Perio

Front 1

systemic antimicrobials are used in

Back 1

aggressive periodontitis

necrotising ulcerative gingivitis/periodontitis

periodontal abscesses

recurrent periodontitis

Front 2

treat aggressive periodontitis with what antimicrobials and why

Back 2

metronidazole 400mg tds 7/7

amoxicillin 500mg tds 7/7

or

azithromycin 500mg od 3/7

can prevent further risk of progression or active disease, best prescribed in the initial phase of therapy

Front 3

advantages of systemic antimicrobials

Back 3

useful for aggressive/active/progressing sites,

multiple sites

low cost

less clinical time

Front 4

disadvantages of systemic antimicrobials

Back 4

patient compliance

antimicrobial resistance

unwanted side effects

can lead to sensitivities and allergies

Front 5

what locally applied antimicrobials are used and why?

Back 5

metronidazole (elyzol), chlorhexadine (perio chip and chlosite gel)

used when there are few sites, had poor response to debridement and deep sites in maintenance patients

Front 6

metronidazole (elyzol)

what,

how it is applied,

how it works

problems

indications

contraindication

Back 6

made of 25% metronidazole semi solid suspension gel

use after rsd, syringe into pockets and wipe away excess, then reapply 1 week later

it forms crystals when it reacts with water, dissolves the metronidazole and diffuse into surroundings

affective antimicrobial concentration lasts for 1 day and a substantial amount is swallowed

used in slowly progressing periodontitis and grade 2 furcations

not used in patients with recurrent/aggressive perio, with predisposing illness, those under med treatment and grade 3 furcations

Front 7

perio chip

what

how it works

indications

Back 7

chlorhexadine digluconate 2.5mg in gelatine

it biodegrades releasing chlorhexadine over 7-10days

used in pockets greater than 5mm

Front 8

minocycline

what

indications

contraindications

Back 8

2% dentomycin

use in moderate to severe chronic perio in sites greater than 5mm,

don't repeat within 6mths

Front 9

doxycycline

what

how it works

indications

Back 9

8.5% atridox

gel solidifies in minutes, doesn't flush out, released over 7-10days, absorbed and doesn't require removal,

works in smokers and is used for non-responding sites

Front 10

advantages of local antibiotics

Back 10

high conc of antimicrobial with minimum side effects, less reliance on patient compliance, useful for isolated sites

Front 11

disadvantages of local antimicrobials

Back 11

more expensive, as effective?

Front 12

overall treatment aim of periodontal treatment and aim of maintenance phase

Back 12

no bleeding on probing

maintain infection control

Front 13

risk analysis categories

Back 13

bleeding on probing, PD greater than or equal to 4mm, bone level/age ratio, smoking, bacterial flora, root caries, medical history

Front 14

low risk patient

Back 14

all categories low with a maximum of one in the medium risk

6mth recall

Front 15

medium risk patient

Back 15

maximum of 3 in the medium risk category and or maximum of 1 in the high risk category

4mth recall

Front 16

high risk patient

Back 16

4 or more in the medium category or a maximum of 3 in the high category

if higher than 3 in the high category this requires further investigation and diagnosis

3mth recall

Front 17

acute periodontal diseases

Back 17

acute herpetic gingivostomatitis

acute fungal gingivitis

acute allergic gingivitis

non-specific gingivitis

necrotising ulcerative gingivitis

gingival abscess

trauma

acute necrotising periodontitis

acute generalised periodontitis

traumatic perioapical periodontitis

HIV associated

lateral periodontal abscess

Front 18

acute herpetic gingivostomatitis

cause

signs

treat

progression

reactivation

Back 18

caused by herpes simplex 1

signs: sore painful mouth, loss of appetite, numerous vesicles will rupture, grey ulcers, irritable young children, malaise, salivation, raised temp, flu like symptoms, lymphadenopathy, stomatitis, pharyngitis

treat the symptoms, analgesics, antipyretics, antiseptics,

can progress to herpetic whitlow, eye lesions, satellite lesions

reactivations leads to cold sores, stays in the trigeminal ganglion

Front 19

acute fungal gingivitis causes

Back 19

candida albicans, denture stomatitis, recently finished broad spectrum antibiotics

Front 20

acute allergic gingivitis

causes, symptoms, treatment

Back 20

from direct contact or systemic of drug/chemical, leads to gingival tenderness, can be from mild to anaphylactic shock, stop drugs

Front 21

necrositing ulcerative gingivitis

symptoms

Back 21

affects interdental papilla, lasts 1-2 weeks, with permenant deformation

Front 22

acute necrotising periodontitis

symptoms

caused by

Back 22

causes sore and bleeding gingiva, grey/painful/yellow ulceration and necrosis, lymphadenopathy, metallic taste, halitosis, bone loss and perio attatchment loss

opportunistic infection, anaerobes, immunocompromised, smoking, stress, poor oral hygiene,

Front 23

lateral periodontal abscess

what

symptoms

aetiology

treatment

Back 23

a collection of pus in the connective tissue wall of the perio pocket

pain, red, swollen, lymphadenopathy, fever, malaise, ttp, tooth is mobile and high in occlusion, very deep pocket

caused by deep pockey, inflammation, microulceration, microorganisms, blockage, trauma, bone loss

drain the abscess, rsd, selective grinfing, hot salt mouth wash, antibiotics, retain the tooth.

Front 24

features of aggressive periodontitis

Back 24

healthy patient, rapid attachment loss, bone destruction, microbial deposits not consistent with destruction, phagocyte abnormalities, inflammatory response,

Front 25

classification of perio-endo lesion

Back 25

primary periodontal lesion with secondary pulpal involvement

primary endodontic lesion with secondary periodontal involvement

combines lesion with independent co-existing pathology

Front 26

endo origins

Back 26

pulpitis extending into the perio ligament

perforation during rct

internal resportion extending to the ligament

Front 27

perio origins

Back 27

severe periodontitis leading to pulp necrosis,

external resorption

Front 28

management of perio/endo lesion

Back 28

consider extraction

do endo first, place CaOH and wait, then revisit

perio flap needed if no improvement

may need hemisection/root removal

Front 29

most difficult areas to clean when wearing a fixed appliance

Back 29

gingival margins, mesial and distal areas of each tooth between the brackets

Front 30

ortho for perio patients

Back 30

as long as perio is under control, used in dental drifting

Front 31

3 componants of oral cosmetics

Back 31

lipline

teeth

gingiva

Front 32

gingiva aesthetics

Back 32

knife edge margins, smooth transition from tooth to gingiva, fill embrasures with light stippling

Front 33

what procedures are needed for these:

high frenum

gingival recession

unaesthetic gingival margin

delayed gingival maturation

subgingival restoration margin

ridge collapse

gingival discolouration

excessive gingival height

Back 33

frenectomy

gingival grafting

crown lengthening

crown lengthening

crown lengthening

grafting

grafting/excision

gingivectomy

Front 34

need to treat perio before restorations to

Back 34

locate gingival margins

position of tooth may alter in disease

restorations may produce injurious tensions

inflamed perio impairs abutment teeth

interferes with mastication and function

easier to obtain impressions and make precise preparations

minimise risk of trauma to gingival tissues

Front 35

biological width

Back 35

protects the alveolar bone

the width of soft tissue attached to the tooth crown to the crest of the alveolar bone, usually 2mm, needs to be maintained