1why is eval of ini therapy done
determine pt response to perio tx
determine effectiveness of home care
confirm each tooth prognosis
confirm further tx
2EIT parameters
gingival color, consistency, contour
plaque score
PD
attachment
furcation
suppuration (infection)
mobility
BOP
3why is 4-8 weeks optimal time frame for evaluating perio post ini therapy
re-establish junctional epithelium: pocket will adhere to tooth surface, pocket depth shrinks over 4-5wks
repair of connective tissue: 7wks
microbial repopulation of sulcus: 11wks
4expected pocket depth reduction with SRP AND OHI
1.34mm
5what changes expected to PD and AL after initial perio therapy?
PD reduction 1-2mm
AL gain 0.5mm
6what side effect can come from PD reduction
recession; need to talk to pts about fluoride due to sensitivity
possibility of root caries
7significance of BOP
correlaction with histology
predictor of future attachment loss
8what correlation exists at the base of the pocket
BOP and inflammation (macrophs and leukocytes)
9is there a correlation between redness at gingival margin and inflam
NO correl bt VISUAL SIGNS of inflamed marginal gingiva and histological inflammation
10longitudinal exp: probe patients for 4 sessions, if they bled all 4 times, chance of what % into attachment loss?
30% chance of progression
11longitudinal exp: probe pts for 4 sessions, bled once, chance % progression into AL?
3% chance of progression
12absence of BOP means
good indicator for maintaining healthy perio tissue
(because correl bt BOP and eventual AL)
13expected response EIT
dec in plaque score, PD, tooth mobility
improvement in gingival health
no suppuration (no pus)
14medical/clinical findings that ready a pt for further ODCT
medical: anything systemic, patient must be stable to continue perio tx
clinical: good plaque control
15(cont ODCT) non-surgical perio therapy consists of
local drug delivery
occlusion therapy
16(cont ODCT) surgical perio therapy recommended for
generalized residual PDs
access to subgingival calculus
deep pockets
signs/symptoms of gingival inflam
vertical/furcation defects
subgingival margins or inadequate crown length
17techniques used for perio surgery
resective and regenerative
18perio surgery objectives
inc access for removing plaque/calc
reduce/elim defects from pdtitis
19patients are not ready for furter odct if
only slight or no change in gingival inflam/plaque score
patient desires
finances
systemic issue
20palliative/comprised maintenance
attempt to keep perio dz from progressing; includes non surg techs
21what does palliative/compromised maintenance include
SRP
OHI
stop smoking
antibiotics
host modulation
22goals of perio therapy
reduce organization and mass of biofilm
create shallow gingival crevices that cannot host anaerobic microbes