W1 - Supportive Periodontal Therapy - Sharma Flashcards
Which is worse- Horizontal bone loss or Vertical bone loss? Why?
Horizontal bone loss is worse
- Less treatment options than vertical/angular bone loss
7 Steps of Carranza’s approach
- OHI - build concern, limited
- Supragingival calculus removal - make it possible for pt to control plaque
- Recontour defection margins and crowns
- Treat caries
- Comprehensive plaque control instruction
- Subgingival debridement
- Tissue re-evaluation - determine need for further therapy
What are some reasonable expectations to have following treatment? (3)
- Reduction in redness and bleeding
- Gingival shrinkage
- Dentinal sensitivity
Factors that affect dentinal sensitivity (3)
- Marginal plaque control
- Acidity of diet
- Saliva (quality and quantity)
What clinical parameter is our goal / endpoint of therapy?
Absence of BOP
Is gingival shrinkage good or bad? (2)
Good
- Gingiva is becoming less inflamed
- Shrinkage will provide better access for non-surgical debridement
Why are large probing depth changes not accurate?
Pocket may appear shallower due to recession
Indication for active/corrective therapy vs supportive therapy following initial therapy
>4mm pockets present with BOP - will require corrective therapy. If not, just supportive therapy
What are the main components of periodontal assessment
- Probing depths
- BOP
- Plaque score
- Level of calculus
- Furcation
- Suppuration
- Recession
- Mobility
- Radiograph (if justified)
What should be done at the re-evaluation appointment?
- Update Med and dent hx
- Smoking status
- Assesss OH and plaque score
- Clinical examination and diagnosis
- Compare perio health status compared to baseline
What is more important during supportive periodontal therapy - professional or patient contribution?
Patients effort more important (75%) than clinicians (25%)
1What is done in the supportive periodontal therapy appointment?
- Exam, re-evaluation, diagnosis
- Motivation, re-instruction (OH, smoking cessation)
- Treatment of re-infected sites
- S/C & debridement
- Minor surgical therapy
- Polishing, fluoride
- Recall
Goals of SPT
- Prevent disease recurrence or progression
- Prevent tooth loss
- Treat any disease found during examination
- Ensure good pt plaque control
What type of prost should you make sure the pt does or does not have prior to tx? Why?
Implants
may cause complications if ultrasonics used on surface
Rationale behind SPT
- Less CAL and tooth loss occurs with regular SPT
- Allows for monitoring of tissues
- Gives chance to reinforce OH which greatly limits recurrent periodontitis
