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BDS4 Perio > step 3 > Flashcards

step 3 Flashcards

1
Q

What Tx adjucts are there

A

local

systemic

inidcations

outcomes

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2
Q

What are local Tx adjuncts

A

Disinfectants eg. chlorhexidine

Locally delivered antiobiotics

Adjucts to PMPR

May be indicitive to sites where surgery contraindicated or not desired

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3
Q

What is perio chip

A

Biodegradeable gelatin matrix

2.5mg chlorehidine diglucontate that is slowly released over 7 days

Insert to pocket after PMPR

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4
Q

What is dentomycin periodontal gel

A

2% minocycline gel that is inserted via syfringe into pocket after PMPR

3-4 applications every 14 days

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5
Q

In SDCEP guidance should locally delivered antimicrobials be considered as an adjunct to PMPR in perio pt

A

Not recommended for routine care and management of pt with perio

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6
Q

How do systemic antimicrobials work

A

Suppress bacterial species responsible for bioflim grwoth leading to a less pathogenic oral enviroment

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7
Q

When consider systemic

A

Younger Pt with grade C where high rate of progression documented

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8
Q

What used for sytemic in gdh

A

Full mouth instrumentation within 24hr then 400mg metrondiazole TDS 7days

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9
Q

When perio surgery indicated

A

Sites where good quality non-surg perio Tx not working

Perio pocket >/= 6mm

If pt has no contraidications, teeth with good prognosis, infrabony defects and furcation disease

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10
Q

What are the pt factors for surgery to happen

A

OH <20% plaque <10%BOP

Pt can maintain perio health

Pt can tolerate and pt compliance to maintenance post surgery

Cost and pt acceptance

Aestheics of site and potentional for post op recession

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11
Q

What tooth factorsd are there for surgery

A

Access to site

Shape of defect

Pros and endo considerations

Tooth postion and anatomy

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12
Q

Systemic/MH factors for surgery

A

Smoking

Unstable angina, uncontrolled HyperT, MI/stroke within 6months

Poorly controlled diabetes

Immunsupressed

Anti coags

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13
Q

What are the aims of access surgery/open flap debridement

A

access areas of continued inflam or inf

PPD >/= 6mm

Allow acess for debridement

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14
Q

What are the stages of access surgery/open flap debridement

A
  1. Exam shows pre-surgery dep perio pocket with good superficial gingival health and good OH
  2. Full thickness flap raised with inverse bevel intra crevicular inicion to periosteum to expose root
  3. defect granulation tisse removed and root suraface curettage to leave clean root and bone & identify any other reasons for nonresponsiveness such as root fracture
  4. Suture and aim for primary closure and use MONOFILAMENT as plaque retention
  5. Follow up after 1wk to remove sutures, 6wk to check, 3month proper review
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15
Q

What is regenerative periodontal surgery

A

Procedures that regenerate lost bone and tissue supporting your teeth

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16
Q

Indications for perio regen surgery

A

Infrabony defects 3mm or deeper

Class 2 or 3 furcationc defect

17
Q

What is guided tissue regeneration

A

Barrier membrane +/- bone grafts
-eg. BoneOss

Membrane prevents gingival epithelium or connective tissue from entering bone defect and induce osteogenesis and PDL regen

Creates space t oact as a scaffold for vascularisation and cell ingrowth from base of defct

18
Q

What is enamel matrix derivative

A

Emdogain

tissue healing agent derived from porcine tooth germ

Forms a matrix on root surface that mediates production of cementum by modulating wound healing process

Can induce regen of functional attachment in perio

19
Q

what options are there for furcation surgery

A

Regen surgery

Root resection

Root seperation

Tunelling

20
Q

When use regen furcation surgery

A

Mandubular class II furcation

Maxiallary Class II furcation (buccal)

Maxiallry class II furcation (interdental) can also use root seperation or resection

21
Q

When use Root resection or seperation

A

Class III lesions or multiple class II in same tooth

Good endo needed

Root assessed radiographically, not be mobile and tooth restorable

Pt is motivated and excelletn OH and low caries rate

22
Q

When use tunneling

A

Mandib Class III lesions

Bone and soft tissues recontiured to allow insertion of ID brush

BDS4 Perio (5 decks)

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