What are the aims of periodontal treatment?
- modifcation of the supra and sub ging biofilm
- removal of sub and supra plaque
- removal of plaque retentive factors
- removal of periodontal pathogens in tissues
- prevention of recolonization
What do plaque inhibitory factors do?
- affect the rate of development of dental plaque
- affects amount of plaque
- affects the quality of plaque
- not really affective for perio disease or caries
What do antiplaque agents do?
affect plaque but have a proven affect on careis and gingivitis
What are the characteristics of antiseptics?
- topically placed or subgingival along with debridement
- common in mouthwash h
What alters the actions of an antiseptic?
- absorbtion to oral surface
- Maintanance of antimicrobial activity
- slow eutralisation of antimicrobial activity
What are the doses for CHX? What can CHX work on?
- 2%10ml = 20mg twice a day
- 12% 15ml =18ml twice per day
No noted bacterial resistance
Active against: gm –ve and gm +ve, fungi, yeast, viruses
What antibiotics would be given for a periodontal abscess ?
Amoxy 500mg for 3-5 day
or Metro 200mg for 3-5 days
along with RSD
What antibiotics should be used for NUG?
Metro 400mg 3 day
or Amoxy 500mg 3-5 days if that doesnt work
CHX or hydrogen peroxide 10%
also do debridement
What are the signs / symptoms of ANUG?
punched out creator like ulcers which extends from papillae and extending down to the gingival margin.
Ulcers covered in grey slough which when wiped away leaves bleeding lesions.
Necrotic tissue rather than pocketing.
What are the possible outcomes if a restoration is encroached into the biological width?
repeated inflammation leading to
- LOA
- pocketing
- recession
Bio width is 2mm made up of junctional epithelium and connective tissue (1mm of each)
What are the characteristic of Localised aggressive perio disease?
- puberty age
- 6’s and incisors
- Localised LOA - v shaped
- robust antibody response
What are the characteristics of generalised aggressive perio disease?
- usually under 30 years
- LOA other than 6’s and incisors
- clear detruction of perio attachment - usulaly more horizontal
- poor serum antibody response to infectious agent
What is the new classification for local and generalised gingivitis when considering BOP?
<30% = localised >30% = generalised
What are the medical conditions/systemic disease would aaffect the perio tissues?
Papillon lefevre syndrome
Leucocyte adhesion deficiency
Hypophoshatasia
Downs syndrome
Ehlers danlos
Diabetes
Obesity
Stress
Osteoporosis
Rheumatoid arthritis
HIV
How does the the pocket heal post periodontal treatment?
Fibrin clot- fails to adhere to the root surface
Downward growth of eipithelial cells between the cloth and root surface
Epithelial attachment to the root
Progenitor cells from the surrounding tissues proliferate, migrate and differentiate
Formation of bone, PDL and cementum
What are the indications for periodontal regeneration?
- two and three walled proximal defect
- grade 2 mandibular furcation defect
- Grade 2 buccal maxillary furcation defects
What are the types of perio regeneration?
Osteoconduction -Scaffold
Osteoinduction -Promoting osteoblast activity
Osteogenesis - Osteoblasts present in the graft
