Periodontology Flashcards
Diagnosis of Pt with Code 0/1/2 with <10% BoP
Clinical Gingival Health
Diagnosis of Pt with Code 0/1/2 with 10-30% BoP
Localised Gingivitis
Diagnosis of Pt with Code 0/1/2 with >30% BoP
Generalised Gingivitis
What else should a Code 2 diagnosis include?
A comment on plaque retentive factors
Management of a Code 3 with no obvious interdental recession and appropriate radiographic assessment
Initial periodontal therapy and review in 3 months with localised 6-point pocket chart in involved sextant(s)
Management of a Code 3 following 3 month review with pockets > or = to 4mm remaining &/or radiographic evidence of bone loss due to periodontitis
Continue with Code 4 pathway
Diagnosis of Code 4 with Molar-incisor pattern
Periodontitis Molar-Incisor Pattern
Diagnosis of Code 4 with <30% of teeth involved
Localised Periodontitis
Diagnosis of Code 4 with > or = to 30% of teeth involved
Generalised Periodontitis
What stage is interproximal bone loss of <15% (or <2mm attachment loss from CEJ)?
Stage I (Early/Mild)
What stage is interproximal bone loss to the coronal third of root?
Stage II (Moderate)
What stage is interproximal bone loss to the mid third of the root?
Stage III (Severe)
What stage is interproximal bone loss to the apical third of the root?
Stage IV (Very Severe)
What site should you use to meansure interproximal bone loss?
The worst site of bone loss due to periodontitis!
What is Grade A and what does it mean?
<0.5 (% bone loss/pt age)
Slow rate of progression
What is Grade B and what does it mean?
0.5-1.0 (% bone loss/pt age)
Moderate rate of progression
What is Grade C and what does it mean?
> 1.0 (% bone loss/pt age)
Rapid rate of progression
What are the signs of currently stable periodontitis?
BoP <10%
PPD < or = 4mm
No BoP at 4mm sites
What are the signs of periodontitis currently in remission?
BoP > or = to 10%
PPD < or = 4mm
No BoP at 4mm sites
What are the signs of currently unstable periodontitis?
PPD > or = 5mm
OR PPD > or = 4mm & BoP
Limitations of ‘closed’ RSD (5)
- May not stop progressive & aggressive disease completely
- Persistent acute episodes (e.g. perio abscess).
- Deep complex bone defects (difficult to debride adequately)
- Severe hyperplasia or tissue deformitly.
- Pathology e.g. epulides
Aims of Periodontal Surgery (8)
- Gain access to root surface for effective debridement.
- Visulisation of bone defects.
- Improvement of tissue contour.
- Reduction in pocket depth.
- Removal of chronically inflamed tissue (granulation tissue).
- Encourage regeneration.
- Removal of hyperplastic gingival tissue.
- Crown lengthening.
Indications for Gingivectomy (3)
- Hyperplasia; not going away with NSPT, remove tissue to improve aesthetics & improve pt’s ability to clean or function.
- False pockets -soft tissue growing coronally.
- Adequate attached gingiva -want to have some keratinised gingiva remaining after resection.
Indications for Open Flap Debridement (1)
Deep persisent bleeding (suppurating) pockets.
Indications for Apically Repositioned Flap (3)
- Pocket elimination
- Crown lengthening
- Unsuccessful gingivally encroaching restorations.
Considerations before Periodontal Surgery (5)
- NSPT been undertaken and review appropriately?
- Pt suitable? (medically and emotionally).
- Do they understand the procedure?
- Is OH/compliance adequate?
- Has restorative strategy been considered?
Signs of Successful Flap Surgery (9)
- Decrease in inflammation
- Less bleeding on probing.
- Decrease in pocket depth.
- Increase in attachment.
- Eliminate pus.
- No increase in mobility.
- Improvement in tissue contour.
- Stabilisation of bone levels.
- Regeneration (take radiograph 1 yr on).
