question

Periodontal maintenance has also been reffered to as

answer

periodontal recall supportive periodontal care contiuning care

question

Refractory periodontal disease occurs in treated periodontal patients who

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failed to respond to periodontal treatment including maintenance therapy

question

What are some reasons that pt my be refractory

answer

because of inadequate treatment presences of systemic diseases such as diabetes deficient immune response if periodontal pathogens

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Recurrent PERIODONTAL DISEASE OCURSS IN PT WHO previously responded well to periodontal therapy but later showed signs of

answer

disease reactivation

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What are some treatment options for pt with refractory periodontal diseases

answer

adjunctive use of antibiotics referral for medical consultation

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treatment of recurrent diseases sites is based on

answer

conventional periodontal therapy

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NAME THE FOUR PRIMARY OBJECTIVES OF PERIODONTAL MAINTENANCE

answer

1 to prevent or minimize the recurrence of periodontal diseases in pt by controlling risk factors known to contribute to the disease process 2 to prevent or reduce the incidence go of tooth or implant loss by monitoring the dentition and prosthetic replacement of natural teeth 3 to increase the probality of locating and treating other conditions or diseases found in the mouth 4 to preserve the health, comfort, and function of teeth

question

WHAT ARE SOME RISK FACTORS FOR PERIODONTAL DISEASES

answer

dental bioflim calculus

question

Name the three types of pt that are indicated for periodontal maintenance

answer

- periodntally healthy pt who have never had periodontal disease as a preventive procedure (primary prevention) - pt who have responded favorably after active periodontal therapy to prevent or minimize the recurrence and progression o periodontal diseases and tooth loss (secondary prevention) - medically compromised pt or pt who maintain poor oral hygiene and are not considered candidates for periodontal surgery

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Before any treatment is initiated what should be done

answer

review previous periodontal treatments including periodontal maintenance care

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When is it best to probe a periodontal pt

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at each appointment visit

question

Basline values are first established at the initial examination of examination and again when?

answer

following active therapy

question

What is the primary risk factor for periodontal disease

answer

dental bioflim

question

Name the secondary factors for periodontal disease

answer

bioflim retentive areas such calculus and restorations with over hangs or effective margins

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When should a medical consultation be warranted

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if new illnesses are recognized r if previous conditions has changed significant ally

question

What are some risk factors that contribute to periodontal diseases

answer

cigarette smoking stress nutrition medications systemic diseases

question

What is the purpose of an extra and intra oral exam

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to detect any abnormalities including enlarged lymph nodes or salivary glands and red, white to pigments lesions

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What is done in the dental examinations

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caries risk assessment look at restorations teeth

question

The periodontal assessment invovles

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recording PPD gingival recession CAL furcations Supperation (pus) mobility

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What is gingival recession

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the position of the gingival tissues on the tooth is defined as the location of the gingival marign in relation to the CEJ

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gingival recession usually results from

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improper toothbrush techniques attachment loss during disease process shrinkage of tissue after initial therapy

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What are common complaints for pt with gingival recession

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poor aesthetics tooth pain hypersensitivity with air or cold application

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How can pt with dentinal hypersensitivity be managed

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use desensitizing agents such as stannous fluoride potassium nitrate or sodium flouride

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What is the most reliable way to determine disease stability

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CAL

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Measurements of CAL is made from the

answer

CEJ to the apical extent of the probe tip

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Compared to a pt last appt. if the pt has a 2 - 3mm increase in attachment loss means

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disease is present

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Should a 1mm increase in attachment loss be a concern for a reappoint for a pt

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yes

question

Should a pt with a 3mm PPD without recession or no attachment loss be a concern

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no because there is no bone loss

question

BOP can me what

answer

laceration from too firm pressure ulceration: inflammation in the connective tissues

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Bleeding while stroking the lateral wall of the gingival crevice means

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there is early gingival inflammation

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Bleeding sites and in deep pockets seem to have an increase risk for

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progression of periodontist (progressive attachment loss)

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What is an indicator for go gingival health

