1benefits of ortho for perio pts
correct crowding: align malposed teeth > facilitate access for plaque removal
uprighting: align, reduce/correct tissue defects, improve occlusion
correction of pathologic migration: extrusion, labial flaring, rotation
intrusion: correction of tissue defects, favorable crown:root ratio
2how does a missing tooth contribute to bad perio
occlusal forces no longer directed down the tooth > supraeruption
food impaction in the IPC of supraerupted tooth
3how to fix missing tooth perio
selective coronoplasty > prevent additional destruction of supporting tissue
likely need fixed prosth
4what is pathologic migration assoc w
PERIODONTITIS AND OCCLUSAL TRAUMA MAIN!
MAYBE loss of posterior tooth support
5what does perio therapy need to do before ortho
remove deposits and resolve marginal inflammation
6types of perio endo lesions
primary endo: endo infection from PA or accessory foramen into periodontium
primary perio: perio pocket deepens to apex, 2ndary pulp involvement
primary perio 2ndary endo: perio pocket infect pulp via acc. canal > PA lesion
true combine lesion: two indep lesions, PA and perio, coexist and eventually fuse
7tx for combined perio-endo lesion
endo therapy first
removal plaque/calculus, non surg or surgical
evaluate tooth for residual pocket or bony defect
periodontal therapy (osseous resective surgery, regeneration)
8how to tell apart perio lesion
might have pain but if no pain its perio
swelling within gingiva
VITAL PULP!
9how to tell apart endo lesion
NO POCKETS
NEGATIVE VITAL PULP TEST
RL at apex
10how to tell apart perio-endo
swelling around root
no vitality in pulp
RL anywhere along root