Periodontitis vs. occlusion/endo/ortho Flashcards
What is Carranza’s (Glickman) concept?
Trauma from occlusion changes alignment of transeptal and alveolar crest fibres.
This changes the pathway of inflammation to direct it towards the PDL, leading to bone loss.
Can occlusive forces or unilateral forces (from braces) aggravate periodontitis?
With healthy periodontium, these forces do not lead to bone loss. With active perio, it might.
What are THREE types of splints?
- Wire splint
- CR splint
- Removable acrylic splint
What are FOUR situations where mobile teeth might need to be splinted?
- For progressively worsening mobility (not stable)
- For very mobile teeth to prevent further trauma
- For pt chewing comfort
- After regenerative therapy (adding bone)
What is primary endo/perio and secondary endo/perio describing?
The cause of endo-perio lesions (includes PA and perio lesions)
E.g. primary endo = endo lesion
primary perio = perio lesion
secondary endo = perio lesion with secondary endodontic involvement (ie. bacteria travel via perio lesion into pulp and form endo lesion)
NOTE: endo lesion = any lesion around the root that is from the pulp (includes PA lesion and accessory canals at furcation or side of root)
What are the THREE classifications of endo/perio lesions?
Class I = primarily endodontics
Class II = primarily periodontics
Class III = combined (endo-perio)
How do we treat Class I, II, III endo-perio lesions? What is the main driver of prognosis?
RCT is the primary treatment for all, followed by debridement if perio involvement.
- Prognosis driven by extent of perio involvement. If severe, RCT can’t save the tooth.
How is ortho linked with gingival hyperplasia? How is this relevant clinically?
Gingival hyperplasia will occur on the side in which movement is directed. This pseudopocket is a plaque trap and needs to be cleaned thoroughly.
How is ortho and perio linked?
Just like occlusive trauma, ortho will cause active perio to progress faster. Perio must be treated and stabilised before ortho treatment commenced.
How often should an ortho patient with stabilised periodontitis undertake supportive periodontal therapy (SPT)?
2-3 monthly.
