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Perio > SRP > Flashcards

SRP Flashcards

1
Q

When should periodontal charting be done?

A
  • Initial exam- all new adult patients
  • Pediatric patients if:
    • Radiographic bone loss
    • irritated gingiva
    • suppuration
    • abnormal mobility
  • Patient hasn’t been seen in over 1 year
  • Periodontal Maintenance patients
    • every 3 months
  • Periodontal re-evaluation
    • 4-6 weeks after scaling and root planing
  • Non-periodontal patient
    • every periodic eval-6 months
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2
Q

Periodontal charting contraindications

A
  • High risk of abscess
    • complete dentures
  • heavy deposits prevent accurate readings
    • need debridement first
    • full exam at later appointment
  • Did not take antibioitic prophylaxis
    • delay appointment
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3
Q

Why are the Handles of instruments made small and thick?

A

Prevents Carpal Tunnel Syndrome

  • Large diamter lightens grasp–> less stress
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4
Q

Shank

A
  • Connects working end with handle
  • Functional Shank
    • working end to bend closest to handle
  • Lower Shank
    • aka terminal shank
    • working end to first bend
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5
Q

Explorers

A
  • locate subgingival deposits and carious areas
  • Check smoothness of root surfaces after SRP
  • Pointed end detects calculus
  • ODU 11-12
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6
Q

SRP Instruments: Define

Face, Bac k, Lateral surfaces

A
  • Face-area between cutting edges
  • Back-area opposite the face
  • lateral-area between cutting edges and back
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7
Q

Sickle Scalers

A
  • Triangular Cross section
  • Pointed tip and back
  • 2 cutting edges
  • Face 90 degress to terminal shank
    • functions at 70 degrees to tooth surface
  • removes supra-gingival calculus from enamel
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8
Q

Universal Currettes

A
  • Rounded back & toe
  • 2 cutting edges
  • Face 90 degrees to lower shqank
    • functions at 70 degrees to tooth surface
  • Removes both supra-gingival and sub-gingival calculus from enamel/cemtentum
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9
Q

Gracy Curettes

A
  • Aka Area Specific Curettes
  • 1 cutting edge
  • face 70 degrees to terminal shank
  • Supra and Subgingival
    • remove calc from enamel and cementum
  • Best instrument for debridement of complex root anatomy
    • area specific currette so better access
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10
Q

What is scaling?

A
  • Instrumentation of the crown and root surfaces
  • Removal bacterial biofilm, calculus, and stain from these surfaces
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11
Q

What is root planing?

A
  • Removal of diseased cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms
  • ONLY on root surface
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12
Q

What is the goal of root planing?

A
  • reattachment of periodontal structures to the tooth
  • restore gingival health that has been lost due to inflammation
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13
Q

What is the Rationale for SRP?

A
  • Restore gingival health
    • remove elements that provoke gingival inflammation
      • plaque (Bacterial biofilm)
      • calculus
      • endotoxin
    • Shift composition of subgingival plaque
      • gram - anaerobes to gram + falcultative
      • reduce spirochetes and motile rods
      • Increase in coccoid cells
  • Arrest the progression of further periodontal disease destruction
  • create an enviorment conductive to fiber repair
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14
Q

Therapeutic outcomes of SR?

A
  • Securing biologically acceptable root surface
  • reduce bacterial burden
  • resolving inflammation
  • decreasing pocket depth
  • improving or maintaining attachment level
  • preparing the tissues for surgical procedures
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15
Q

How can I prevent plaque buildup?

A
  • Easy to prevent buildup with proper care
  • Brush at least twice a day to remove plaque from all surfaces of your teeth
  • Floss daily to remove plaque between your teeth and under gumline where toothbrush may not reach
  • Limit sugary or starchy foods
  • Schedule regular dental cleanings and exams
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16
Q

Plaque index

A

of surfaces with plaque/ total # of surfaces x100

  • Excellent hygiene: 0-20%
  • Good hygiene: 21-40%
  • Fair Hygiene: 41-60%
  • Poor Hygiene: 61%-100%
17
Q

Brushing techniques:

A
  • Bass or Sulcus cleaning method
  • Modified Bass technique
  • Modified Stillmann’s technique
  • Fones or circular or scrub method
  • Vertical or Leonard’s method
  • Charter’s method
  • Scrub brush mehtod
  • Roll technique
  • Physiologic or Smith method
18
Q

