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Perio > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Anything deeper than ___ mm is too deep for scalers and curettes to clean during SRP

A

4 mm

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2
Q

7 factors that make SRP difficult

A
  1. Probing depth >5 mm
  2. Furcations
  3. Root Proximity
  4. Root Flutings
  5. CEJ Relationship
  6. Restorations
  7. Bony defects
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3
Q

Name 6 locations where locally delivered antimicrobials might be effective

A
  1. Pockets of greater than or equal to 5 mm
  2. maint. pts with isolated PD of 5-6 mm
  3. Early stage perio abscesses
  4. PD at DF line angle of 2nd molars related to 3rd molar extractions
  5. Failing implants
  6. Furcations
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4
Q

Name 3 types of locally delivered antimicrobials and main ingredient

A
  1. PerioChip - CHX
  2. Atridox - Doxyclycline
  3. Arestin** - Minocycline
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5
Q

Which locally delivered antimicrobial is easiest to use and longest lasting?

A

Arestin - 28 days, preloaded cartridge

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6
Q

Describe the characteristics a locally delivered antimicrobial must have for efficacy. 1. ____ or ____ the appropriate target microbes. 2. Reach the disease ____. 3. Achieve adequate _____ for effectiveness. 4. Achieve appropriate _____ of effect. 5. Have few ___ ___ and or cause no harm to the patient.

A 
Inhibit or kill
Site
Concentration
Duration
Side effects
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7
Q

How does low dose doxy affect the pathogenesis of perio disease?

A

Inhibits cytokines, prostanoids & MMPs (Inflammation) therefore stopping CT and bone metabolism

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8
Q

How does locally delivered antimicrobials affect the pathogenesis of perio disease?

A

Inhibits microbes, antigens, LPS, virulence factors therefore decreasing host immuno-inflammatory response (microbes reappear in 9-11 weeks)

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9
Q

What kind of pocket change can you expect to see with SRP alone?

A

(Deeper the pocket, greater the change)
About 2 mm (possibly 3 in ideal situations)
(studies show on avg its 1.23 reduction and .81 change in CAL) IDK

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10
Q

What common antibiotic can you not drink alcohol while taking?

A

Metronidazole ( 250 mg 3x daily)

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11
Q

6 advantages to systemic antibiotics

A
  1. affects bacterial reservoirs
  2. Targets multiple sites of infection
  3. Reduces chair time required to tx pts
  4. absorbs into soft tissues adjacent to infected site
  5. penetrates to base of infected pocket
  6. wide choice of different antibiotics
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12
Q

11 disadvantages to systemic biofilms

A
  1. Allergy
  2. GI intolerance / nausea
  3. Patient compliance
  4. potential for drug interaction
  5. Cost to patient
  6. Inability to penetrate an intact biofilm
  7. Bacterial resistance
  8. Photosensitivity
  9. Decreases effect of BC
  10. Esophagitis
  11. Candidiasis
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13
Q

What 2 situations call for systemic antibiotics?

A
  1. Patient with aggressive perio disease (younger pts)

2. pts with GENERALIZED SEVERE perio disease (not localized)

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14
Q

5 reasons for SRP failure

A
  1. pt non-compliance
  2. inability to penetrate infection
  3. inability to eradicate source of infection
  4. cost to pt
  5. inability to penetrate intact biofilm
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15
Q

At re-evaluation, what 11 things do you look for in the clinical evaluation?

A
  1. visual examination (color, contour, consistency, texture of gingiva)
  2. PD
  3. GR
  4. CAL
  5. plaque control
  6. BOP
  7. mucogingival defects
  8. furcation involvements
  9. mobility/fremitus
  10. occlusion
  11. caries
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16
Q

What is a treatment plan?

A

A working document - unforseen development during tx may require modification of the plan and/or sequence of tx

17
Q

5 phases of a perio tx plan

A
  1. Urgent - pain
  2. Control - caries/perio
  3. Re-eval - response to initial tx & design for prosth
  4. Definitive - prosth/implants/orthro
  5. Maintenance - regular re-care exams & OHI
18
Q

What are the 4 considerations when determining prognosis of perio tx?

A
  1. Diagnostic - prognosis w/o tx
  2. Therapeutic - effect of tx on disease
  3. Prosthetic - w/ anticipated results, what is the forecast for the success of the prosthetic restoration
  4. Provisional - prognosis prior to initial tx, may change
19
Q

8 factors that effect overall prognosis of perio tx

A
  1. systemic background (also age/habits)
  2. pt compliance
  3. availability of mainenance care
  4. bone loss
  5. furcation involvement
  6. pt history
  7. skill/interest of operator
  8. finances
20
Q

6 factors that effect prognosis of a single tooth with perio disease

A
  1. PD
  2. bone loss
  3. tooth morphology
  4. furcation
  5. intraradicular morphology
    6, mobility
21
Q

what is the single most important risk factor in perio tx prognosis?

A

Smoking - cigarette smokers are 5-8 times more likely than non smokers to develop periodontitis

22
Q

Avg % of teeth lost with furcation involvement following tx?

A

35.7% @ 20.5 years

23
Q

PD is less important than ____ or _____

A

CAL or bone loss

24
Q

Following SRP at PD > 5 mm, residual calculus will remain ___ % of the time

A

85%

PD over 6 mm will be difficult to maintain without surgery

25
Q

Curette efficiency ___mm

A

3.73 mm

26
Q

What are the Classes for furcation prognosis?

A

Class I - fair
Class II - questionable ( best is mandibulats and buccal maxillary)
Class III/IV - hopeless

27
Q

What type of teeth have worse prognosis when it comes to mobility?

A

multi-rooted teeth

28
Q

Gingivitis diagnosis criteria

A

BOP
PD 1-4
No CAL, bone loss, mobility, furcation

29
Q

mild chronic perio criteria

A

BOP
CAL 1-2
PD 3-4
bone loss

30
Q

Moderate chronic perio

A 
BOP
Inflammation to the bone
CAL 3-4 mm
PD 5-6 mm
bone loss 20 -40%
class I and II furcation
class I and II mobility
31
Q

Advanced chronic perio

A 
inflammation to the bone
BOP
CAL >5
PD >7
bone loss > 40%
Class I, II, III furcation and mobility

Perio (3 decks)

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