Week 1- Supportive Periodontal Therapy

Question 1

What is Carranza’s approach to supportive periodontal therapy?

Answer 1

1. Limited plaque control instruction, build concern
2. Supra gingival removal of calculus to make it possible for patient to complete OH
3. Recontouring of defective restos and crowns
4. Obturation of carious lesions
5. Comprehensive plaque control instruction
6. Subgingival debridement
7. Tissue re-evaluation.

Question 2

What are reasonable expectations following debridement?

Answer 2

• Reduction in redness and gingival bleeding
• Gingival shrinkage (recession, gaps between teeth, worse where bone loss is greatest)
• Dentinal sensitivity

Question 3

What factors is dentinal sensitivity dependant on?

Answer 3

• Marginal plaque control
• Acidity of diet
• Saliva (quality and quantity)

Question 4

What clinical parameters need to be assessed?

Answer 4

• Marginal plaque control (BOP)
• Marginal tissue character (colour, texture, oedema)

Question 5

What is the benefit of debridement after there is some gingival shrinkage?

Answer 5

Better access for non-surgical debridement that enables access to areas missed before.

Question 6

What are the 2 healing outcomes when probing depth decreases after treatment?

Answer 6

• Recession
• Attachment gain

Question 7

What is the difference between corrective and supportive therapy?

Answer 7

Corrective: (PD_>_4mm with BOP) more non-surgical perio therapy, adjunct antimicrobials, perio surgery, restore function/aesthetics.

Supportive: (PD <4mm) Recall, monitor perio status, repeat OHI, re-treat disease.

Question 8

What should you check in the examination and re-evaluation?

Answer 8

• Update med and dental history
• Smoking status
• Assess OH/plaque score
• Clinical exam and diagnosis (soft tissue, dental, perio, radiographs)

Question 9

What is the definition of supportive periodontal therapy?

Answer 9

Therapeutic measures to support the patient’s own efforts to control perio infections and avoid re-infection.

Question 10

What are the 5 steps involved in SPT appointment?

Answer 10

1. Exam, re-evaluation, diagnosis
2. Motivation, re-instruction
3. Tx of re-infection sites, may need further appointments (non-surgical perio therapy- debridement & local antimicrobials, minor surgical therapy)
4. Polishing, fluorides
5. Recall

Question 11

What are important goals of SPT?

Answer 11

• Prevent/minimise disease recurrence or progression.
• Prevent or reduce incidence of tooth/implant loss.
• Treat any diseases
• Ensure adequate OH control by pt

Question 12

What is the rationale for SPT?

Answer 12

• Less CAL and tooth loss
• Individual risk assessment
• Limit recurrent periodontitis

Question 13

What is the typical tx plan for SPT?

Answer 13

• Plaque control instructions
• Any necessary exos
• Scale and debride under LA
• Systemic antibiotics
• Surgical tx?
• Healing for 3 months
• Referral to ortho