Systemic Antimicrobials in Periodontal Therapy 2 (NAIK) Flashcards
What has periodontitis now been classified into in the new 2017 classification?
- Necrotising periodontal disease
- Periodontitis
- Periodontitis as a manifestation of systemic disease
What is necrotising ulcerative gingivitis caused by?
spirochaetes and fusiform bacteria (fusospirochaetal complex)
Do we have an indication to use antibiotics when treating necrotising ulcerative gingivitis?
YES
What do we do about diagnosing patients who would formerly have been diagnosed with aggressive
We expect that they will be classified as stage III or IV and grade C in the new system
What are some of the features of chronic periodontitis?
- Most prevalent in adults
- Clinical attachment loss of 1-2mm on incisors/molars
- Slow to moderate progression+ exacerbations
- Plaque aetiology
- Destruction is consistent with local factors
Which ethnic groups have a higher prevalence of chronic periodontitis?
Indo Pakistanis
Do we prescribe systemic antibiotics to a patient suffering from chronic periodontitis?
No unless they are suffering from systemic spread of the disease
What is clinical attachment loss?
it is the distance from the CEJ to the base of the pocket/sulcus
Which land mark is hard to find in the mouth?
Cemento enamel junction
How do we calculate the clinical attachment loss if the patient has recession?
You need to add the probing depth to the amount of recession
What problems are associated with measuring CAL in patients with gingival overgrowth?
It is hard to determine where the CEJ is
How do we calculate the clinical attachment loss if the patient has gingival overgrowth?
You need to do probing depth - the amount of gingival overgrowth
How do we over come the difficulty of locating the CEJ on patients with gingival overgrowth?
We recording probing pocket depth and then look at the radiographic bone loss
What are the common features of aggressive periodontitis?
- The patient is healthy except for having periodontitis
- Theres rapid attachment loss and bone destruction
- There’s familial aggregation
List the secondary features of aggressive periodontitis
- Microbial deposits amount that are inconsistent with the severity of periodontal tissue destruction
- Theres elevated promotions of Aggregatibacter actinomycetemcomitans (and in some populations p, gingivlais may also be elevated)
- Phagocyte abnormalities
- Hyper responsive macrophage phenotype including elevated levels of PGE and IL-1Beta
- Progression of attachment loss and bone loss may be self arresting
If, when you are a GDP, you come across a patient with aggressive periodontitis what would you do?
Refer them to a specialist
In the old specification n what is meant by localised aggressive periodontitis?
It describes rapid destruction of the periodontium at a young age
Give some features specific to localised aggressive periodontitis
- Circumpubertal (teenagers) onset
- Robust serum antibody response to infecting agent (aggregatibacter actinomycetemocomitans A.a)
- Localised first molar/incisor presentation
- Interporximal attachment loss CAL on at least. 2 permanent teeth (one of which is a the 1st molar)
How do we diagnose localised aggressive periodontitis?
- Do a history
- take BPEs which should flag warning
- Do perio indices with periodontal probe
3, Take radiographs where justified
How do we take BPEs of patients under 18
We do a simplified BPE
We use index teeth