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Theory DH Test 4
Perio Patient to Pregnant Patient
| Question | Answer |
|---|---|
| what is slight, mild periodontitist? | Baylor classification 2 changes in crest of inter proximal bone septum less then 20-30% bone loss vertical bone loss |
| what is moderate periodontitis? | Baylor classification 3 apparent bone loss (horizontal and vertical) 30-50% bone loss radioluecencies appear in furcation |
| what is severe periodontitis? | Baylor classification 4 greater than 50% vertical and horizontal bone loss furcation involvement, mobility |
| what is chronic periodontitis? | gradual, being going on a long time, prevalent in adults pocket formation, bone loss, inflammation |
| what bacteria are found in chronic periodontitis? | P. gingivalis, T. forsythensis, P. intermedia, E. corrodens |
| what is aggressive periodontitis? | happens very quickly, usually affects persons under age 30 bone loss, pocket formation and inflammation |
| what bacteria are found in chronic periodontitis? | P. intermedia and Aa |
| what is localized aggressive periodontitis? | sparse amount of plaque/calculus, little inflammation localized to incisors and 1st molars |
| what is generalized aggressive periodontitis? | severe gingival inflammation, rapid bone loss affecting at least three permanent teeth other than 1st molars and incisors |
| what is NUG? | usually in young adults, punched out or cratered papillae, pain and bleeding, bacteria are spirochetes, P. intermedia and F. nucleatum |
| what is NUP? | perio involvement of deeper structures, rapid bone loss spontaneous bleeding |
| what is scaling? | removal of the stain, plaque calculus and soft deposit |
| what is a scaling stroke? | shorter with heavy pressure |
| what is root planing? | taking away the sub gingival calculus and smoothing the tooth surface smoothing the cementum |
| what is periodontal debridement? | eliminates the sub gingival biofilm and mineralized deposits |
| what is a root planing stroke? | longer and light pressure |
| when would you want to use periodontal debridement? | all sites exhibit gingival inflammation, elevated levels of pathogens, alveolar bone loss, progressive attachment loss, visual plaque and calculus and bleeding on probing |
| all chronic periodontitis patients should... | undergo nonsurgical therapy prior to surgical intervention |
| why would you want to do periodontal debridement? | treat and resolve inflammation, promote healing, produce favorable tissue response, stop disease progression, induce gram positive changes in bacteria, achieve surgical manageability |
| what is your primary goal in non surgical periodontal treatment? | biologically clean root surface that promotes healing this is different for every patient |
| what is the long junctional epithelium? | new junctional epithelium that is formed from collagen after periodontal debridement |
| after initial periodontal debridement, junctional epithelium will reestablish in... | 1-2 weeks |
| repair of connective tissue continues for... | 4-8 weeks |
| subgingival microbial repopulation occurs within... | 2 months in absence of improved plaque control |
| when does re eval usually take place following treatment? | 4-6 weeks |
| when do we do our re eval at Baylor? | 2 weeks because of our semesters normally do them in 4-6 weeks |
| what should the progress notes per one quad include | pocket depths and bleeding point changes description of any changes in the tissue such as color, consistency, contours determine and record the severity of perio disease for quad |
| how do you select the appropriate recall interval? | patient's immune response to that bacteria, put them on a short recall and then let them out as response is evaluated |
| what does deplaquing mean? | mechanical disruption of non attached, free floating sub gingival plaque someone who does not have a lot of calculus |
| what is oral prophylaxis? | removal of plaque, calculus and stains from exposed and unexposed surfaces of teeth by scaling and polishing do this on patients who have little plaque or calculus but doing this will make them healthy |
| what are the instructions after the use of ARESTIN? | resume brushing after 12 hours wait 10 days before using floss do not touch area for 1 week except for brushing avoid eating hard, sticky foods for 1 week |
| what are the three main things your powered instruments are going to do for you? | dislodge calculus, disrupt plaque biofilm, flushes out bacteria by lavage |
