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36 Cards in this Set
- Front
- Back
systemic antimicrobials are used in
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necrotising ulcerative gingivitis/periodontitis periodontal abscesses recurrent periodontitis |
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treat aggressive periodontitis with what antimicrobials and why
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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 |
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advantages of systemic antimicrobials
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useful for aggressive/active/progressing sites, multiple sites low cost less clinical time |
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disadvantages of systemic antimicrobials
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antimicrobial resistance unwanted side effects can lead to sensitivities and allergies |
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what locally applied antimicrobials are used and why? |
used when there are few sites, had poor response to debridement and deep sites in maintenance patients |
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what, how it is applied, how it works problems indications contraindication |
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 |
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perio chip what how it works indications |
it biodegrades releasing chlorhexadine over 7-10days used in pockets greater than 5mm |
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minocycline what indications contraindications |
2% dentomycin use in moderate to severe chronic perio in sites greater than 5mm, don't repeat within 6mths |
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doxycycline what how it works indications |
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 |
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advantages of local antibiotics
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high conc of antimicrobial with minimum side effects, less reliance on patient compliance, useful for isolated sites |
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disadvantages of local antimicrobials
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more expensive, as effective? |
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overall treatment aim of periodontal treatment and aim of maintenance phase
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maintain infection control |
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risk analysis categories
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bleeding on probing, PD greater than or equal to 4mm, bone level/age ratio, smoking, bacterial flora, root caries, medical history
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low risk patient
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6mth recall |
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medium risk patient |
4mth recall |
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high risk patient |
if higher than 3 in the high category this requires further investigation and diagnosis 3mth recall |
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acute periodontal diseases |
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 |
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cause signs treat progression reactivation |
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 |
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acute fungal gingivitis causes
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candida albicans, denture stomatitis, recently finished broad spectrum antibiotics |
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causes, symptoms, treatment |
from direct contact or systemic of drug/chemical, leads to gingival tenderness, can be from mild to anaphylactic shock, stop drugs |
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necrositing ulcerative gingivitis symptoms |
affects interdental papilla, lasts 1-2 weeks, with permenant deformation |
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symptoms caused by |
opportunistic infection, anaerobes, immunocompromised, smoking, stress, poor oral hygiene, |
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lateral periodontal abscess what symptoms aetiology treatment |
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. |
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features of aggressive periodontitis
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healthy patient, rapid attachment loss, bone destruction, microbial deposits not consistent with destruction, phagocyte abnormalities, inflammatory response, |
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classification of perio-endo lesion |
primary endodontic lesion with secondary periodontal involvement combines lesion with independent co-existing pathology |
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endo origins |
perforation during rct internal resportion extending to the ligament |
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perio origins |
severe periodontitis leading to pulp necrosis, external resorption |
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management of perio/endo lesion |
do endo first, place CaOH and wait, then revisit perio flap needed if no improvement may need hemisection/root removal |
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most difficult areas to clean when wearing a fixed appliance
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gingival margins, mesial and distal areas of each tooth between the brackets
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ortho for perio patients
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as long as perio is under control, used in dental drifting |
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3 componants of oral cosmetics
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teeth gingiva |
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gingiva aesthetics |
knife edge margins, smooth transition from tooth to gingiva, fill embrasures with light stippling |
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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 |
gingival grafting crown lengthening crown lengthening crown lengthening grafting grafting/excision gingivectomy |
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need to treat perio before restorations to |
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 |
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biological width |
the width of soft tissue attached to the tooth crown to the crest of the alveolar bone, usually 2mm, needs to be maintained |
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