Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Perio 2 - SP19 > Root planing review > Flashcards

Root planing review Flashcards

1
Q

why go subg on cleaning

A

PD = 6 pockets with subg calculus + attachment loss

if we clean it out and get a smooth root it will improve PD and gingival health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PD = 6mm, no attachment loss, gingival inflammation. supra and subg calculus and plaque

how do we treat

A

it’s a pseudo pocket - gingival inflammation

only subg scaling, no root planing because no attachment loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

the subg microenvironment common to pseudo and true pockets

in true pockets only?

A

bacterial biofilm
calculus
chronically inflamed pocket wall(soft tissue)
destructive host response

in true pockets only;
altered (diseased) root cementum
apical migration of attachment apparatus
bone loss

in true pocket we remove cementum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

plaque, calculus, and diseased cementum in etiology/pathogenesis

periodontal disease = +

A

bacterial plaque + susceptible host

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

calculus is not a _ or _ irritant

it is _ retentive

A

calculus is not a mechanical or chemical irritant

it is plaque retentive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

diseased cementum

barrier to _
perpetuates tissue _
host response

A

barrier to repair

perpetuates tissue destruction

host response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

methods to alter the subg microenvironment

first we _

A

Nonsurgical treatment first
Then surgical
Every patient have to go to nonsurgical treatment first even if we know that from the beginning
We do this because - with inflammation or fluid filled tissue we can’t control our incision and surgical procedures

Smoking is a risk factor

All of this is controlling subgingival microenvironment

  • caries control
  • replacing defective restorations
  • subg instrumentation
  • local chemother
  • surgical correction of gingival deformities
  • strategic extractions
  • smoking cessation
  • orthodontics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

subg instrumentation rationale

mechanically alter the subg ecosystem by removing ,,_

promote health associated host-response- adjunctive treatment alternatives

A 
remove plaque
remove plaque and retentive factors
remove diseased surfaces 
(soft tissue- currettage)
(hard tissue - root planing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

curettage is soft or hard tissue

A

soft tissue removal

not a code anymore - it happens by itself if you are root planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

root planing is soft or hard tissue

A

hard tissue

removing cementum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what defines the technique for subg instrumentation

A

treatment rationale does

NOT instrument

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

a treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms

A

root planing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus and stains from these surfaces

A

subgingival scaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

scaling vs root planing

goal - remove deposits

A

scaling

need to use curettes(rounded tip of blade) not regular scalers (will tear soft tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

scaling vs root planing

goal - modify root surface

A

root planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

scaling vs root planing

supra/subg
wedging stroke
scalers,rotaries, ultrasonics and curettes

may be performed in gingivitis and periodontitis

A

scaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

scaling vs root planing

subgingival
shaving stroke
curettes, rotaries and ultrasonics

performed in periodontitis only patients

A

root planing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

healing after SRP steps

repair
reattachment
new attachment
regeneration

A

repair - some healing, tissue will heal not exactly what it was before but healthy

reattachment -

New attachment = on clean root planned surface
True new attachment - 3 different types of tissue forming PDL, cementum, bone

If you don’t nonsurgical treatment (scallign and root planning)- not true new We usually get just long junctional epi (long JE is Tx outcome)

regeneration - everything from scratch

at least 4 week to re-eval and SRP again

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

objectives in root planing

restore gingival health by _ that promote gingival inflammation

A

by completely removing tooth surface factors that promote gingival inflammation

make the root surface biologically acceptable to the soft tissues

20
Q

keys to effective root planing

_ instruments
more efficient
make root planing possible
prevents burnished calculus

access cemental surface

correct angulation of the instrument face

A

sharp instruments

21
Q

ideal conditions for root planing

_inflammed (better access, more resolution)

_pocket depth

_ rated periodontitis

obvious deposits

A

moderately inflammed - better access, more resolution

moderate pocket depth

slight to moderate periodontitis

22
Q

when to expect less than ideal results from root planing

_ periodontitis

_ tissues

_ restorations

_ probing depths

A

slight periodontitis - responds to scaling alone

fibrotic tissues

defective restorations

very deep pockets and/or furcations

23
Q

both mandibular and maxillary teeth have concavities at or within _mm apical to their CEJ

A

5mm

24
Q

as much as _ minutes are required for a comprehensive subg treatment of one single tooth when hand instruments are used

A

6-8minutes

25
Q

where do we miss most while root planing

4 places

A

CEJ
furcation areas
line angles
deeper parts of the pocket

26
Q

complete removal of calculus from periodontally diseased root is common or rare

A

rare

27
Q

curettes can or cannot reach the bottom of deep pockets ?

