When does formation of functionally orientated collagen occur after PMPR?
3 weeks
How long does it take for the pocket wall to be re epithelialsed after PMPR?
And how long does it take for the long junctional epithelium to be fully complete?
Epithelialised after 2 days
Full reattachement via long junctional epithelium after 2 weeks
What causes a decrease in pocket depth after PMPR?
Decreased oedema leading to gingival recession
Increase in clinical attachment resulting from long junctional epithelium and increase in tissue tone (which resists probing)
When is most of the healing of the pocket complete?
By 8 weeks although gradually improves further over 9-12 months
When dental therapists carry out treatment under the direction of a dentist, what must be provided?
A treatment prescription
What does a simple treatment prescription for maintenance care include?
- monitor risks factors and provide patient advice as needed - using oral hygiene TIPPS behaviour change strategy
- monitor plaque biofilm and gingival bleeding levels
- carry out PMPR where required
- set risk-based recall interval with referring dentist
What does a complex treatment prescription for step 1 perio include?
- Baseline indices to record plaque biofilm and margin bleeding and full perio charting
- discuss risk factor control with the patient +/- smoking cessation
- removal of supragingival plaque, calculus and stain. Carry out PMPR at all sites with probiong depths >4mm with BOP +/- presence of subgingival deposits
- use local anaesthetic as required for the above sites - lidocaine 2% 1:80,000 adrenaline, max 4 cartridges of 2.2ml per visit
- review with referring dentist 3 months post completion of treatment
What are modifying risk factors for perio disease?
Age
Previous tooth loss to perio
Smoking
MH that may affect periodontal tissues - diabetes, RA, osteoporosis, stress, obesity, Ca channel blockers, nifedipine.
Pregnancy
FH
Engagement with treatment
Plaque retentive factors
Furcation involvement
