Term
True or False
In supportive periodontal therapy it is important to re-educate the patient on cleaning hard to reach areas and give positive feedback. |
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Definition
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Term
| An example of supportive perio therapy for a patient with an inability to maintain his dentition in a healthy status due to rheumatoid arthritis would be? |
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Definition
| recommend an electric toothbrush |
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Term
| In the beagle dog study, they found that _____ and _______ on the opposed quadrants resulted in reduction of progression of periodontal disease |
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Definition
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Term
| What are the 2 patients you will see in periodontal maintenance? |
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Definition
Patients at risk for periodontitis
Patients with gingivitis |
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Term
| Why is it important to see patients with gingivitis every 6 months? |
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Definition
| to prevent development of periodontitis |
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Term
What patients are at risk for periodontitis?
How often will you want to see them |
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Definition
-Diabetes (blood glucose will go out of control >7… limited host defense)
-osteoporosis
-a lot of stress
-high dose corticosteroids
-immunosuppressed
Maybe every 4 months |
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Term
| What is the rationale for perio maintenance (5) |
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Definition
Incomplete Subgingival Plaque Removal (5mm pocket can leave calculus in 30% of cases)
Remaining bacteria in the gingiva may recolonize the periodontal pocket
Periodontopathogenic bacteria may be transmitted between spouses and other family members
Long junctional epithelium may form a non- resistant attachment to inflammation and reinfection
Subgingival scaling alters the microflora of periodontal pockets (destruct biofilm, eliminate anaerobic gram - bacteria) |
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Term
How long does it take for anaerobic gram - bacteria to colonize?
How often do we want to see patients to prevent this from happening? |
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Definition
9-11 weeks
3 months (insurance may not cover extra visits but it's important!!) |
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Term
Do we want to do scaling and root planing on all of the teeth during perio supportive therapy?
Why or why not? |
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Definition
No, only do localized on the remaining pockets based on the chart
Don't want to scale teeth with normal PD because it will cause trauma and attachment loss (iatrogenic) |
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Term
True or false:
bite wings are used only to look for caries |
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Definition
False
also used to look at progression of perio disease |
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Term
| We use Ultrasonics in combination with ______. |
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Definition
| Scalers (Scaling and root planing in areas with residual pockets- for places we can't reach with ultrasonics) |
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Term
| What are (4) reasons for recurrence of disease? |
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Definition
Inadequate or Insufficient Periodontal Treatment (didn't do surgical phase, have remaining pockets)
Inadequate Restorations
Poor compliance
Medical conditions affecting host response (we want to reduce host response) |
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Term
| What 3 things do you do for an implant maintenance visit? |
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Definition
Peri-implant evaluation (NOT gingiva, peri-implant mucosa)
Prosthetic evaluation
Removal of plaque and calculus |
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Term
| What are the things you look for in peri-implant evaluation? |
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Definition
Plaque index
Peri-implant tissue health
-Signs of inflammation: Redness, swelling, purulent exudate, bleeding on probing
-Probing (lightly)
-Tissue type (Bound down or moveable tissue)
Mobility
Radiographic evaluation |
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Term
| What is the primary etiological factor of peri-implantitis |
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Definition
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Term
| What is inflammation of the tissue around dental implants |
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Definition
| peri-implantitis (Similar micro flora as in Periodontitis) |
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Term
| What can peri-implantitis lead to? |
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Definition
| peri-implant bone loss --> keeps progressing will lead to implant loss |
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Term
How often do you want to check implants in the first year?
After the first year?
If it is a "problematic" implant? |
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Definition
More frequent in the first year
At least semiannual thereafter
More frequent for "problematic" implants |
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Term
| What do we want to tell the patient when giving oral hygiene instructions? |
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Definition
Prevent damaging the implant surface
Be aware of the "different shape" of the implant
Use a soft bristle toothbrush
Use super floss, floss threaders
interdental brushes need nylon coating |
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Term
| What needs to coat interdental brushes to prevent scratching the implants? |
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Definition
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Term
| What types of floss do you want to use for implants? |
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Definition
Superfloss
Floss threaders |
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Term
| What types of toothbrush do you want to use for implants? |
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Definition
Soft bristle toothbrush
End Tufted toothbrush |
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Term
| What type of probes do you want to use on dental implants? |
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Definition
Use plastic probes
Metal probes scratch the implant or abutment surface |
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Term
| What do we want to avoid when probing an implant? |
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Definition
| breaking the seal of soft tissue around implant |
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Term
| What are the implant probes calibrations? |
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Definition
3-mm sections
3-6-9-12
or
3-6-8-11 |
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Term
| What makes up the interface of the implant? |
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Definition
Epithelium- Sulcus epithelium, Junctional epithelium
Connective tissue-Collagen fibers |
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Term
| What attaches the epithelium to the implant? |
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Definition
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Term
True or false:
You can use conventional instruments used for plaque and calculus removal on implants. |
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Definition
False
Conventional instruments used for plaque and calculus removal can damage the titanium abutment surface and alter the implant surface |
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Term
| What type of scaler would we rather use for implants? |
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Definition
titanium or gold
Plastic-may leave residue that causes infection
Graphite-very breakable, brittle, will have to change them after 2 sterilization cycles |
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Term
True or false:
Avoid using ultrasonic scalers with regular tips on implants |
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Definition
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Term
True or false:
Plaque and calculus is not very retentive around the smooth implant abutment |
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Definition
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Term
True or false:
Calculus and biofilm can not adhere as tightly to the smooth implant surface |
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Definition
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Term
| Ultrasonic is adjusted at _____ power setting to debride the implant site |
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Definition
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Term
When do we want to take a radiograph of an implant after loading?
Why? |
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Definition
6 months after loading
to check for excess cementum to avoid peri-implantitis |
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Term
| How long do we check implants annually? |
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Definition
Annually for the first 3 years
Biannually afterwards |
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Term
| How much bone loss can we lose in the first year? |
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Definition
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Term
| When looking at the multi-level risk assessment, what 3 things are we assessing? |
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Definition
Subject Risk Assessment
Tooth Risk assessment
Site Risk assessment |
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Term
| What all are we looking at when in the subject risk assessment? |
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Definition
compliance
oral hygiene
BOP
residual pockets
teeth loss
bone loss
systemic conditions
cigarette smoking |
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Term
| What would be considered a high and low risk BOP? |
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Definition
<10% LOW RISK
>25% HIGH RISK |
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Term
What is considered a residual pocket?
What would be considered a high and low risk residual pockets? |
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Definition
residual pockets greater than 4mm
Less than 4 remaining pockets LOW RISK and more than 8 residual pockets HIGH RISK. |
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Term
| What would be considered a high risk with numbers of teeth? |
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Definition
| more than 8 missing teeth |
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Term
| What would be considered a high and low risk of loss of periodontal support in relation to the patient's age? |
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Definition
1mm or 10% divided by the patient’s age
0.5 mm LOW RISK
1 mm HIGH RISK |
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Term
| What systemic conditions would be considered high risk? |
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Definition
| Diabetes and IL-1 genotype (sensitive inflammatory response to a little plaque) |
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Term
| How many cigarettes would be considered high or low risk? |
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Definition
10 cigarettes LOW RISK
20 cigarettes HIGH RISK |
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Term
| What are you looking at during tooth risk assessment? |
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Definition
Tooth position within the dental arch
Furcation involvement
Iatrogenic factors
Residual Periodontal support
Mobility |
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Term
| What are you looking at during site risk assessment? |
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Definition
Bleeding on probing
Probing depth and attachment loss
Suppuration
Radiographic evaluation of periodontal disease progression |
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