Flossing

A
  1. Guide the floss between your teeth using a gentle rubing motiion
  2. Never snap the floss into the gums
  3. When the floss reaches the gum line, curve it into a C shape against one tooth
  4. Gently Slide it into the space between the gum and tooth
19
Q

6 ways to prevent Gum Disease

A
  • Brush thoroughly at least twice a day
  • use a toothpaste like CREST Pro-health
  • Rinse Thoroughly with Crest Pro-Health Multi-Protection
  • Use Soft Bristled Tooth brush
  • Floss Daily
  • Visit a Dentist regularly
20
Q

What is Endotoxin?

A
  • heat stable, lipid polysaccharide (LPS) complex found in the cell wall of many gram negative microorganisms
  • Can be cytotoxic, progenitor, and have been shown to induce/amplify inflammation
  • Bacteria shed endotoxins when broken down or growing/dividing.
  • Superficially attach to the root surface meaning that extensive removal of root structure is not necessary
  • found in plaque, calculus, cementum
  • associated with bone resorption
21
Q

What brushing technique is used on periodontist patient?

A

Modified Bass technique

  • Place the toothbrush at 45 degree angle toward the gingiva to get under the sulcus
  • Small vibrational circles followed by a downward sweeping motion
22
Q

What is difference between bass and modified bass?

A

Modified Bass includes a sweeping motion

23
Q

What is the shape of the interdental area?

A

“Col” is pyramidal-shaped

24
Q

What is granulation tissue?

A
  • New vascularized tissue that has a lot of neutrophils
  • The result of the inflammatory tissue
25
Q

What is the difference between long junctional epithelium and junctional epithelium?

A
  • Long junctional epithelium has more epithelial cells on the apical surface than normal JE
26
Q

What kind of attachment is made when the junctional epithelium is reattaching?

A
  • Junctional epithelium forms a tight connection to afibrillar cementum and root cementum via a hemidesmosome attachment within the interal basal lamina
27
Q

What is plaque?

A
  • aka Dental biofilm
  • Sticky, colorless film of bacteria and other microorganisms
  • causes:
    • immune response
    • cavities
    • gum disease
  • constantly forms on our teeth and along gum line
  • Can harden into tartar/calculus if not removed daily
28
Q

What is LPS?

A
  • Outer membrane of gram negative bacteria
  • induces inflammation
  • it is an endotoxin
  • composed of lipid A an dpolysaccharide components
  • recognized by host toll-like receptors
29
Q

What is the extracellular matrix and what are the components?

A
  • Polysaccharides, lipids, and proteins
  • Involved in the formation of biofilm because secreted by bacteria
30
Q

What is biofilm?

A
  • Nonmineralized microbial accumulation
  • Adheres firmly to tooth surfaces, dental restorations, and prosthetic appliances
  • Exhibits structural organization with predominance of filamentous forms
  • composed of organic matrix
  • derived from salivary glycoproteins and extracellular microbial products
  • cannot be removed by rinsing or water spray
31
Q

What is the difference between biofilm and microbiome?

A
  • Microbiome
    • all genetic material of microorgniams inside or on body
  • Biofilm
    • microorganisms adhering to hard surfaces
    • ex: catheter, tooth
32
Q

What else in plaque besides bacteria?

A
  • Food, endotoxin, LPS, extracellular matrix
  • Associated microorganisms
    • viruses, protozoa, fungi
33
Q

Difference between gracey and universal curettes?

A
  • Universal
    • 2 cutting edges
    • blade is 90 degrees to the shank
    • need to work with the blade 70 degrees to the tooth surface
  • Gracey
    • 1 cutting edge
    • blade is 70 degrees to the shank
    • Terminal shank should be parallel to the long axis of the tooth when working bc the blade is already at 70 degrees
34
Q

How do you treat disease granulation tissue?

A

soft tissue curretage

  • uses a currette to remove the soft tissue lining in the pocket
35
Q

Modified Bass technique:

Advantages vs disadvantages

A
  • Advantages
    • excellent sulcus cleaning
    • good interproximall and gingival clenaing
    • good gingival stimulation
  • Disadvantage
    • dexterity

Perio (1 decks)

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