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NSPT Scaling and Root Planing
Terms in this set (57)
Overview steps of NSPT
1. Address Chief complaint, Pt Hx, Dental Hx, Comprehensie Exam
5. Treatment Plan
6. Disease Control, Surgery, Restoration Maintenance
What is Phase 1 of treatment plan?
List examples of things Dentist can do during Phase 1/Disease Control?
Prophy, Root Planing, Extraction of Hopeless Teeth, Remove iatrogenic factors, caries control, occlusion control, OHI
What are the two major forms of inflammatory disease affecting periodontium?
Gingivitis and Periodontitis
Main outcome of periodontal disease
inflammation and destruction
Dental Biofilm-Induced Gingivitis (reversible/irreversible)
List clinical signs of biofilm-induced gingivitis
Inflammation, Plaque, Calculus
Since Oral Hygiene alone isn't sufficient in treating gingivitis, what else is needed?
Patient Compliance, Professional Plaque Control
When is OHI given?
Steps of Gingivitis Therapy
1. Index (using pink tabs)
5. Eliminate local etiological factors
List local contributing factors affecting oral hygiene maintenance
Calculus, Overhang, Restoration margin, Poor Contact, Overcontered Restoration, Caries, Poor Temps
Removal of calculus from crown of teeth
Scaling uses what type of strokes?
Short, powerful pull
Scaling is only supra gingival. T/F
Both supra-gingival and sub-gingival
What is the therapeutic goal when treating gingivitis?
Return to healthy, reduced inflammation
Periodontitis therapy's two main approaches
1. Anti-infective/Resective Treatment
2. Regenerative Therapy
Define Anti-infective/Resective Treatment
Halt progression of periodontal attachment loss by removing etiological factors
Define regenerative therapy
includes anti-infective treatment AND restores structures destroyed by disease
Periodontitis can be treated without controlling supra-gingival plaque. T/F
List a few non-surgical periodontal therapies
Scaling & Root Planning, Polishing, OHI, Eliminating etiological factors, giving local or systemic antibiotics
List local factors that interfere with oral hygiene and predispose to periodontitis?
Calculus, Overhang, Open Contacts, Restoration margins, Caries, ill-fitting prosthesis, Crowding, Root proximity
Define Root Planing
Subgingival instrumentation to remove calculus/plaque on the root surface and contaminated cementum
Why do we want a smooth root surface?
No granulations= less plaque retention
Describe the root planing stroke
Moderate pull strokes for final smoothing
Root Planing and scaling both use hand-tools, sonic, and ultrasonic tools. (T/F)
Root planing is the _____________ of periodontal treatment
What is considered the gold standard of periodontal treatment?
Therapeutic Goals when treating Periodontitis (there's a lot, I'm going to just list 4)
- To resolve inflammation and establish gingiva health
- To eliminate microbial etiology
- To arrest progression of disease
- To reduce/eliminate pockets
List patient-related factors that dentists should consider during treatment
Systemic Health, age, compliance, therapeutic preference
In gingivitis, scaling should be limited to ____
tooth crown ONLY
In periodontitis, scaling should be done where
Coronal and/or radicular surfaces
Root Planing is time consuming, and technically demanding. (T/F)
How many quadrants are root planed at a time?
Two, sometimes it requires local anesthetic
Periodontal reattachment is done by _______________
long junctional epithelium
Made from grafting precursor cells
Periodontal Healing has four parts. They are?
Repair, Reattachment, Regeneration, and New Attachment
repair areas of root not previously exposed to the pocket
Natural renewal of a structure
Define New Attachment
Embedding new PD ligament fibers into new cementum and attachment of gingival epithelium to a tooth surface previously denuded by disease
Characteristics of the 11/12 explorer
- Small fine tip (easy insert)
- Universal application
What instruments would you use on natural teeth? Be specific.
Hand Instruments: Scalers + Curettes
Power-Driven Instruments: Ultrasonics
Characteristics of a scaler
- used supra-gingivally
- Curved and straight
Characteristics of a curette
- used subgingivally
- Universal vs Area-specific (Gracey)
What's the difference between a universal and Gracey curette?
Universal: 90 angle and two cutting edges, used on all surfaces
Gracey: 70 degree angle with one cutting edge, used in specific areas
If I describe a curette with a round back, round toe, semi-circular cross section, and 70 degree angle....which curette am I using?
Gracey/ Area-specific curette
Characteristics of power-driven instruments
- Rapid calculus and stain removal
- minimal discomfort to patient
- Used supra AND sub gingivally
Limitations of Hand Instruments (3)
1. Technique Sensi
2. Anatomic limitations
3. Instrument Limitations (size)
List limitations of Ultrasonic instruments
1. Altered tactile sensation
2. Fluid control, evac
3. Effects of noise, vibrations
4. Contamination w aersol
5. Caution with pacemakers
Advantages of Ultrasonic Instruments
1. Reduced clinician fatigue
2. Less repetitive stress
3. Increases access
4. less tissue distention
5. Water irrigation
Plaque removal can be equally accomplished by power-driven scalers and hand-instruments. (T/F)
True, manual just takes longer
Smoothest roots are produced by using
Ultrasonic followed by Curette
List some side effects of SRP
Bleeding, Gingiva Tear, Pain, Periodontal Abscess, dental hypersensitivity from exposed cementum
Which of these is used for anteriors?
How does probing depth affect SRP??
Deeper pockets= harder to remove calculus, since most probes can't go deeper than 6mm
How does root surface affect SRP?
Interproximal cleaning gets harder with increase PD
Furcation is more like to happen in (maxillary/mandibular) molars
SRP on a tooth under ________mm will result in attachment loss
Why do we only do scaling on major pocket depths, like greater than 4.2?
SRP on a tooth with a pocket depth of less than 4.2 results in attachment loss
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