| what are the modes of action for powered instruments? | mechanical removal, water irrigation, acoustic microstreaming, cavitation |
| what does mechanical removal mean in powered instruments? | action of the tip itself, movement of the tip removes calculus |
| what does water irrigation mean in powered instruments? | lavage, water comes off the end of the tip and anything loosened by the mechanical removal is flushed away |
| what does acoustic mirostreaming mean in powered instruments? | spray that is produced from the movement and sound of the instrument will destroy the bacteria it is not the tip actually touching the tooth |
| what does cavitation mean in powered instruments | bubbles are produced by the fast moving water and they remove bacteria |
| when would you use powered instrumentation? | subgiginval period debridememnt removal of supra gingival calculus and tenacious stains, initial debridement, furcation areas, removal before oral surgery, orthodontic cement and overhanging margins |
| when would you NOT use a powered instrument? | systemic health conditions like communicable diseases or susceptibility to infections respiratory risk, difficulty swallowing, demineralized areas, exposed dentinal surfaces |
| why are children not good to use powered instruments on? | pulp is very large so the chance of injuring the teeth is very high |
| what are the advantages of powered instruments? | reduces operator fatigue saves time, patient comfort, do not have to sharpen, bactericidal effects, lavage: water flushing out the pocket |
| what are the limitations of powered instruments? | heat production, less tactical sense, requires water and suction, aerosols produced, impeded visibility |
| what are the two types of ultrasonic powered instruments? | magnetostrictive and piezoelectric |
| what is magnetostrictive ultrasonic frequency? | 18,000-42,000 cycles per second |
| what is megnetostrictive ultrasonic stroke pattern? | ellipitcal |
| how does a magnetostrictive ultrasonic work? | copper wire around inside of hand piece creates magnetic field around the insert stack and creates vibration, do not put in the ultrasonic cleaner |
| what is the frequency of the piezoelectric ultrasonic? | 24,000-50,000 cycles per second |
| what is the stroke pattern of piezoelectric? | back and forth or linear |
| how does a piezoelectric work? | ceramic crystals in sealed hand piece create vibration water is not needed to cool transducer so less water is needed overall |
| what is the frequency of sonic scalers? | 3,000 to 8,000 cycles per second |
| why can the purple tip be turned on to high power for short periods of time? | water comes out the base so the tip is solid |
| what is frequency? | times per second the insert tip moves back and forth during one cycle speed, same distance but how fast it is going |
| what is the active tip area? | amount of the tip that can be used affected by the frequency |
| what is the active tip area at 25K? | 4.3 mm |
| what is the active tip area at 30K? | 4.3 mm |
| what is the active tip area at 50K? | 2.3 mm |
| what is the power or amplitude? | length of the stroke of the insert? longer the stroke the higher the power, distance of tip movement |
| what is the most powerful part of the ultrasonic tip? | #1 point #2 concave side: inside portion #3 convex side: rounded back #4 lateral surface |
| when is the baby considered an embryo? | conception to the end of the second month |
| when is the baby considered a feats? | 3rd month on |
| when does the gestation period normally last? | 40 weeks |
| when is the baby considered to be premature? | before 37 weeks |
| what happens during the first trimester? | organogenesis: all the organs are forming susceptible to terategenic effects featus moves and swallows by the end of the first trimester |
| when does initial mineralization happen for the tooth? | 4-5 months of gestation |
| when does the tooth bud form? | 5th-6th week |
| when does tetracycline staining begin? | 4th month |
| when do the lips form? | 4-7 weeks |
| when does the palate form | 8-12 weeks |
| when is cleft lip apparent by? | 8th week |
| when is the cleft palate apparent by? | 12th week |
| what are the drugs that cause cleft lip or palate? | barbituates, valium, corticosteroids |
| when does pregnancy gingivitis begin and peak? | begins in 2nd month peaks in the 8th month |
| what is a pyrogenic granuloma? | pregnancy tumor exaggerated response to bacteria, irritants and ovarian hormones appears on interdental papilla of maxillary anterior teeth |
| what are the periodontal pathogens present in the sub gingival plaque of pregnant patients? | provetella intermedia, gingivalis and T forsythia |
