Treatment Plan For Managinment of gingival and periodontal diseases Flashcards
what is the definition of periodontal disease?
a group of diseases affecting the periodontal tissues, representing an immune reaction (innate and adaptive) to adjacent microbial plaque
what is periodontal health?
the outcome of the balance between bacteria of the dental plaque and the host immune system
what are the three categories of treatment strategies for periodontal disease?
- mechanical disruption (reducing the bacterial challenge)
- systemic antibiotics/ local antimicrobials
- host modulation therapy
what is the main goal of periodontal disease treatment?
- plaque control
- removal of plaque retention factors
BPE scores
treatment plan
what is involved in the initial phase (step 1) of the treatment plan?
- examination
- assessment of risk factors
- control of local (eg overhangs) and systemic (eg smoking) risk factors
- PMPR
- extractions
- endodontics
- initial occlusal correction
what are examples of oral hygiene instruction?
- tooth-brushing technique
- flossing
- interdental brushes
what tool is used for gingival PMPR?
scalers
what are the two categories within PMPR?
supragingival and subgingival
what does re-evaluation of step1 involve?
- adherence and PPD
- > 3mm=step 2
- lack of adherence= repeat step 1
what is involved in step 2?
step 1 + :
- subgingival instrumentation
what is involved in the re-evauation of step2?
- no residual pockets= step4
- residual pockets >4mm= step 3
what is involved in step3?
step 1&2 + :
- periodontal surgery
access-flap
resective
regenerative
- only in cases with suitable patients, tooth and defect factors
what is involved in the re-evaluation of step3?
PPD <4mm= step 5
what is involved in step5?
- supportive periodontal therapy
- risk-adapted intervals 3-12months
- continuous monitoring of local and systemic risk factors
- PMPR
how is a scaler used?
- working edge on lateral surfaces of 2-3 mm of the tip
- 0-15* angle between work edge and tooth surface
- slight pressure applied
- tip zig-zags in overlapping motions
- occlusal to gumline
- contant movement
- water spray
what are contradictions of ultrasonic scaler use?
- oral infectious diseases
- dysphagia (difficulty swallowing) with high risk of aspiration of fluids during the procedure
- acute leukemias and lymphomas
- pregnancy/heart pacemakers
what is the difference between sonic and ultrasonic scalers?
ultrasonic are much faster, more powerful
what are examples of non-surgical periodontal therapy?
- subgingival PMPR
- teeth splinting
- further correction of traumatic occlusion
- dentine hypersensitivity prevention
- reinforcement of OH
- controlling modifiable risk factors
what are examples of host modulation therapy?
- anticytokine/biological therapies
- lipid mediators of resolution of inflammation
- small molecules compounds
- bisphophonates
what is the difference between engaging and non-engaging patients?
engaging patients show improvement
what must be present to use systemic antibiotics or local antimicrobials?
mechanical disruption of biofilm
what is RSD?
root surface debridement
