Periodontal Maintenance Flashcards
What is maintenance therapy in periodontics?
Procedures performed at selected intervals to assist the periodontal patient in maintaining oral health
What are typical components of maintenance therapy?
Update of medical and dental histories
Radiographic review
Extraoral and intraoral soft tissue examination
Dental examination
Periodontal evaluation
What is established as part of periodontal therapy during maintenance?
An interval for periodic ongoing care
What are clinical procedures included in maintenance therapy?
Removal of bacterial flora from crevicular and pocket areas
Scaling and root planing where indicated
Polishing of the teeth
What patient education step is included in maintenance therapy?
Review of the patient’s plaque control efficacy
What is a key therapeutic goal in periodontal maintenance regarding disease?
Minimize the recurrence and progression of periodontal disease
What is a therapeutic goal related to tooth retention?
Reduce the incidence of tooth loss by monitoring the dentition and prosthetic replacement
Why is data collection important in periodontal maintenance?
It is used to compare with past information, may indicate the need for new treatment, and should be used in conjunction with clinical and radiographic data
Examination and Data Collection completed during a periodontal maintenance?
Medical history
Dental history
Head and neck examination
Caries identification
Existing restorations/prostheses
Endodontic evaluation
Reconstructive needs
Periodontal evaluation
Gingival appearance
Probing depths (PD) and attachment loss (AL)
Bleeding on probing (BOP)
Mobility
Occlusion
Furcations
Presence of plaque/calculus
Radiographic examination
What are Common Therapeutic Procedures?
Oral hygiene reinforcement
Localized scaling and root planing
Scaling
Flossing
(Rubber cup) polishing
In-office fluoride application
What did Axelsson and Lindhe (1981) find about plaque control with feedback?
Patients given plaque control instructions with performance feedback show less plaque and gingivitis than those receiving instructions alone
What type of procedure should oral hygiene reinforcement be?
An interactive procedure
What does interactive reinforcement lead to over time?
More efficient plaque removal by the patient
How long did it take for bacteria to return to pretreatment levels after SRP?
16 weeks
How can a clinician help correct patient technique?
By observing and correcting using a mirror
What effect does instrumentation have on bacteria associated with periodontal health?
It leads to an increase in bacteria associated with periodontal health and a decrease in bacteria associated with periodontal disease
How does SRP affect pathogenic bacteria in 5-6 mm sites?
SRP disrupts pathogenic bacteria, favoring a more health-supportive microbiota
What maintenance schedule does SRP justify?
Every 3-4 months
What might be observed after SRP, depending on periodontal phenotype?
Recession, leading to sensitivity and root caries
What are some Factors influencing a 3-4 month maintenance interval?
Oral hygiene status
Degree of gingival inflammation
Probing depth and attachment loss
Furcation involvement
Proximity to active treatment
Pre-therapeutic disease severity
T or F: First-year patients should have maintenance every 3 months to establish good habits.
True
What is the Justification of Maintenance?
Maintenance slows disease progression and supports tooth retention.
What are the Patient Compliance Rates based on Wilson et al., 1987?
Complete compliance: 16%
Erratic compliance: 34%
Noncompliance: 50%
How much did complete compliance increase after an intense patient education program?
It increased from 16% to 32%.
