Perio Chp25/26/28

  1. Periodontal abscess is a ________ associated with a _______. May be _____ or _____
    • bacterial infection in the periodontal tissues
    • localized accumulation of pus or suppuration

    acute or chronic
  2. What are some characteristics of PERIODONTAL ABSCESSES
    • –Pain that is constant and localized
    • –Circumscribed swelling in the periodontium
    • –Possible increase in mobility of the tooth
    • –Radiogaphic loss of bone no involving the apex
    • –Tooth usually has a vital pulp
  3. What is the clinical appearance of an acute periodontal abscess
    Shiny, red, raised mass on the gingiva
  4. What are the causes of periodontal abscesses
    • Blockage of the opening to the pocket possibly due to temporary healing of the superficial gingiva
    • Foreign object being lodged in the pocket
    • Incomplete calculus removal in the deeper part of the pocket
  5. GINGIVAL ABSCESSES is the result of
    forceful impaction of foreign body
  6. What is the treatment for a gingival abscess
    draining and irrigation
  7. Pericoronitis is an abscess associated with a partially or fully erupted tooth that is covered completely or partially by a flap of tissue called an
  8. NUG is aka as __________ and has an appearance of ________ and is associated with the bacteria ___________
    • trench mouth and Vincents infection
    • Punched out papilla with a pseudo-membranous white coating w/ a fetid odor
    • Prevotella Intermedia and spirochetes (treponema denticola)
  9. What are the classic patient characteristics of NUG
    • Usually smoke
    • History of stress
    • Poor nutrition
    • May be alcohol abuse
    • May be immunocompromised
    • Highest incident 20-30 years
  10. What is the initial treatment of NUG
    • debridement with ultrasonics and local or topical anesthetic
    • Postpone Scaling
  11. NUP has signs and symptoms _________ but includes a _________
    • similar to NUG
    • loss of attachment
  12. Primary herpetic gingivostomatitis results from
    the initial infection with the herpes simplex virus (HSV)
  13. In most patients the initial HSV infection results in ________ but in some patients the initial HSV infection produces _________
    no sign or symptoms and goes undetected

    very severe oral symptoms that are known as primary herpetic gingivostomatitis
  14. PRIMARY HERPETIC GINGIVOSTOMATITIS Regresses on its own in about
    2 weeks
  15. PERIO-ENDO LESIONS present as a
    a periapical lesion (radiolucency on x-ray) with a negative pulp test
  16. With an endodontic lesion what is the cause of the bone loss
    The pressure of the suppuration
  17. What is host modulation therapy
    altering the host’s (patient’s) defense responses to help the body limit damage to the periodontium due to periodontal infection
  18. What are the anti-inflammatory biochemical mediators produced that are meant to prevent the infection from doing serious harm to the periodontium
    • Cytokines:
    • IL – 4, IL – 10, tissue inhibitors of MMP’s
  19. What are some potential Host-Modulating Agents
    • Doxycycline
    • Nonsteroidal anti-inflammatory drugs (NSAIDS)
    • - Ibuprofin
    • - Aspirin
    • Bisphosphonates
  20. What is the antibacterial dose of doxycycline
    • a dose of doxycycline high enough to kill bacteria
    • 50 – 100 mg Q12H
  21. What is the sub-antibacterial dose of doxycycline?
    • doses of doxycycline that are below the bacterial killing or inhibiting dose
    • 20 mg twice a day
  22. At sub-antibacterial dose doxycycline ________ thus decreasing the __________
    • decreases the effect of collagenase (an MMP)
    • destruction of collagen
  23. The FDA approves sub-antimicrobial doses of doxycycline for use in treating patients with ______ which is the drug ________
    • periodontitis
  24. NSAIDS are used to treat ________ and can reduce _________ by the inhibition of __________ and can inhibit
    • pain and acute and chronic inflammation (arthritis)
    • inflammation
    • prostaglandins (PGE2)
    • osteoclastic activity
  25. What are the long term effects of NSAIDs and have they been approved in the treatment of periodontitis?
    • GI problems including ulcers and bleeding
    • Bleeding due to blood thinning properties
    • Kidney and/or liver damage

    Not approved for periodontitis
  26. What is the mechanism of action of bisphosphonates, side effects and is it approved for the treatment of periodontitis?
    • Drugs inhibit the resorption of bone by altering osteoclastic activity
    • Side effects include possibility of osteonecrosis of jaws

    Not approved for periodontitis
  27. What are the pro-inflammatory mediators
    Il - 1, Il – 6, prostaglandin E, tumor necrosis factor alpha, matrix metalloproteinases
  28. What is the systemic delivery of antibiotics and they include
    Taking antibiotics orally as a tablet or capsule which disolves in the stomach and enters the blood stream and is circulated systemically throughout the body

    • Penicillin(Amoxicillin)
    • Metronidazole (Flagyl)
    • Amoxicillin and metronidazole
    • Tetracycline
    • Erythromycin
  29. What is topical delivery of antibiotics and they include
    Delivery of the chemical agent into the periodontal pocket to control the plaque biofilm

    • PerioChip
    • Arestin
    • Atridox
    1.Agent has to reach the base of the pockets

    2.Antiplaque action - antimicrobial agents must be used at bactericidal/bacteristatic concentrations (nondiluted)

    3.Substantivity - agents must be present long enough to work. Some agents have the ability to adhere to structures and be released slowly over time (substantivity)

    4. Low toxicity – Agents must be nontoxic so that surrounding tissues are not damaged. 

    5. Low permeability – The agent must have a low permeability in the oral mucosal tissues so that the chemical is minimally transported to the rest of the body and will remain in the area where it needs to act
  31. Who is the prime candidate for the
    Systemic Delivery of Antibiotics
    those that continue to display continued attachment loss despite adequate mechanical therapy
  32. What are the current recommendations for the systemic Delivery of Antibiotics for gingivitis or chronic periodontitis
    avoid systemic antibiotic use
  33. What are the current recommendations for the systemic Delivery of Antibiotics for aggressive periodontitis
    Combination of Metronidazole and Amoxicillin for 10 days during SRP
  34. Tetracyclines tend to concentrate in the _________ and are effective against Aa
    gingival crevicular fluids
  35. Controlled-release of antibiotics/antimicrobials is placed directly into the pocket where it is slowly released over a period of ________
    1 to 2 weeks
  36. Controlled-release of antibiotics/antimicrobials may be indicated in localized pockets that are nonresponsive BEFORE OR AFTER nonsurgical and surgical periodontal treatment
  37. Actisite periodontal fiber is a ________ and delivers ______ to the site of gingival infection for _______ but is not available in the U.S
    • monofilament fiber impregnated with the antibiotic tetracycline
    • 12.7 mg
    • ten days
  38. Atridox is _____ mg of ________ delivered subgingivally by ______ in a liquid form which solidifies and then allows for controlled release for a period of about _______ days
    • 42.5
    • Doxycycline
    • canulla
    • seven
  39. Arestin __mg of ________ and maintains therapeutic drug concentrations for at least ______ days
    • 1
    • minocycline HCl
    • 5-7
  40. Arestin is bactericidal or bacteriostatic and works by preventing the protein synthesis of _________
    • E. corrodents
    • F. nucleatum
    • P. gingivalis
    • A.a.
    • P. intermedia
  41. PerioChip is composed of __ mg of _________ and is described as a _________. It is not an antibiotic but an ________
    • 2.5
    • Chlorhexidine digluconate
    • small, orange brown, rectangular chip
    • antimicrobial
Card Set
Perio Chp25/26/28
Perio Chp25/26/28