2.2 Nonsurgical Periodontal Therapy

• OHI

• SRP

• Gingival curettage

• Occlusal evaluation

• Coronal polishing

• Antimicrobial use

Procedures of NSPT

Scaling

Instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus, and stains from these surfaces. Removal of identifiable deposits of calculus; plaque is removed in the process. Achieved using sharp hand instruments and/or ultrasonic instruments

Root planing

Designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms. Goal remains the same to thoroughly clean the roots; the degree of smoothness has come under scrutiny. Accomplished using sharp hand instruments or ultrasonic instruments

Debridement

Proposed to take the place of SRP. Focus is pocket space and underlying tissues as well as root surfaces of the. Goal is to remove all hard and soft deposits with minimal tooth structure removal. Restore health, not necessarily smooth and glassy surface

Prophylaxis

Preventive procedure to remove local irritants to gingiva, including complete calculus removal followed by root planing. Focus is to assist patient in preservation of periodontal health

Coronal polishing

Use of polishing agents to remove stains from the teeth. It also removes surface deposits. Selective polishing is the current trend in tooth conservation and identified need.

True

T/F: The presence of plaque does not interfere with fluoride uptake

Gingival curettage

Scraping or cleaning the walls of a cavity or surface by means of curet. Closed curettage procedure that removes the inflamed sulcular epithelium and attempts to remove all pocket lining.

True

T/F: Healing following curettage does not result in increased or new CT attachment

Long junctional epithelium

What tissue is formed following healing from curettage?

One week

How long does epithelial healing take following curettage?

Apical

Following curettage healing, hemidesmosomes begin to reattach at which end of the JE?

Weeks or months

How long does it take for CT to heal following curettage procedure?

4 weeks

How long should probing be avoided during healing of the underlying CT?

5-12 days

How long does sulcular lining healing take following gingival curettage?

Spirochetes and capnocytophaga

Which microorganisms are some of the last to populate, taking up to 6 months, following gingival curettage?

3-6 weeks

When does the greatest amount of healing take place after NSPT?

None; 1 mm; 1.5-3 mm

How much improvement is expected to be seen in PPDs 1-3 mm following NSPT? 4-6 mm? 7 and greater?

False

T/F: In general, distal surfaces are debrided more thoroughly than mesial surfaces

True

T/F: Longer shanks are not necessarily better than conventional shanks

Tetracycline, metronidazole, and sometimes penicillin

What are the most often used systemic antibiotics used to treat aggressive forms of periodontitis?

False

T/F: Irrigation is just as effective without debriding the area first

• Chlorhexidine

• Stannous fluoride

• Povidone-iodine

What are the 3 effective irrigants used in adjunct therapy?

False

T/F: Lasers are an acceptable method for debriding tooth surfaces

• Meticulous root debridement

• Regular maintenance visits

• Good daily OH

• Adjunctive therapies for nonresponsive cases

What are recommendations for increased reliable and predictable results of periodontal treatment?

• VSCs

• Salivary flow

• Eating

• Periodontitis

• Tongue hygiene

What are mechanisms of halitosis?