Week 2 Non-surgical Perio Therapy Flashcards
Define Non-Surgical Periodontal Therapy (NSPT).
plaque removal, plaque control, scaling, root planing, and adjunctive chemical agents to treat periodontitis without surgery.
Define Scaling
Removal of plaque, calculus, and stains from the tooth surfaces.
Define Root Planing
Removal of rough or contaminated root surfaces to create a smooth surface, facilitating healing
Define Periodontal debridement
Removal of plaque, calculus, and diseased tissue from the periodontium
Define Full mouth debridement
Removal of plaque and calculus from all tooth surfaces to perform a comprehensive evaluation
Define Prophylaxis
Routine cleaning to remove coronal plaque, calculus, and stains, primarily for preventing gingivitis
Define Periodontal maintenance
Ongoing care to prevent disease progression after active treatment
Define Coronal Polishing
Polishing the tooth surface to remove stains and biofilm
Define Selective Polishing
Polishing only stained or biofilm-affected areas
Define gingival curettage
Removal of inflamed soft tissue lining of the periodontal pocket
What is the rationale for Non-Surgical Periodontal Therapy (NSPT)?
The rationale is to remove the etiologic agents, reduce gingival inflammation, decrease probing depths, and achieve clinical attachment gains.
Describe the multifaceted approach to treatment
Treatment includes controlling bacterial infection, eliminating local contributing factors (e.g., calculus), managing systemic factors (e.g., diabetes), and reinforcing oral hygiene
Discuss the role that plaque biofilm removal effects NSPT
Plaque biofilm is the primary cause of periodontal disease, and its removal is essential to disrupt the bacterial colonies. Supragingival removal alone is insufficient for deep pockets
Describe the specific plaque hypothesis and periodontal pathogens
Certain bacteria such as Aggregatibacter Actinomycetemcomitans
Porphyromonas gingivalis
Treponema denticola
Tannerella forsythia
plays a role in periodontal disease
How does calculus affect periodontal disease and NSPT?
Calculus serves as a surface for bacterial attachment, contributing to inflammation. Its removal is crucial, although deep pockets make complete removal challenging.
What are the short-term goals of NSPT?
The short-term goals include oral hygiene instruction, removal of plaque biofilm, calculus, and stains, debridement and smoothing of root surfaces, and decreasing bacterial load.
What are the long-term goals of NSPT?
The long-term goals include maintaining gingival health, reducing gingival inflammation, reducing probing depths, gaining clinical attachment, and preventing disease recurrence.
Explain the limitations of calculus removal and expectations of clinical proficiency
Calculus removal becomes progressively difficult in deeper pockets. Even the most skilled clinicians may leave residual deposits, but small deposits do not necessarily cause treatment failure
What are two of the four main goals of NSPT?
) Minimize the bacterial challenge to the patient.
2) Eliminate or control local contributing factors for periodontal disease.
How much time is needed to perform NSPT?
Time varies depending on factors such as pocket depth and deposit tenacity, but typically a maximum of 10 minutes per tooth is required.
What instruments are used during NSPT?
hand instruments: curettes (universal and area-specific), sickle scalers, and
powered instruments: ultrasonic and sonic scalers.
What is the goal of root planing?
The goal is to remove rough or contaminated root surfaces to promote healing and reattachment of the gingiva.
How does root texture affect scaling and gingival health?
Rough root surfaces can trap plaque, inhibiting healing. Smoothing the root helps reduce plaque retention
Differentiate between periodontal debridement and full-mouth debridement.
Periodontal debridement is the removal of plaque, calculus, and diseased tissue from the periodontium,
while full-mouth debridement is an initial cleaning to allow for a comprehensive evaluation.
Differentiate between scaling, root planing, periodontal debridement and NSPT.
- Scaling and root planing: Targets removal of calculus and smoothing of the root surface
- Periodontal debridement: Involves the removal of plaque, calculus, and diseased tissue.
- NSPT: Encompasses scaling, root planing, plaque control, and adjunctive chemical therapy.
What is the difference between closed curettage and inadvertent curettage?
Closed curettage is the intentional removal of inflamed soft tissue from the pocket wall, while
inadvertent curettage is the accidental removal of pocket lining during SRP.
What is the role of gingival curettage in NSPT?
Gingival curettage has no additional benefit compared to SRP alone and is not commonly endorsed.
What are the expectations of healing after NSPT?
Healing includes reduced inflammation, reattachment of the junctional epithelium, reduced pocket depths, and is greatest 4-6 weeks after NSPT.
What is gingival curettage?
Scraping or cleaning the walls of a cavity or surface by means of a curette, including the junctional epithelium and the underlying inflamed connective tissue
How do microorganisms repopulate after NSPT?
Bacterial repopulation occurs in a specific order,
* Streptococcus and Actinobacillus
* Veillonella, Bacteriodes, Porphyromonas,
* Prevotella, Fusobacterium
* Capnocytophaga
* Spirochetes
shifting from gram-negative to gram-positive bacteria, and can fully repopulate in 6 months.
What are the limitations of NSPT healing?
Healing may be limited by factors such as poor plaque control, severe attachment loss, root anatomy, and systemic conditions, occlusal forces, mobility, diagnostic deficency and clinican skill.
What are common reasons for failure of gingiva to respond to NSPT?
Common reasons include diagnostic deficiencies, poor plaque control, residual calculus, or uncorrected contributing factors.
How can you evaluate successful NSPT?
monitoring pocket depths, clinical attachment levels, bleeding on probing, and radiographic changes such as crestal lamina dura reappearance.
