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describe the various types of nonsurgical periodontal therapy

november 30, 2020 Geen categorie 0 comments

Some residual calculus is likely to remain after dental hygiene treatment, especially in deeper pockets, but patients can probably tolerate some small amount. J Clin Periodontol. It describes. In fact, in some studies, gingivae next to root surfaces that were notched for orientation of researchers after tooth extraction healed uneventfully in the mouth. Learning Outcomes • Define nonsurgical periodontal therapy. Hydrodynamic theory of dentinal sensitivity. Nonsurgical therapy includes the procedures listed in. Kepic and colleagues, Achieving root smoothness is important for evaluating short-term goals during treatment appointments. Studies indicate that endotoxins do not penetrate deeply into cemental surfaces and that retained toxins are associated with missed calculus and plaque rather than diseased cementum. The goal of root planing, leaving the roots clean, has not changed, but the extent to which root tissue is scraped away to create a glassy, hard texture has been under scrutiny. Experience suggests that the roots in an individual patient’s mouth will feel equally smooth after thorough instrumentation. A study published in the 1980s compared the performance of hand instruments with that of ultrasonic tips in the removal of plaque in pockets. Thus, the rationale for root planing to remove root roughness and achieve glassy, smooth root surfaces is no longer valid. Smooth root surfaces do not appear to promote better or faster healing than rough surfaces. The thoroughness of calculus removal by instrumentation has been studied and shows surprising results. Because of the fragile state of healing connective tissues, probing after treatment should be avoided for 4 weeks.17. The definitions of procedures must be clear and consistent. Scaling and periodontal debridement are effective in reducing the volume of plaque biofilm bacteria in treated sites. The term is commonly used and has several variations: oral prophylaxis, dental prophylaxis or, simply, prophy. In the early stages it may not even be noticeable to you. Your periodontist is best trained to determine if this treatment approach will help your specific condition. Treatment frequently requires the use of pain control measures. Curettage had been defined by the AAP as scraping or cleaning the walls of a cavity or surface by means of a curette.12 It is a commonly misused term, often applied to a variety of procedures from removal of the pocket lining, termed closed curettage, to a surgical flap procedure called open curettage. In its broadest sense, nonsurgical therapy defines all of the procedures performed to treat gingival and periodontal diseases up to the time of reevaluation, which is when patients begin maintenance care and the need for periodontal surgery to enhance results is determined. The difference between scaling and root planing is a matter of degree; root planing involves a specific effort to instrument every portion of the root surfaces, not simply identifiable calculus deposits. One size fits all grit paste ignores the science of abrasion, can cause sensitivity, and damage aesthetic restorations.5. • Identify the techniques and applications for nonsurgical periodontal therapy procedures. This article presents the essential elements of a PTPincluding diagnosis, treatment planning, implementation of therapy, assessment and monitoring of therapy, insur-ance coding, introduction of the patient to periodontal therapy, and enhanced verbal skills. One side was treated with conventional root planing and the other with calculus carefully flicked off and root surfaces polished before the tissue was sutured back in place. Most importantly, no surfaces should feel rough, as if calculus is still present. Thus, the rationale for root planing to remove root roughness and achieve glassy, smooth root surfaces is no longer valid. Local anesthetics are also used to numb the area for greater comfort. This rationale has been questioned for many years and the procedure is no longer considered standard treatment.21,22. Due to the contradicting findings in the literature, we wanted to evaluate the influence of nonsurgical periodontal therapy on the metabolic control in type 1 diabetes in Malaysian subjects. These local factors are described in. Phyllis L. Beemsterboer and Dorothy A. Perry. True, this will increase the manageability of the tissues during surgery and allows for better healing What term is used when the healing outcome after surgery does not replicate the tissues originally lost, but rather there is formation of a long junctional epithelium? Calculus, although not an etiologic agent in itself, is virtually always associated with plaque biofilm, and its removal is associated with improved periodontal health. Collectively, these methods represent the fundamentals of non-surgical periodontal therapy. When treating gum disease, it is often best to begin with a non-surgical approach consisting of one or more of the following: Scaling and Root Planing. It varies in crystal composition, type of attachment, and degree of difficulty in removal (see Chapter 5). Smooth root surfaces do not appear to promote better or faster healing than rough surfaces. Abrasives used during polishing can scratch amalgam, composite resin, and gold restorative materials. However, subgingival plaque is not effectively altered by supragingival oral hygiene procedures, especially in deeper pockets of 5 mm or more. After periodontal debridement is performed (unless there are systemic complications) periodontal pockets, alveolar bone, periodontal ligament, and epithelium will heal. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. The dental hygienist must develop a tactile sense that permits detection of obvious calculus on the teeth. This indicated that roughness itself had no effect on wound healing. Although some periodontal destruction has been observed in germ-free (gnotobiotic) animal experiments, it tends to be localized and related to the impaction of foreign objects, such as hairs. Patient plaque biofilm control is a cornerstone of long-term successful nonsurgical therapy. The question remains whether root surfaces need to be glassy smooth. Nonsurgical periodontal treatment has been shown to control periodontal infection and to arrest progression of the disease in a significant number of cases. This chapter discusses the biologic basis and rationale for nonsurgical therapeutic procedures performed in the dental office. This uniform smoothness should be identified. The. Additional Services | Financial Policies | FAQs | Contact Our Office | Disclaimer | Sitemap. periodontally healthy sites. Inflammation and tissue destruction in conventionally raised animals with oral biota are vastly more widespread and severe. Because this system produces an extensive aerosol, it is contraindicated in patients with infectious diseases, respiratory illnesses, hypertension, or those who are on hemodialysis.10 The periodontal patient often has multiple exposed root surfaces and caution with the choice of polishing agent is advised. The cycle may take as long as 6 months to complete.8 Repopulation can be expected to vary for many reasons, one of which is clinician differences in complete removal of plaque biofilm and calculus. • Explain the benefits and indications of antimicrobial adjuncts to nonsurgical therapy. 