srp

D4341: SRP for 4+ teeth
D4342: SRP 1-3 teeth
D1110 adult prophy
D4910 perio maintenance

tx removing cementum or surface dentin that is rough, has calculus, or contaminated

rough or diseased root surface

dec bacterial colonization
remove necrotic cementum/toxin
produce healthy root surface for reattachment

NO, prophy PREVENTS pdtitis

remove plaque, calculus, stain from exposed and unexposed surfs by scaling and polishing

presence of plaque, stain, or calculus in patient WITHOUT PDTITIS!

remove plaque, stain, supra and sub-g calculus

reduction of gingivitis, reduced plaque and calculus, prevent pdtitis, improved esthetics

sensitivity, root caries

3 times more attachment gain

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

32% or 1/3

maintaining plaque biofilm control

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

recession

long junctional epithelium
no new CT attachment
maybe some bone gain

decrease TOTAL BACTERIAL COUNT
dec red/orange complexes
INCREASE proportions of G+ aerobic cocci and rods

porphyromonas gingivalis
treponema denticola
tannerella forsythia

G- anaerobic

pocket/incision, local abx

local abx, perio surgery

improved oral hygiene
reduced gingival inflam
reduced probing depth
increased attachment

bad: inc recession

gingival tenderness
perio abscess
root sensitivity
excessive scaling

drain via pocket, incision
local antibiotic

perio surgery
local antibiotic

1.36mm greater PD reduction
0.52mm greater att gain

both have similar results

70%