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the abscense of BOP

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BOP usually appears ______ seconds after probing

answer

10

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What is the probing force that is recommended

answer

0.25 N or 25 g

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When should radiographs be taken on an recall periodontal pt with a history of bone less and periodontal surgery

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based on clinician judgement

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What type of radiographs should be taken on periodontal disease pt

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periapical bitewings

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Sites that has have had bone grafting (osseous) or guided tissue regeneration can be evaluated at least ______ months after surgery

answer

6

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4A program

answer

◦ Ask ◦ Advise ◦ Assist ◦ Arrange for a follow-up

question

Bupropion HC1 is associated with smoking cessation and is

answer

Zyban Sustained-Release Tablets

question

Wellbutrin Sustained-Release Tablets (a smoking cessation med) can be prescribed by

answer

by dentists or physicians as an oral medication to decrease withdrawal symptoms

question

Chantrix (varenicline) a drug use to help with smoking cessation may also be

answer

prescribed by dentist or physician

question

The need for bite wings or peri-apicals depends on

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stage and severity of disease risk for caries presence of implants

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what type of bite wings are ideal for a pt with periodontal disease and why

answer

vertical bite wings; because they show more of the alveolar bone

question

If inflammation is present or disease is suspected around an implant what should you doWellbutrin Sustained-Release Tablets ◦ Can be pr

answer

probe the area, note if BOP, suppuration (pus)

question

What should be noted for dental implants and what should you check

answer

Note: stability of abutment teeth and mobility loose screws Check for: occlusal wear

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What is the abutment used for

answer

a tooth or implant used for support and retention of a crown or removable partial denture

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Why don't calculus firmly attached to implants

answer

because the titanium surface is non-porous.

question

Because of implant failure and bone chracterics how often should radiographs be taken for implants

answer

periapical films are indicated at 6 months to 1 year intervals to the determine the height of bone around implants

question

What is the acceptable standard for a stable end osseous implant 1 year after placement is

answer

vertical bone loss less than 0.2 mm per year

question

Recurrent periodontal diseases occurs when

answer

signs and symptoms of disease return after having subsided during active treatment

question

What are some clinical signs of recurrent periodontal diseases

answer

BOP increase in tooth mobility continued soft tissue attachment loss (including deep pockets) suppuration from the pocket radiographic changes

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Recurrent tooth mobility includes increasing

answer

tooth mobility fremitus

question

When BOP or suppuration is seen 4-8 weeks following the periodontal maintenance therapy then

answer

pretreatment is plausible

question

What is a reason for pretreatment

answer

1-2 mm or greater increase in PPD or attachment loss

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Subgingival instrumentation including root planning of shallow pockets has shown to increase sort tissue attachment t/f?

answer

t

question

What should you ask pt with dental implants

answer

any difficulty in oral hygiene self care, chewing, discomfort,

question

Chemotherapeutic agents help prevent repopulation of

answer

gram negative organisims

question

Chemotheraputic agents are great for sub gingival t/f

answer

false

question

What can be helpful with dealing with sub gingival bacteria

answer

oral irigation

question

Why aren't systemic antibiotics not recommended in during periodontal therapy

answer

because of th e potential development of bacterial resistance

question

Periodontal maintenance intervals are based on

answer

individual basis according to periodontal disease severity, type of treatment performed, adequacy of oral hygiene, self care ,presence of orthodontic and prosthetic appliances systemic health and pt adherence (compliance)`

question

Data suggest that periodontal maintenance intervals should be

answer

3 months or less

question

A 12 month recall is indicated for

answer

pt with limited suceptablity to periodntisit

question

Although periodontal pt can be seen by general dentist it is recommend that these to see a periodontist atleast

answer

1 a yeat

question

if a pt has gingivitis or mild chronic periodontitis can they receive total care including chronic periodontal maintenance by a general dentist

answer

yes

question

Severe chronic periodnotixt pt should be seen primarily be a

answer

periodontist

question

Moderate chronic periodontist pt can be seen by

answer

a general dentist and periodontist alternatively

question

Refractory and aggressive periodontitis should be seen exclusively by

answer

the periodontist

question

non adherence with regular periodontal maintenance visit will result

answer

in recurrence or progression of the disease

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