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PPPPeriooooo > Tx Planning (can't get the planning?) (E3,L2) > Flashcards

Tx Planning (can't get the planning?) (E3,L2) Flashcards

1
Q

The _____ phase of care begins with a thorough review of the patient’s medical condition and history. This initial emergency appointment is to establish patient’s comfort.

A

URGENT

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2
Q

In the URGENT Phase 2 examples of Tx can include:

A
  1. eliminating pain 2.Address emergency concern
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3
Q

Which Phase: active pathological lesions (apical, periodontal abscess, primary occlusal trauma

A

CONTROL

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4
Q

Which phase to we treat general caries?

A

Control

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5
Q

Which phase do we perform oral surgery procedures?

A

control

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6
Q

Which phase do we initiate endo tx?

A

control

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7
Q

Which phase?? phase of treatment plan is to determine the response to our initial therapy before our definitive phase begins

A

Re-Evaluation Phase

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8
Q

Which phase does DEFINITIVE PERIO surgery occur?

A

Re-Evaluation Phase

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9
Q

After reassessing the initial treatment, the patient enters the corrective or definitive phase of treatment.

A

Definitive Phase

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10
Q

This phase includes all therapies that restore function after the patient’s disease has been controlled

A

Definitive Phase

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11
Q

What are 3 examples of the Difinitive Phase?

A

1.Pros (fixed/removable) 2.Implant Restoration 3.Ortho

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12
Q

Which phase is Ortho usually done?

A

Definitive (pull teeth, fix cavities first)

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13
Q

This includes regular re-care examinations

A

Maintenance Phase

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14
Q

What are the 5 stages to a treatment plan??

A

1.Urgent 2.Control 3.Re-evaluate 4.Difinitve 5. Maintenance

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15
Q

How you gonna treat gingivitis? (5)

A
  1. Med consult? 2.OHI 3.Full mouth SCALE and polish 4.Re-eval 4-6wks 5.Prophy every 6mon if resolved
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16
Q

DIAGNOSE ME! What does this patient have??? Inflammation extending to bone–Bleeding on provocation—Attachment loss of 1-2 mm from CEJ—Probing depths of 3-4 mm—Radiographic bone loss of

A

Mild Chronic Periodontitis

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17
Q

Mild Chronic Periodontitis- Attachment loss of __-__ mm from CEJ

A

1-2 mm

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18
Q

Mild Chronic Periodontitis- Probing depths of __-__ mm

A

3-4 mm

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19
Q

Mild Chronic Periodontitis-Radiographic bone loss of

A

less than 20%

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20
Q

Mild Chronic Periodontitis- Class __ or no furcation involvement

A

Class I

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21
Q

Mild Chronic Periodontitis- Class __ or no tooth mobility

A

Class I

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22
Q

How you gonna treat Mild Chronic Periodontitis???(6)

A

1.med consult? 2.OHI 3.Quad/Half Mouth SRP w/ Anestesia 4.2-4 appointments 5.Re-eval (4-6 wks) 6. 3-4 mo maintenance

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23
Q

How much attachment loss to be considered Moderate Chronic Periodontitis?

A

3-4mm from CEJ

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24
Q

How deep of PD to be considered Moderate Chronic Periodontitis?

A

5-6mm PD

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25
Q

How much Radiographic bone loss to be considered Moderate Chronic Periodontitis?

A

20-40%

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26
Q

What Class of Furcation & Mobility are associated with Moderate Chronic Periodontitis?

A

Class I or II furcation & mobility

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27
Q

What are the only 32differences in treating moderate chronic perio as opposed to Mild chronic perio?

A

1.Locally delivered antimicrobials in the 5-6mm residual pockets 2.Refer to a periodontist!

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28
Q

ADVANCED Chronic Periodontitis-Attachment loss of > ____mm from the CEJ

A

> 5mm

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29
Q

ADVANCED Chronic Periodontitis- Probing Depths of >__mm

A

> 7 mm

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30
Q

ADVANCED Chronic Periodontitis- Radiographic Bone loss >___%

A

> 40 %

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31
Q

ADVANCED Chronic Periodontitis- What class of furcation and mobility?

A

Class I, II, or III

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32
Q

What are the differences in initial therapy for Advanced Chronic Periodontitis compared to Moderate?

A

None!

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33
Q

What is Prognosis without treatment?

A

Diagnostic Prognosis

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34
Q

What type of prognosis–What effect will periodontal treatment have on the course of the disease?

