11.08 EIT

Question 1

list parameters collected at evaluation of initial therapy

Answer 1

!  Gingival color, consistency and contour !  Plaque score
!  Probing depths
!  Attachment level
!  Furcation invasion
!  Suppuration
!  Tooth mobility
!  Bleeding on probing

Question 2

provide the rationale for the 4-8 week interval between initial periodontal therapy and its evaluation

Answer 2

• reestablishment of the junctional epithelium to the tooth 1-2 weeks
• repair of the connective tissue: 4-8 wks
• subgingival microbial repopulation occurs in about two months (without improved plaque control)
• a decrease in bop, redness and edema occurs within this time frame (esp anterior teeth)

Question 3

describe changes in probing depth and attachment level expected as a result of initial periodontal therapy

Answer 3

*SRP + OHI=1.2 mm pocket reduction
*just OHI=0.4 mm pocket reduction
(first two from CERCEK)
*SRP + OHI= Pocket depth reduction 1.34 mm, attachment level gain=0.52 mm
*OHI = 0.56 mm pocket depth reduction and 0.05 mm attachment level gain
(last two from TAGGE)

Question 4

explain significance of bleeding on probing

Answer 4

• sometimes inflammation can’t be seen, but if inflammation exists at the base of the sulcus, it will bleed
• study from LANG, showed that the incidence of BOP and progression to attachment loss is related
• BOP means the site is at risk for future attachment loss

Question 5

list expected outcomes of EIT

Answer 5

• Decrease in: Plaque score, Probing depth,Tooth mobility
• Improvement in gingival health
• Tissue color, contour, and consistency !  Bleeding on probing:
• Decrease percent of sites bleeding on probing
• Decrease in gingival index
• Suppuration

Question 6

describe three common clinical scenarios at EIT

Answer 6

1. No further ODCT periodontal treatment is indicated and periodontal maintenance phase is recommended
2. Further ODCT periodontal treatment (non- surgical or surgical) is indicated and patient proceeds with recommended treatment
3. Further ODCT periodontal treatment (surgical) is indicated and patient does not proceed with recommended treatment

Question 7

Why is EIT done?

Answer 7

Determine patient’s response to periodontal treatment

• Determine effectiveness of home care
• Confirm decisions regarding further treatment

Question 8

why is 6-12 months the optimal time frame for evaluation of the tooth mobility post initial periodontal therapy?

Answer 8

• Fleszar et al.17 documented that the relationship between tooth mobility and the post-treatment level of at- tachment is established by the end of the first year
• In 1998, Ricchetti18 found that the reevaluation of mobility could be delayed for 6 to 12 months after control of the plaque-related inflammatory lesion to better determine whether mobility was due to plaque- related inflammation or to occlusal trauma.
• and this time frame permits the attachment to heal

Question 9

the LANG BOP study what were the chances of progression related to the BOP/four times probed?

Answer 9

No BOP - 1.5 % chance of progression
! One out of four - 3% chance of progression
! Two out of four - 6% chance of progression
! Three out of four - 14% chance of progression ! Four out of four - 30% chance of progression

Question 10

maintenance phase

Answer 10

BEGINS AT THE END OF ODCT TREATMENT AND PERFORMED SIMUTANEOUSLY WITH RECONSTRUFCTIVE PHASE TREATMENT

Question 11

goals of maintenance phase

Answer 11

• maintenance of probind depths
• gingival inflammation eliminated
• eitology controlled and/or modified

Question 12

CAFFESSE study on % of calculus free surfaces after ScRP

Answer 12

• for 1-3 mm pockets open and closed ScRP are the same (86% calc free)
• 4-6 mm pockets: closed ScRP=45% calc free, open ScRP=76% calc free
• > 6 mm pockets: closed ScRP=32%, open ScRP=50%

Question 13

what things can put a patient into a “holding pattern?”

Answer 13

• Patient desires
• Finances
• Systemic factors

Question 14

what procedures might be done in a holding pattern

Answer 14

!  Includes non-surgical techniques in an attempt to keep periodontal disease from progressing
!  May include
!  Scaling and root planing
!  Oral hygiene instruction
!  Smoking cessation
!  Local and/or systemic antibiotic therapy !  Host modulation
!   No reconstructive phase treatment is generally done until periodontal surgical therapy is completed

Question 15

SOCRANSKY study

Answer 15

red complex prevalence increases as pocket depths increase