Week 5 Flashcards
what happens during periodontitis
- microbial biofilm formation (dental plaque)
- periodontal inflammation - gingival swelling and BOP)
- attachment loss
- bone loss
1999: types of periodontal disease
- chronic periodontitis
- aggressive periodontitis
- periodontitis as a manifestation of systemic disease
- necrotizing periodontal disease
- periodontal abscesses
1999: disease distribution
- localized - <30% of SITES show attachment and bone loss
- generalized - >30% of SITES show attachment and bone loss
1999: disease severity
- slight: 1-2 mm of attachment loss
- moderate: 3-4 mm of attachment loss
- severe: 5 mm or more of attachment loss
2017: types of periodontal disease
- necrotizing periodontitis
- periodontitis as a direct manifestation of systemic disease
- periodontitis
2017: disease distribution
- localized: <30% of TEETH show attachment and bone loss
- generalized: >30% of TEETH show attachment and bone loss
2017: disease stage classiications
- stage I: 1-2 mm attachment and…
- stage II: 3-4 mm attachment loss and…
- stage III: 5 or more attachment loss and…
- stage IV: 5 or more attachment loss and..
2017: disease grade
A, B, C
what is the instrumentation aspect of initial periodontal therapy
scaling and root planing
what is the process by which plaque and calculus is removed from all tooth surfaces coronal to the junctional epithelium
scaling
what is the process by which residual plaque, calculus and portions of cementum or dentin are removed to produce a smooth, hard, clean root surface
root planing
does calculus contribute to gingival inflammation
yes
what does scaling remove
plaque and calculus from enamel surfaces
what does root planing remove
inflammation-provoking plaque and calculus near cementum
forms of subgingival calculus
nodular and veener
what are small to large “bumps” that are usually easy to detect
nodular sub-gingival calculus
what is a flat sheet of calculus that is usually difficult of impossible to detect
veneer sub-gingival calculus
where does calculus initially form
CEJ
where is calculus mostly missed? why?
at the CEJ
when using the up-stroke with the explorer at the CEJ, you may not be able to determine if what you are feeling is just the CEJ or calculus along the CEJ
are scaling and root planing separate procedures
NOOOO!
scaling without root planing will often be inadequate to remove all the factors responsible for gingival inflammation
is the patients ability to remove plaque effectively an important factor in ultimate success?
YES!
no matter how thorough you are with instrumentation, poor plaque control by pt will inevitably result in recurrent marginal inflammation
what can be used for scaling
scalers, curettes, and cavitron
type of curettes
- universal: B1-2 and McCall 17-18
- Gracey: G1-2, 11-12, 3-14
angulation of universal curette vs. gracey
universal: 90 degrees
gracey: 70 degrees
the blade of a _____ has a round toe and back, and two cutting edges for scaling, making it an efficient design for scaline the entire mouth
universal curettes
____ are area specific to allow for deep scaling, root planing and periodontal debridement
gracey curettes
how many cutting edge on gracey
one
which gracey:
- anterior teeth
- scaling deeper pockts
- root planing strkoes
gracey 1-2
which gracey:
- mesial 2/3 surface of posterior teeth
- scaling deeper pockets
- root planing strokes
gracey 11-12
which gracey:
- distal 1/3 surface of posterior teeth
- scaling deeper pockets
- root planing strokes
gracey 13-14
ideal angulation for insertion
0-40 degrees
angulation for calculus removal/ working angle
45-90 degrees
IDEAL angulation for calculus removal
60-90 degrees
what angle is beyond a good working angle, and removes soft tissue from inner pocket
greater than 90 degrees
on that picture with the angulation of the gracey, what does each letter represent from left to right
A) 0-45 degrees - INSERTION
B) 45-90 degrees - WORKING ANGLE
C) 0-40 degrees - INSERTION
D) >90 degrees NOT GOOD
do you use just one type of stroke to remove all deposits? why or why not?
NO! varying the strokes allow deposits not to be missed
does the universal curette have both edges of the blade as cutting edges?
YES. just like scaler
methods for using universal curette
- start on distal aspect of tooth then redirect to mesial line angle
OR
- begin at midline then work towards distal on all teeth, then start again at midline and work on all mesial surfaces
what instrument:
- one end used on facial surfaces of right side and lingual surfaces of left side
- other end used on lingual surfaces of right side and facial surfaces of left side
11-12 explorer OR universal curette
can curettes be used both supra and sub gingivally
YES