A

curettes can’t reach bottom of deep pockets

28
Q

ultrasonics vs hand instruments on calculus removal

most literature shows _ is more effective

A

literature shows both are equally effective

modified ultrasonic inserts remove calculus and plaque without operator fatigue

combo of both is better - start with ultrasonic and move to more efficient site specific instrument

29
Q

ultrasonic or hand instruments remove more cementum

both can gouge a root if used incorrectly

A

hand instruments

may be better in smoothening a rough root

30
Q

rough vs. smooth roots

_ created smoothest surface

_ roughen the root surface

A

curettes and fine rotating diamonds created smoothest surface

vibrating instruments (ultrasonics nd sonic scalers) roughen the root surface

31
Q

effects of rough roots?

roots that are intentionally grooved during surgery have as good a response to surgery as roots that have been _

A

lead to more bacteria binding and plaque retention

as good as roots that have been planed to be smooth

32
Q

how to know if oyu are finished SRP

A

smooth roots are a method of clinically determining the end point in instrumentation

33
Q

endotoxin is potent inflammatory stimulator

_ only partly reduces endotoxin

_ rendered roots endotoxin free

A

scaling - reduces endotoxin

root planing rendered roots endotoxin free

34
Q

IN VIVO which is better, hand instruments or ultrasonics, in removing endotoxin

A

hand instruments better in vivo at removing endotoxin - but ultrasonics can do it too

it is clinically sound to remove some but not all cementum

35
Q

removal of tooth structure

_11.6um
108.9um - most
average 40 strokes at low forces

cementum thickness in cervical port of the root and apical portion of root

A

ultrasonic scaler - 11.6um
curets - 108.9um - the most

cementum thickness cervical root - 20-50um - CEJ, coronal - acellular cememtum - doesn’t repair much

apical part of root - 150-250um
Apical cementum - thicker - cellular cementum

36
Q

single vs. multiple episodes of instrumentation based on evidence

A

no advantage to multiple sessions of root planing

repeated SRP won’t help

37
Q

critical probing depth is the pocket depth below which there is attachment loss and above which there is attachment gain for a procedure

for root planing, critical probing depth is _mm

A

Critical probing depth - 3mm or shallower
Do not root plane - because we will be the one causing the attachment loss

shallow healthy sites should not be instrumented

38
Q

the use of piezo-electric ultrasonic instruments and the use of an EDTA (calcium chelation agent) both together removed the smear layer and exposed collagen fibrils

A

used during surgery

we don’t use it during non-surgical

39
Q

root instrumentation with laser

surface smoothness?
amount removed?
effective?

A

smoother surface with YAG laser

removed less cementum

not as effective at removing calculus

40
Q

After SRP - laser into pocket to get rid of bacterial byproducts

by bacterial killing
inactivating bacterial virulence factors

inactivating host cytokines that impair healing

currently accepted as adjunctive therapy to SRP

A

antimicrobial photodynamic therapy - APT

low level diode laser

41
Q

the process of debriding the soft tissue wall of a periodontal epithelium

involves removal of _ and _

we don’t do intentionally - it will tear soft tissue, it happens by itself in advanced perio cases

A

gingival Curettage

removal of

  • ulcerated epithelium
  • inflamed connective tissue (granulation tissue)
42
Q

reasons curettage is not separated from root planing?

A

inadvertent curettage occurs during root planing

when intentional curettage is performed, the root is always planed, therefore it is impossible to separate the procedures

43
Q

gingival curettage is difficult to accomplish effectively in deep pockets

conclusion?

A

gingival curettage not justified in periodontitis

may have some application in some forms of periodontitis

44
Q

preprocedural rinsing can significantly reduce the microbial content of _ generated during ultrasonic scaling

A

aerosols

no signif difference in mean combined totaly colony-forming units - CFU for various ultrasonic scaling

45
Q

local antimicrobial therapy is or isnt accepted at adjunctive therapy to SRP

A

it is accepted

46
Q

re-evaluation

of treatment outcome following root planing how soon?

evaluation of gingival health

eval of local and systemic risk factors and short and longterm prognosis

decision making for surgical phase

A

4-12 weeks is ideal time or re eval of nonsurgical

if longer than biofilm restarts and is big again

Perio 2 - SP19 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions