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Periodontology > Periodontal Treatment 2 > Flashcards

Periodontal Treatment 2 Flashcards

1
Q

What is necrotising gingivitis/periodontitis?

A
  • The most severe inflammatory periodontal disorder caused by plaque bacteria
  • Rapidly destructive + debilitating
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2
Q

List some main features of necrotising gingivitis (2)

A
  • Painful bleeding gums

- Ulceration + necrosis of the interdental papilla

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3
Q

What is vincents angina?

A

Disease of the throat (not periodontium)

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4
Q

What is necrotising ulcerative gingivitis (NUG)?

A

Common, non-contagious infection of the gums

  • Acute form the usual course the disease takes
  • If improperly tx’d NUG may become chronic and/or recurrent
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5
Q

What is necrotising ulcerative gingivitis?

A

Where the infection leads to attachment loss

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6
Q

What diseases are classified together under the term necrotising periodontal diseases? (2)

A
  1. NUG - Necrotising Ulcerative Gingivitis

2. NUP - Necrotising Ulcerative Periodontitis

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7
Q

Define necrotising stomatitis

A

Progression of NUP into tissue beyond the mucogingival junction
- Mostly in malnutrition + HIV infection (may result in denudation of the bone leading to osteitis and OAF)

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8
Q

Symptoms of necrotising stomatitis (4)

A
  1. Ulcerated + necrotic papillae + gingival margin resulting in a characteristic punched out appearance
  2. Ulcers covered by a yellowish, white or greyish sloughthing
  3. Lesions develop quickly and are very painful
  4. Bleeding readily provoked
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9
Q

Why are the ulcerations from necrotising stomatitis often associated with?

A

Deep pockets formation as gingival necrosis coincides with loss of crestal alveolar bone

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10
Q

Risk factors for necrotising periodontal disease (5)

A
  1. Psychological stress
  2. Sleep deprivation
  3. Poor OH
  4. Smoking
  5. Immunosuppression
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11
Q

Tx of acute disease

A
  1. Ultrasonic debridement
  2. Antibiotics - metronidazole
  3. Chlorrhexidine mouthwash
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12
Q

List the 3 tx strategies for periodontal disease

A
  1. Mechanical distribution
  2. Systemic antibiotics or local antimicrobials
  3. Host modulation therapy
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13
Q

Examples of mechanical distribution of biofilm (4)

A
  1. OHI
  2. Tooth brushing instruction
    - Modified bass technique
  3. Flossing
  4. Interdental brushes
  5. Supra+subgingival plaque control
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14
Q

What is a biofilm?

A

A bunch of micro-organisms in which cells adhere to each other on a surface

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15
Q

What cases do we consider to tx with systemi antibiotic with mechanical disruption of biofilm? (2)

A
  1. Aggressive periodontitis

2. Young people with grade B/C (fast progressing periodontitis)

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16
Q

Tx protocols for patients after initial HPT and with excellent OH

A
  1. OH
  2. Supragingival scaling + RSD of all sites indicated in 6PPC
  3. Start antibiotic regiment on the morning of the first RSD visit
    - 500mg amoxicillin (3x a day for 7days)
    - 200mg Metronidazole (3x a day for 7days)
17
Q

What do patients who are allergic to amoxicillin or on warfarin get instad of amoxicillin/ metronidazole (2)

A
  1. 100mg doxycycline
    - Once a day for 21 days with 200mg loading dose during 1st day
    -
  2. 500mg Azithromycin
    - 1 a day for 3 days
18
Q

Advantages of local antimicrobials (4)

A
  1. Reduced systemic dose
  2. High local concentrations
  3. Drug interactions unlikely
  4. Site specific
19
Q

Disadvantages of local antimicrobials (3)

A
  1. Expensive
  2. Still require RSD or biofilm disruption
  3. Limited indications
20
Q

Indications for using chlorrhexidine (local antimicrobial)

A
  1. Only persisting pockets >5mm
  2. Always with RSD
  3. Only in isolated pockets (if many deep perio pockets in 1 area OFD or systemic antibiotics combined with RSD is more beneficial)
  4. In cases of periodontal abscesses
21
Q

What drugs can host modulation therapy involve?

A

Host modulation therapy not as successful

  1. Corticosteroids
  2. NSAIDs
  3. Anti-cytokine + biological therapies
  4. Bisphosphonates

Periodontology (6 decks)

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