removal of biofilm, endotoxins, bacterial products, and calc
root planing to remove residual calc and create a smooth surface
irrigation
sustained-release antibiotic, or antimicrobial agent particularly for refractory infections
removal of iatrogenic retainers
concurrent dental therapeutic interventions
What is the focus of periodontal debridement treatement?
focus is on the elimination of the contributing factors of the infection; dental biofilm, endotoxins, cementum, and calc
What is derived from the cell walls of gram-negative pathogenic microorganisms, are toxic to human tissue, and lead to inflammation and destruction of the periodontal attachment; they are embedded in the cemental surface and in the superficial biofilm and can be removed readily
endotoxins
true or false. In periodontal case types II, III, or IV, you should never promise that the treatment will be finished in a given number of appointments
true
What are 4 important things to educate the pt about when treatment involves nonsurgical periodontal instrumentation?
appreciate values of a healthy mouth
assume a co-therapist role in maintaning the health established in treatment phase
commint to perform daily personal biofilm control
continue with perio maintenance appointments at recommended interavals
What are 4 things to expect in the outcomes of nonsurgical therapy?
interrupt or stop progress of disease
create an environment that encourages the tissue to heal and the inflammation to be resolved
induce positive changes in the quality and quantity of the subgingival bacterial flora
provide initial preparation for complicated periodontal therapy required for advanced disease
What are 5 pieces of information to include in the written instructions for the pt to take home with them after nonsurgical periodontal instrumentation?
possible discomfort to expect
rinsing - warm solution - hypertonic slat; sodium bicarbonate - rinse w/previous 2 every 2 hrs after eating and tooth brushing, and before bed; or rinse with chlorhexidine
toothbrushing - use soft brush
eating - avoid solid food until anesthetic has worn off; if tissues are tender eat bland food
What are 3 predisposing factors for abscess formation?
deep suppurating pockets; advanced perio infection
pockets extending into furcation areas or intrabony defects
pt susceptible to infection i.e. diabetes, immunodeficiency disease, or immunosuprressants
What are 5 steps leading to the development of an abscess with partial scaling?
healing can begin
the tissue at the gingival margin tightens
the pocket closes
microorganisms multiply within
an abscess develops
_________ is the formation of tiny bubbles in the fluid; when these tiny bubbles collapse, they produce shock waves that destroy bacteria by tearing the bacterial cell walls
cavitation
______ is the swirling effect produced within the confined space of a periodontal pocket by the continuous stream of fluid flowing over the vibrating instrument tip. This intense swirling effect disrupts the plaque biofilm
