periodontal instrumentation

Question 1

know the reading assignments :(

Answer 1

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Question 2

SRP

Answer 2

1) initial phase therapy
2) remove factors which promote gingival inflammation
3) evaluation of success depends on soft tissue response
4) total root smoothness vs a cleaned root surface

Question 3

scaling

Answer 3

1) removal of dental biofilm and calculus on both supra and subgingival tooth surfaces

Question 4

periodontal debridement

Answer 4

1) removal of dental plaque, calculus, and disease tissue from supra/subgingival surfaces
2) conservation of cementum and a good healing response 3)

Question 5

deplaquing

Answer 5

1) mechanical disruption of the plaque
2) power flossers

Question 6

prophy

Answer 6

1) removal of plaque, calculus, and stain from exposed and unexposed surfaces of the teeth by SCALING ONLY and polishing as a preventative measure for the control of local irritants

Question 7

coronal polish

Answer 7

1) remove stains but doesnt have therapeutic benefits

Question 8

gingival curettage

Answer 8

1) AAP: not acceptable as a separate procedure in periodontics as studies have shown effects by not any better than SRP alone
2) involves removal of the diseased lining of the soft tissue pocket including junctional epithelium and underlying inflamed CT

Question 9

indications for scaling

Answer 9

1) removal of calcified deposits
- not causing periodontal disease
- contributing to periodontal inflammation
- observed at surgery
2) elimination of gross inflammation prior to surgery

Question 10

root planing

Answer 10

1) residual calculus for cementum are removed
2) extensive root planing is not needed to obtain healthy tissue
3) ultrasonics can help remove calculus and bacterial products
4) depends on tactile ability
5) control of instruments near soft tissue

Question 11

detection skills

Answer 11

1) radiographic, visual, tactile
2) tactile is most important

Question 12

2x2

Answer 12

1) can be pushed into the vestibule so you can dab blood

Question 13

prophy indications

Answer 13

1) <3 mm or less pockets

Question 14

SRP

Answer 14

1) 3-5 may need SRP and success is not great
2) 5 mm pockets is likely to fail
- may need to do surgery

Question 15

anesthesia

Answer 15

1) usually local anesthesia or quad
2) allows deeper insertion of instrument and more thorough cleaning
3) provides hemostasis
4) necessary for deep pockets or heavy calculus

Question 16

objective for RP

Answer 16

1) supra and subgingival plaque and calculus
- expect reduction not elimination
- p. gingivalis
- a. actinomycetemcomitans
- spirochetes
2) recolonization levels 2-4 months after instrumentation
3) reduce gingival inflammation and promote healing
4) removal of altered cementum
- no more “classic” root planing
5) inadvertent tissue contact
- due to proximity of plaque and calculus to soft tissue wall
6) calculus and apical termination of JE

Question 17

effect of SRP on soft tissue

Answer 17

1) removes portion of the pocket
2) leaves a cut connective tissue surface
-can take months
3) but usually soft tissue heals in days