⭐ TREATMENT PLAN OF PERIODONTOLOGY :
📌 POINTS TO PONDER
📣 Sequence of periodontal therapy:
🔹Emergency/preliminary phase.
🔹Phase I: Etiotropic phase.
🔹Phase II: Surgical phase.
🔹Phase III: Restorative phase.
🔹Phase IV: Maintenance phase.
📣 PALLIATIVE TREATMENT
🔺Following are the candidates for palliative treatment:
🔹Patients with short-life expectancy either due to advanced age/systemic diseases with poor survival prognosis, such as poorly controlled diabetes or valvular heart defects.
🔹Patients with severe mental and physical disabilities.
🔹Patients with severe furcation involvement.
🔹Patients with limited financial ability.
🔹Noncooperative patients for existing procedures.
📣 Referral
🔺There are 3 basic reasons for referral:
🔸Professional referrals may be medical or dental
🔸Moral and ethical
🔸Legal
📌 MCQs
💡 Which of all the following come under Phase I therapy:
A. Excavation of caries
B. Chemical plaque control
C. Removal of calculus
D. All of the above
Answer : D
💡Implant surgery is done in:
A. Phase I
B. Phase II
C. Phase III
D. Phase IV
Answer: B
💡Extraction of hopeless teeth is done in:
A. Emergency Phase
B. Phase I
C. Phase II
D. Phase III
Answer : A
📌 VIVA VOCE
Q1. In which phase, extraction of hopeless tooth is done?
Ans. Emergency/preliminary phase.
Q2. In which phase, occlusal therapy is done?
Ans. Phase I: Etiotropic phase.
Q3. In which phase, implant is placed surgically?
Ans. Phase II: Surgical phase.
Q4. In which phase, excavation of caries is done?
Ans. Phase I: Etiotropic phase.
Q5. What is the primary goal of phase I?
Ans. Elimination of inflammation and plaque control.
Q6. In which phase, Correction of restorative and prosthetic irritational factors is done?
Ans. Phase I: Etiotropic phase.
Q7. In which phase, provisional splinting is done?
Ans. Phase I: Etiotropic phase.
Q8. In which phase, fabrication of fixed or removable prosthesis is done?
Ans. Phase III: Restorative phase.
Q9. In which phase, root canal therapy is done?
Ans. Phase II: Surgical phase.
Q10. What are the three basic reasons for referral?
Ans. Professional referrals; moral and ethical; legal.
⭐ MECHANICAL PLAQUE CONTROL
📌 POINTS TO PONDER
🔹Adjunctive aids used for cleansing oral cavity are irrigators, tongue scrapers and dentifrices.
🔹Tooth powders contain about 95% abrasives and 5 times more abrasive than pastes.
🔹Detergents found in dentifrices denature lectin adhesins.
🔹Approximal areas are the visible spaces between teeth that are not under the contact area and interproximal areas refer to the area under and related to the contact point.
🔹“Hawthorne effect”, which occurs when research subjects behave differently because they realize that they are being observed.
🔹Interdental cleaning aids are dental floss, dental tape, interdental brushes, interdental tips, wooden tips, rubber tips and plastic tips.
📣 ADA specifications of toothbrush
🔸Length – 1 to 1.25 inches
🔸Width – 5/16 to 3/8 inches
🔸Rows – 2 to 4 rows of bristles
🔸Tufts – 5 to 12 per row
📣 Bass recommendation for toothbrush
🔸Handle : Plain straight handle of 6-inch long and width about 7/16-inch.
🔸Head: High quality nylon bristles.
🔸Rows: 3 rows of bristles.
🔸Tufts: 6 tufts per row, evenly spaced tufts.
🔸Bristles: 80–86 bristles per tuft.
🔸Bristles diameter: 0.007-inch (0.18 mm).
🔸Bristles length: 0.406-inch (10 mm).
🔸Round-ended bristles
📣 Diameter of bristles
🔺Bristle diameter ranges from soft to hard.
🔹Soft: 0.2 mm/0.007-inches.
🔹Medium: 0.3 mm/0.012-inches.
🔹Hard: 0.4 mm/0.014-inches.
🔹Filament stiffness : α diameter square/length square
📣 Methods
🔺Toothbrushing Methods which are categorized according to pattern of motion during action of brushing:
🔹Roll: Roll and modified Stillman method.
🔹Vibratory: Stillman, Charter and Bass method.
🔹Sulcular: Bass method.
🔹Circular: Fones method.
🔹Vertical: Leonard method.
🔹Horizontal: Horizontal and scrub method.
🔹Physiologic: Smith method.
📌 VIVA VOCE
Q1. What is oral physioprophylaxis?
Ans. Physical resources described by the dentist to prevent oral diseases, especially periodontal diseases.
Q2. What is a novel toothbrush design?
Ans. The head is located horizontal to the tooth surface, multiple tufts of bristles are angled in the different directions of the approximal tooth surfaces. This design aims of improving plaque removal in approximal areas and based on the fact that the majority of the subjects use a simple horizontal brushing action.
Q3. What is the difference between bass and modified bass toothbrushing method?
Ans. In modified bass method, bristles are swept towards the occlusal surface after completing the vibratory motion in the gingival sulcus.
Q4. After how much time toothbrush should be changed?
Ans. Brush should be replaced before filaments fray, at least every 2–3 months. But patients who are debilitated, have a known infection or are about to undergo surgery should be advised to disinfect their brushes or use disposable brushes.
Q5. Which disclosing agents differentiate between old or thick plaque accumulations and recent or thin plaque accumulations?
Ans. Two-tone dye test that uses FDC red No. 3 and FDC green No. 3. The solution stains thick accumulation of plaque as blue and thin deposits are stained red or pink.
Q6. Where Modified Stillman method is indicated?
Ans. Gingival recession and root exposure.
Q7. Which toothbrushing technique is advised after periodontal surgery?
Ans. Charters toothbrushing method.
Q8. What is superfloss?
Ans.It is a type of floss that consists of both rigid plastic portion and spongy portion.
Q9. Which interdental aid is used in Type 1 embrasures where no gingival recession present?
Ans. Dental floss.
Q10. What are the advantages of interdental brushes over dental floss?
Ans. The advantages of interdental brushes over dental floss are that interdental brushes clean concave root surface and furcations more efficiently than dental floss and are much easier to use than dental floss.