PIA Flashcards
How would you set up your treatment plan?
CC:
- Urgent treatment needs eg., relief of pain and stabilisation
- Reduction of disease risk and disease such as gingivitis, periodontal disease,
caries and toothwear - Non-surgical MI: preventive measures
- Dental extractions
- Periodontal care
- Surgical MI: restorative
- Endodontics
- Fixed prosthodontics
- removable prosthodontics
How to write diagnosis for Perio?
Type of Disease
Stage
Grade
Status
Risk factors
Generalised periodontitis, Stage 3, Grade C, periodontitis currently stable, modified by a risk factor of smoking (20 cigs per day)
How to write diagnosis for Rem Pros?
Type of edentulousness
Edentulousness
Location
Tissue or tooth support
Associate issues
Example: Bilateral edentulous maxillary arch with localised periodontitis and unilateral edentulous mandibular arch with large mandibular tori
How to write diagnosis for Endo?
First pulpal diagnsosis: Aka normal pulp, reversible pulpitis, irreversible pulpitis, pulpal necrosis, previously treated, previously initiated
Second periapical diagnosis: normal apical tissues, symptomatic apical periodontitis, asymptomatic apical periodontitis, chronic apical abscess, acute apical abscess, condensing osteitis.
What is considered to be periodontitis that is currently stable?
Currently stable with BoP of less than 10%, PPD less than equal to 4mm and no BoP at 4mm sites
What is considered to be periodontitis in remission?
Currently stable with BoP of more than 10%, PPD less than equal to 4mm and no BoP at 4mm sites
What is considered to be periodontitis currently unstable?
Currently PPD of 5 or above or 4 or more with BOP
How do you describe an OPG?
What is considered to be Stage I perio?
CAL - 1-2mm
Radiographic Bone Loss - upto 15%
Tooth loss - no tooth loss
Max prob depth of less than or equal to 4 mm
What is considered to be Stage II perio?
CAL - 3-4mm
Radiographic Bone Loss - 15-33%
Tooth loss - no tooth loss
Max probing depth equal or below 5mm
What is considered to be Stage III perio?
CAL - equal or above 5mm
Radiographic bone loss extending to the to middle or apical third of the root
Tooth loss - equal or below 4 teeth
Probing depths - more or equal to 6mm
Vertical bone loss
Furcation involvement of Class II or Class III
What is considered to be Stage IV perio?
CAL - equal or above 5mm
Radiographic bone loss extending to the to middle or apical third of the root
Tooth loss - equal or above 5 teeth
Probing depths - more or equal to 6mm
Vertical bone loss
Furcation involvement of Class II or Class III
+
Secondary occlusal trauma, masticatory dysfunction, bite collapse, less than 20 remaining teeth
What is considered to be Grade B periodontitis
- Less then 2mm bone loss over 5 years
- Bone loss to age ratio between 0.25 to 1.0 non inclusive radiographically (ie for a 50 year old patient the range is around 12.5-49.9 percent)
- Heavy biofilm deposit and periodontal destruction are roughly equal thus following a pattern of more biofilm=more destruction
- Smoking less then 10 cigarettes per day
- HBA1c level of less then 7.0 in diabetic patient
What is considered to be Grade C periodontitis?
- More than 2mm bone loss over 5 years
- Bone loss to age ratio between 1.0 inclusive radiographically (ie for a 50 year old patient the range is around 50.0 percent and above)
- Low biofilm deposit and large amount of periodontal destruction. Unequal pattern, resulting in small amount of biofilm but large amount of destruction.
- Smoking more than 10 cigarettes per day
- HBA1c level of more than 7.0 in diabetic patient
What are some additional examinations available for dental examination?
Perio:
Perio exam
Nabers Probe
Endo:
TTP
Periodontal probing
Pulpal sensibility testing
PAs
Selective LA
Rem pros:
Assessment of ridges
Taking of primary impressions for primary casts
Occlusal assessment
MI operative/surgical:
Tri-plaque gel
Saliva testing
Risk matrix and 14-factor assessment
Caries detection dye
Transillumination
BWs
Fracture/crack finder
Exo:
PAs
Cone beam
Cone shift
How do you set up a treatment plan for perio?
- Emergency stage
- Systemic Stage + Initial debridement stage
- Reevaluation - 8 weeks
- Surgical stage - if any socket of 5mm that are bleeding or 6mm or more
- Supportive stage
How would you set up a treatment plan for MI operative?
Use sextons or quadrant care
