the CEJ
- no bone loss
give 3 reasons why you may get dental biofilm induced gingivitis.
- solely to do with dental biofilm
- systemic or local risk factors
- drug induced
give local risk factors.
- lack of saliva
- tooth anatomy
- restorations
- high frenum - limited oH
- orthodontic applicances
- amelogenesis imperfects
give systemic risk factors.
- smoking
- metabolism - hyperglycaemic - >sugar levels in saliva and dry mouth
- nutritional - vitamin c - < slowed healing and immunity
- pharmacological
- sex hormones - effects of plaque»_space;> progesterone in pregnant women
- haematological
what 3 drugs are KNOWN to create gingival enlargement?
Phenytoin - for epilepsy
Ciclosporin - immunosuppressant to prevent organ rejection post transplant
Calcium channel blockers - Amlodipine, Nifedipine, Diltiazem - for heart problems
what are the types of gingival diseases which aren’t dental biofilm induced?
- genetic/developmental disorder
- specific infection - bacteria, virus
- inflammatory and immune conditions
- reactive processes
- neoplasms
- endocrine, nutrition and metabolic disease
- traumatic
- gingival pigmentation
give 5 viral infections which affect the gingiva.
- herpes simplex I
- pox virus
- chicken pox - varicella zoster
- warts
- Coxsackie virus
what systemic disorders may have a loss on perio tissue by inducing inflammation?
downs - shortened roots and neutrophils defects
papillon-lefevre
chediak higashi
severe neutropenia
leukocyte adhesion deficiency
syndrome
what’s the problems with recession?
plaque accumulation
inflammation
sensitivities
root caries
potential for progression
what’s the treatment plan outline?
history - systemic risk factors
examination - local risk factors and BPE
diagnosis - special tests, classification
initial therapy
corrective therapy
supportive therapy
describe initial therapy
OHI
smoking cessation
remove PRF
extract hopeless teeth
monitor response
describe corrective therapy
NSPT
perio surgery
antibiotics
restorative work
orthodontics
describe supportive therapy
recall at intervals
re-motivate
re-OHI
monitor
what do you do for each BPE stage?
0 = screen again at routine recall or within a year
1 or 2 = treat and repeat 6months
3 = record PD and BoP, treat, consider referral
4 = record 6PPP, consider referral
when should you consider specialist referral?
- advanced stage or grading
- px not responding to tx
- associated medical condition or complicated medical history
- associated genetic condition
- tough root morphology affecting
- drug-induced gingival overgrowth requiring surgery