A

Therapeutic Prognosis

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35
Q

What type of Prognosis–Given the anticipated results of periodontal treatment, what is the forecast for the success
of the prosthetic restoration?

A

prosthetic prognosis

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36
Q

The prognosis given prior initial phase of treatment It may change according to the patient/tooth response

A

Provisional Prognosis

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37
Q

What can you divide prognosis into?

A

overall prognosis and individual tooth prognosis

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38
Q

Overall Prognosis can depend on two major factors:

A

1.life expectancy 2.systemic habits (smoking/diet/drugs)

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39
Q

Overall Prognosis: type of bone loss, pt attitude/_______ and furcation involvement. avail of care.

A

compliance

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40
Q

What is the SINGLE MOST important factor for overall prognosis concerning a Systemic Background?

A

SMOKING

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41
Q

Cigarette smokers are __-__ times more likely than non-smokers to develop severe periodontitis

A

5-8x

42
Q

Don’t Smoke!! Inhibits ______ following periodontal therapy

A

would healing

43
Q

Don’t Smoke!! Alters the quality of _______ in shallow and deep pockets

A

microbiota

44
Q

Don’t Smoke!! Decreases ________, chemotaxis, phagocytosis and oxidative burst

A

neutrophils

45
Q

Don’t Smoke!! Increases _________ production

A

collagenase

46
Q

Don’t Smoke!! _________ gingival venules, arterials and capillaries

A

Constricts

47
Q

Don’t Smoke!! Decreases ____ flow

A

GCF

48
Q

Good DATA to tell Pt!!! How long does this take?? BP drops to normal,Pulse rate drops to normal, Peripheral body temperature increases to normal

A

20 minutes

49
Q

Good DATA to tell Pt!!! How long does this take?? CO in blood drops to normal

A

8 hours

50
Q

Good DATA to tell Pt!!! How long does this take?? Chance of heart attack decreases

A

24 hours

51
Q

Good DATA to tell Pt!!! How long does this take?? Circulation improves Lung function increases up to 30%

A

2wks-3months

52
Q

Good DATA to tell Pt!!! How long does this take?? Coughing, sinus congestion, shortness of breath decreases, Cilia re-grow in lungs thereby enhancing host defense against respiratory infections

A

1-9months

53
Q

Good DATA to tell Pt!!! How long does this take?? Risk of coronary heart disease is 50% less than that of a smoker

A

1 year

54
Q

Good DATA to tell Pt!!! How long does this take??Lung cancer death rate for average smoker (1 pack a day) decreases by almost 50%, Stroke risk is reduced to that of non-smoker in 5-15 year quit range, Risk of oral, pharynx and esophageal cancer is 50% less than that of a smoker’s

A

5 years

55
Q

Good DATA to tell Pt!!! How long does this take?? Lung cancer death similar to nonsmoker, Risk coronary heart disease is that of nonsmokers


A

10-15 years

56
Q

What is the bug increased in Type I Diaetes?

A

Cap-to-cyto-phaga Sp.

57
Q

What is the bug increased in Type II Diabetes?

A

Porphyromonas Gingivalis

58
Q

Not only are BUGS increased in Diabetes, the host defense is also ALTERED…decreased ____ function and increase in glucose in the ____

A

decreased PMN…increase glucose in GCF

59
Q

What happens to vascular changes in Diabetes? ________ thickness of basement membrane and vessel walls therefore…

A

Increased Thickness….therefore….Decreased O2 diffusion and elimination of wastes

60
Q

Also in Diabetes you have more _______ breakdown which leads to impaired wound healing and increased severity of peridontitis.

A

collagen

61
Q

SHE LOVES THIS SHIZ—Untreated moderate to advanced periodontitis expect to lose ____ teeth per patient per year.

A

0.36 teeth

62
Q

SHE LOVES THIS SHIZ— Treated moderate to advanced periodontitis with no maintenance..expect ____ teeth lost per patient per year.

A

0.22 teeth

63
Q

SHE LOVES THIS SHIZ—Treated moderate to advanced periodontitis with regular maintenance _____ teeth lost per patient per year

A

0.11 teeth

64
Q

PERIO Tx WORKZ:::The aggregate data from these six studies show that untreated patients with chronic periodontitis lose 0.28 teeth/pt/yr whereas treated patients lose 0.08 teeth/pt/yr, a difference of x___. Thus, over a ten year period the untreated patient can expect to lose 3-4 teeth and the treated patient 0-1 teeth.

