1codes for srp
D4341: SRP for 4+ teeth
D4342: SRP 1-3 teeth
D1110 adult prophy
D4910 perio maintenance
2root planing
tx removing cementum or surface dentin that is rough, has calculus, or contaminated
3indication for RP
rough or diseased root surface
4RP rationale
dec bacterial colonization
remove necrotic cementum/toxin
produce healthy root surface for reattachment
5is prophy a tx for periodontitis
NO, prophy PREVENTS pdtitis
6adult prophy
remove plaque, calculus, stain from exposed and unexposed surfs by scaling and polishing
7adult prophy indication
presence of plaque, stain, or calculus in patient WITHOUT PDTITIS!
8adult prophy goals
remove plaque, stain, supra and sub-g calculus
9adult prophy rationale
reduction of gingivitis, reduced plaque and calculus, prevent pdtitis, improved esthetics
10problems when doing SRP
sensitivity, root caries
11**toggle study: how much more effective is it to SRP and hygiene to improve PD
3 times more attachment gain
12**critical probing depths
2.9mm; if SRP will have att loss
less than 4.2mm probing: att loss post surgery
deeper pockets (6+mm) surgery leads to more att gain than SRP
13**surfaces clean with 6mm+ pockets non surgical tx
32% or 1/3
14long term success of perio surgical tx is dependent on
maintaining plaque biofilm control
15**why is non-surgical therapy needed (phase I)
long term success of perio surgical tx dependent on maintaining plque biofilm ctrl (which needs phase I)
pts with no biofilm ctrl continue to lose att even post op
can evaluate tissue responses and pt compliance
better tissue management
16biggest limitation/flaw with SRP
recession
17healing results following SRP
long junctional epithelium
no new CT attachment
maybe some bone gain
18**influence of mechanical debridement on subging biofilms
decrease TOTAL BACTERIAL COUNT
dec red/orange complexes
INCREASE proportions of G+ aerobic cocci and rods
19red complex
porphyromonas gingivalis
treponema denticola
tannerella forsythia
20bacteria associated with pdtitis are mostly
G- anaerobic
21how to manage acute perio abscess
pocket/incision, local abx
22chronic periodontal abcess manage
local abx, perio surgery
23expected changes after phase 1 perio therapy
improved oral hygiene
reduced gingival inflam
reduced probing depth
increased attachment
bad: inc recession
24complications after phase 1 perio therapy
gingival tenderness
perio abscess
root sensitivity
excessive scaling
25abscess management: acute perio abscess
drain via pocket, incision
local antibiotic
26abscess management: chronic perio abscess
perio surgery
local antibiotic
27**OHI only vs OHI with SRP numbers for PD and att
1.36mm greater PD reduction
0.52mm greater att gain
28**which is better, surgical or non-surgical for PD 4-6mm
both have similar results
29**% pocket reduction after 6 months from phase 1 non surgical therapy
70%