TUT 1 - re-evaluation and outcomes

Question 1

What are the ideal outcomes of periodontal treatment according to SDCEP?

Answer 1

• plaque scores below 15%
• bleeding scores below 10%
• probing depths less than 4mm

Question 2

factors affecting response

Answer 2

• smoker - 50% less likely to respond
• diabetes
• pt engagement
• pt manual dexterity (RA)
• plauqe retentive factor
  
  • overlapping
  • tilting
  • furcation/ angular bone defect

Question 3

2 typesof bleeding and what do they mean

Answer 3

marginal bleeding:

• measures regulartiy of cleaning
• angle probe 45 degree
• better indicator than pocket bleeding

pocket bleeding

• bleeding from pocket depth
• indicates active disease going on

Question 4

how likely is pocket gonna close

Answer 4

evidence:

• 50-60% pocket closure (>= 5mm site )
• post non-surgical tx

Question 5

What are important questions to ask your patient at review?

Answer 5

• check MH for changes
• stress/drinking/vaping habits
• sensitivity, bleeding, black triangles (negative symptoms in patient’s eyes)

Question 6

What questions should you ask a diabetic patient?

Answer 6

• ask about control
• when they last was nurse
• how often blood checked
• HbA1c test

Question 7

How long does rebound gingivitis typically last?

Answer 7

2-3 months

Question 8

What is a non-responding site?

Answer 8

• > 5mm
• or 4mm with BOP
• does not see improvement after non-surgical PMPR and OH improvement
• still active periodontal disease

Question 9

What are the GDP treatment options for non-responding sites?

Answer 9

• step 1 OHI
• risk factor control
• TIPPS behavioural change
• pockets <6mm subgingval PMPR again
• pockets >6mm should be considered for alternative treatment and referral

Question 10

What are specialist treatment options for non-responding sites?

Answer 10

• conservative surgery - flap access for PMPR
• regenerative surgery
• resective surgery

Question 11

When is regenerative surgery indicated?

Answer 11

• sites with infra bony defects of >3mm
• grade 3 furcation defects
• multiple grade 2 furcation defects
• not suitable for horizontal bone loss

Question 12

When is resective surgery indicated?

Answer 12

• gain additional access for subgingival PMPR
• change architecture of hard or soft tissue to attain shallow probing depths
• reshape roots

Question 13

What risks are associated with resective surgery?

Answer 13

• black triangles
• gingival recession
• sensitivity