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Chapter 21 Response to Nonsurgical Therapy (Key Words (Inflammatory…
Chapter 21 Response to Nonsurgical Therapy
Key Words
Inflammatory periodontal disease
A group of inflammatory diseases of the periodontium including gingivitis and periodontitis
Periodontal debridement
The removal of a foreign material (e.g., plaque, calculus) or dead tissue from the crown, root surface, pocket space, pocket wall, and bone surface
Periodontal therapy
Treatment of the periodontal lesion
Prophylaxis
Prevention of disease
Reevaluation
Pertaining to evaluation the results of therapy a second time (e.g., evaluating the results of initial or surgical therapy).
Root planing
A treatment procedure designed to remove cementum or surface dentin that is rough, impregnated with calculus, or contaminated with toxins or microorganisms
Scaling
The removal of dental plaque, calculus, and stains from the crown and root surfaces
Soft- tissue healing
Natural process by which the body repairs itself after periodontal debridement or surgery
Gain in clinical attachment
A decrease in probing depths after periodontal therapy due to an increase in resistance of the periodontal probe into the tissue and maybe gingival recession. The inflamed tissue is replaced by form collagen fibers
Subgingival debridement
Other term: Subgingival scaling. Removal of plaque and calculus apical to the gingival margin
Deplaqing
The removal of subgingival dental plaque after the completion of periodontal debridement. It is performed at the reevaluation/supportive periodontal therapy appointments
Supragingival debridement
Other term: supragingival scaling. Removal of plaque and calculus coronal to the gingival margin
Rapid Dental Hint
Remember that when measuring clinical attachment level, you use the cementoenamel junction (CEJ) as your reference point to take the measurement
Shallower probing depth readings occur after debridement because healing occur with a long junctional epithelium and/or reduction in inflammation
Nonsurgical Periodontal Therapy
Box 21-1: Reevaluation Measurements
Clinical attachment levels (CALs)
Bleeding on probing
Probing depths
Tooth mobility
Soft tissue status
Furcation involvement
Oral hygiene status
Biofilm index
Box 21-2: Reevaluation of Initial Therapy
After scaling and root planing, there is reestablishment of the junctional epithelium to the tooth surface in 1 to 2 weeks; reevaluation before 2 weeks is too early
After scaling and root planing, the repair of connective tissue continues for 4 to 8 weeks
Longer than 2 months may be too long to wait for the revaluation because pathogenic bacteria have already repopulated periodontal pockets
Subgingival microbial repopulation occurs with a few months (2months) after instrumentation of periodontal pockets in the absence of improved biofilm control
Terminology
Periodontal Debridement