| what are the signs and symptoms of hypertension in pregnant women? | high blood pressure, excessive protein in the urine, swelling of feet, legs and hands |
| what is the mild eclampsia blood pressure? | systolic is 140 or higher diastolic is 15 mm Hg higher than their pre-pregnancy level |
| what is severe eclampsia blood pressure? | systolic is over 160 mm Hg diastolic is 110 mm Hg |
| what does increased levels of progesterone do? | simulate the production of prostaglandins that act as an immunosupresstant |
| what does increased levels of estrogen do? | impair the inflammatory response of the periodontium against bacteria decreases keratinization of the gingiva which results in reduction of effectiveness of the epithelial barrier |
| do we treat pregnancy women during the first trimester? | NO, safest is second trimester |
| what is hypotensive syndrome? | occurs when patient is in supine position, caused by impairment of venous return by compression of inferior vena cava by uterus |
| what are the symptoms of hypotensive syndrome? | abrupt fall in blood pressure, bradycardia (slow heart beat), sweating, nausea, weakness and air hunger |
| what is the treatment for hypotensive syndrome? | roll patient on to left side so it gets the uterus of the inferior vena cava |
| what do you do with a choking pregnant woman? | chest thrust instead of abdominal |
| what do you do with syncope for the pregnant woman? | place patient on side rather than on back |
| what can aspirin do during pregnancy? | can cause fetal and maternal bleeding prolonged gestation longer duration of labor |
| what can ibuprofen do during pregnancy? | affects fetus circulation |
| what is cross arch advanced fulcrum? | finger rest is established on opposite side of arch from the treatment area |
| what is opposite arch advanced fulcrum? | finger rest is established arch from the treatment area |
| what is finger on finger advanced fulcrum? | finger of non dominant hand services as resting point for dominant hand |
| what is piggyback advanced fulcrum? | middle finger of dominant hand is stacked on top of fulcrum finger |
| what is finger assist advanced fulcrum? | finger of non dominant hand is used to concentrate lateral pressure against the tooth surface and help control the instrument stroke |
| where do you use gracey 1/2 and 3/4 | anterior teeth all tooth surfaces |
| where do you use gracey 5/6 | anterior and premolars: all tooth surfaces molars: facial and lingual surfaces |
| where do you use 7/8 and 9/10 | anterior and premolars: all surfaces molars: facial and lingual surfaces |
| where do you use gracey 11/12 | anterior teeth: mesial and distal surfaces posterior: facial, lingual and mesial surfaces |
| where do you use gracey 13/14 | anterior teeth: mesial and distal surfaces posterior teeth: distal surfaces |
| where do you use Gracey 15/16 | posterior teeth: facial, lingual and mesial surfaces |
| where do you use gracey 17/18 | posterior teeth: distal surfaces |
| what is interchangeable with Gracey 11/12? | Gracey 15/16 |
| what is interchangeable with Gracey 13/14? | Gracey 17/18 |
| what is after five SRPG? | terminal shank elongated 3 mm 10% thinner blade superior access to pockets greater than 5 mm increased clearance around crown anatomy also available in rigids and extra rigids |
| what are mini fives SRPG? | terminal shank elongated 3+ mm shorter blade better access and adaptability eases gingival insertion and reduces tissue distention |
| what are vision curvettes? | lower shank has two raised hands bands provide a visual means of estimating the depth of a pocket curved blade 50% shorter, straighter shank blade identification on shank: 5 and 10 mm |
| where do you use the Langer 5/6? | anterior similar shank design as the Gracey 5/6 |
| where do you use the Langer 1/2 | mandibular posterior similar shank design as the 11/12 |
| where do you use the Langer 3/4 | maxillary posterior Gracey 13/14 but suitable for mesial and distal surfaces with greater angle than 1/2 for improved access to molars |
| where do you use the Langer 17/18 | posterior Gracey 17/18 plus universal |
| what are files used for? | crush large calculus deposits roughen burnished calculus deposits use must be followed by curette smooth overhangs of amalgam restorations |
| what are the design characteristics of files? | working end has multiple, straight cutting eyes edges at 90 degrees to 105 degrees rounded back, rigid shank, area specific |
Created by:
Chobchi
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