A

3.5x

65
Q

Well Maintained: _____% of patients lost 0-3 teeth Downhill: 12.6% of patients lost 4-9 teeth Extreme Downhill: 4.2% lost 10-23 teeth

A

Well maintained: 83.2% of patients lost 0-3 teeth Downhill:12.6% of patients lost 4-9 teeth Extreme Downhill-4.2% lost 10-23 teeth

66
Q

Interesting! The level of oral hygiene at the 1st treatment

appointment is not as important as the level of oral hygiene at completion of the _____ phase of treatment (_____).

A

initial phase of treatment (Phase I)

67
Q

Overall Prognosis: Who wins? Aggressive “juvenile” vs Chronic “adult”

A

Chronic “adult” is better prog

68
Q

Overall Prognosis: Who wins? Inflammation: Present vs Not present despite the disease severity

A

Present actually has a better prognosis! huh!

69
Q

Overall Prognosis: Who wins? Plaque/Calc-Almost absent vs Abundant

A

Abundant is better prog..go figure!

70
Q

Overall Prognosis: Who wins? Chronic infection vs. Periodontal abscess

A

Periodontal abscess is better prog

71
Q

INDIVIDUAL TOOTH PROGNOSIS! Pocket Depth….______: 1-3 mm…_______: 4-6 mm……_______: ≥ 7 mm

A

shallow, moderate, SEVERE

72
Q

She loves these numbers—-INDIVIDUAL TOOTH PROGNOSIS! SRP-Following SRP at PD >5 mm residual calculus will remain ___% of the time. This can be blamed on the instruments! The curet is only efficient to ____mm and the best ones we have go to ___mm

A

85% of time…curet-3.73mm..others 5.52mm

73
Q

Whats more important? PD or CAL? So which do we base our prognosis on?

A

CAL!!! and CAL!!!

74
Q

What is the optimal crown to root ratio again? You bet your bottom dollar this has a factor in prognosis!

A

1:2 ratio. shorter the root the worse the prognosis! duh!

75
Q

SHE SAID TO FOCUS ON THIS AVERAGE!!! Loss of teeth w/ furcation involvement following Tx-Average % lost ___% over and average of 20 years.

A

35.7% NOOOOOO!!!!

76
Q

Furcation involvement- Class I – ____ Prognosis

A

FAIR

77
Q

Furcation involvement- Class II – _______ Prognosis. _______ furcations and ______ maxillary furcations have the best predictability for regenerative procedures! umm you think that’ll come up? :)

A

Questionable…mandibular and buccal

78
Q

Furcation involvement- Class III/IV – ________ Prognosis

A

Poor/Hopeless

79
Q

Tooth Mobility- Class 1: _______ prognosis (slight mobility)

A

fair

80
Q

Tooth Mobility- Class 2: _______ prognosis (moderate more than normal)

A

questionable

81
Q

Tooth Mobility- Class 3: _______ prognosis (severe mobility + depressive)

A

hopeless

82
Q

WHAT ARE the 5 Classifications of Prognosis?

A

1.Good 2.Fair 3.Poor 4.Questionable 5.Hopeless

83
Q

Overall, _______ molars are lost more frequently than _______ molars

A

maxillary…mandibular

84
Q

Interesting….Patients do fine with _______ occlusion

A

bicuspid

85
Q

Classes of Prognosis- Adequate bone loss

A

good

86
Q

Classes of Prognosis-Acceptible pt cooperation

A

fair

87
Q

Classes of Prognosis- present and controlled systemic diseases

A

poor or Questionable

88
Q

Classes of Prognosis-grade 2 mobility

A

Questionable

89
Q

Classes of Prognosis- Class III furcation involvement

A

Hopeless

90
Q

Classes of Prognosis- advanced bone loss

A

Advanced OR Hopeless

91
Q

Classes of Prognosis-doubtful patient cooperation

A

Questionable

92
Q

Classes of Prognosis-Grade I mobility

A

Fair or poor

93
Q

Classes of Prognosis- no furcation involvement

A

good

94
Q

Classes of Prognosis- physiologic mobility

A

good

95
Q

Classes of Prognosis-less than adequate bone loss

A

fair

96
Q

Classes of Prognosis- doubtful pt cooperation

A

poor, questionable, OR hopeless

97
Q

Classes of Prognosis-grade 3 mobility

A

hopeless

98
Q

Classes of Prognosis-adequate Pt cooperation

A

good

99
Q

Classes of Prognosis-limited systemic diseases

A

fair

100
Q

Classes of Prognosis-grade 1 OR 2 mobility

A

poor

101
Q

Classes of Prognosis- uncontrolled systemic diseases

A

hopeless

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