2. Damage to the gums and bone support around the upper front teeth following the use of a laser. It was once thought that tooth surfaces had to be plaque-free to absorb fluoride during fluoride treatments, so polishing of teeth was performed routinely before office fluoride applications. “Root planing” involves cleaning plaque from below the gum line that is most often the culprits in periodontal disease. Clearly, this requires clinical experience and judgment on the part of the dental hygienist. 2008;35(Suppl 8):29-44. Normal turnover of cells in the junctional epithelium, which migrate from the apical end to the coronal end, takes about 5 days. This webinar will discuss the diagnosis and treatment planning of periodontal disease. The restoration of gingival health is the sum of good plaque control, complete scaling and periodontal debridement, and sufficient time for healing to occur—several months for complete healing of both the epithelium and connective tissue. Figure 1: Pre-treatment radiographs. Specific definitions accepted in the dental hygiene community, The American Academy of Periodontology (AAP) defines scaling as “instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus, and stains from these surfaces.”, Scaling may be accomplished with sharp hand instruments or with, Root planing is defined by the AAP as “a treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms.”. Dental hygiene procedures with hand instruments or powered scalers adequately accomplish subgingival plaque biofilm removal. Bacteria repopulate in a specific order, starting with, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window). zt THE INFLUENCE OF NON-SURGICAL PERIODONTAL THERAPY ON SALIVARY MELATONIN LEVELS: A PILOT STUDY Kristina Bertl1, Angelika Schoiber1, Hady Haririan1, Markus Laky1,2, Oleh Andrukhov1, Irene Womastek3, Michael Matejka1, and Xiaohui Rausch-Fan1 1 Department of Periodontology, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Austria 2 Department of Dental … After 6 weeks, the dentist will schedule an appointment to examine the patient’s response to the treatment. Removal of this tissue was assumed to enhance pocket reduction beyond the results achieved by scaling and root planing alone, providing faster healing and the formation of new connective tissue attachments to the root surfaces. Cortney Annese, RDH, says attention to detail, patient compliance, and proper selection of adjunctive antimicrobial agents for sustained plaque control are important elements in achieving successful long-term results. The diode laser in nonsurgical cause-related periodontal therapy 5. Supragingival oral hygiene procedures have limited effects on symptoms associated with deeper pockets, such as bleeding on probing.17, Subgingival plaque biofilm removal is essential in nonsurgical therapy to disrupt the established colonies of bacteria and let a younger plaque develop that is less associated with pathologic conditions. Research has shown that patients that have advanced periodontal disease can benefit from the use of these antimicrobial medications but only following scaling and root planing. ... that describe … Although some periodontal destruction has been observed in germ-free (gnotobiotic) animal experiments, it tends to be localized and related to the impaction of foreign objects, such as hairs. Plaque biofilm must also be dislodged from all accessible surfaces. Because this system produces an extensive aerosol, it is contraindicated in patients with infectious diseases, respiratory illnesses, hypertension, or those who are on hemodialysis. 4. Connective tissue fibers are disrupted and lysed beneath the epithelium. The concept of selective polishing emerged when research on enamel and root surfaces after polishing revealed changes in the hard tissues. • Describe the contributions of magnification with use of loupes, endoscopy, and microscopes to nonsurgical therapy. diagnosis and treatment of periodontal diseases. Inflammation will be resolved, long junctional epithelial attachment is likely to occur, and recession will often result. Dental hygiene procedures with hand instruments or powered scalers adequately accomplish subgingival plaque biofilm removal. Nonsurgical therapy includes the procedures listed in Table 13-1. Abrasives used during polishing can scratch amalgam, composite resin, and gold restorative materials. Other terms used to describe nonsurgical periodontal therapy include initial therapy,1 Phase I therapy,2,3 etiotropic phase,2 and periodontal debridement. The effects of nonsurgical periodontal therapy. The focus of the application of the instruments is to remove calculus and biofilms; success of treatment at the time of the therapy is assessed by explorer evaluation of root smoothness after scaling procedures to ensure calculus removal. The long-term goal of treatment is to restore gingival health. Supragingival oral hygiene procedures have limited effects on symptoms associated with deeper pockets, such as bleeding on probing. However, subgingival plaque is not effectively altered by supragingival oral hygiene procedures, especially in deeper pockets of 5 mm or more. Removal of this tissue was assumed to enhance pocket reduction beyond the results achieved by scaling and root planing alone, providing faster healing and the formation of new connective tissue attachments to the root surfaces. Root planing is defined by the AAP as “a treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms.”6 This procedure focuses not on identifiable deposits of calculus but on the entire root surface associated with the periodontal pocket. Describe the process of healing after periodontal debridement procedures, scaling, and root planing. These products are not effective as standalone treatment and are also not effective for long term control of advanced periodontal disease or with patients who have chronically deep gum pockets. However, subtle signs such as red or swollen gums, gums that bleed when brushed or flossed, chronic bad breath or loose teeth can alert you to the presence of gum disease and the need to see a periodontist. Scaling may be accomplished with sharp hand instruments or with sonic or ultrasonic instrumentation using powered scaling devices. Caution must be exercised with this device to prevent damage to exposed root surfaces; thus, its application for periodontal patients is limited. With non-surgical periodontal therapy, many patients can be treated and maintained without the need for surgical intervention. The American Dental Association states that the treatment is aimed to prevent further advancement of the disease, and it is a lifelong plan for treatment. An important goal in the treatment of gum disease is to rid the teeth and gums of pathogenic bacteria and the toxins they produce, which may become incorporated into the root surface of the teeth.

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