Perio Therapy Flashcards
How can we achieve the perio goals?
RSD
Good OH
Consider AB
Consider Surgerg
What are the goals of perio surgery?
- Arrest inflam lesions: establish good OH, remove Subginginval biolfim, estabkish local environment and microflora which is compatible with health
- Reduce PPD and BOP
- Increase or matin CAL
What type of instruments can we use for RSD?
Hand and mechanical
What type of mechanised instruments do we have?
Ultrasonic unit and sonic hand piece
T/F using ultrasonic with antiseptic irrigants is better than water?
F
What frequency do ultrasonic and sonic vibrate at?
18-50kHz
Both use a water cooling system
In addition to the water cooling system, what do that mechanical instruments provide?
Cavitation: bubbles implode and release energy killing bacteria and endotoxins
Acoustic turbulence: swirling effect which disrupts the plaque
Lavage: flushing action
Mechanical action :shattered the calculus
What are the types of ultrasonic units?
Magnetostrictive eg dentspky
Piezoelectric eg MS
What are the features of the magneto stricture?
Low volateg current which produces a magnetic field
Insert then expands and contracts along its length
ELLIPTICAL PATTERN
How does the piezoelectric hand piece work?
Alternating high voltage current which produced an electrical fold in the hand piece
Electrical field causes piezo crystals to expand and contract along the diameter
VIBRATION due to dimensional change in crystals
What are the contr indications to mechanical instruments?
Communicable disease Susceptibility to infection Swallowing difficulty Uncovered cardiac pacemakers Hearing aids Ocular and retinal implants Implants unless special type Demineralised areas
What are the advantages and dis of hand vs mechanical instruments?
US
Many mechanisms of action vs one
Disrupt and destroy bacteria from a distance vs only removes what it touches
Flushing action vs no flushing
Smaller tips vs larger tips
360 action vs only edge in contact with calculus can remove it
Light pressures vs firm pressure
More easily inserted into pocket vs distension of pocket wall
Limited tissue trauma vs quicker healing time
Limited cementum remove vs cementum
No sharpening needed vs sharpening
Why do we have a 3 month review system?
Allow sufficient time for new long JE to form
Sufficient time to re assess OH and motivation
Subginginval flora re establish
Healing after non surgery
According to Herrera et al 2002 what is the effect on SP and RSD on CAL?
SP and RSD and systemic antibiotics can reduce PPD and gains CAL of more than 4mm
How long does it take JE to for,?
1 week
