Indeed, many clinical studies have confirmed that most patients, even with intensive hygiene phase therapy and regular re-enforcement of plaque control meas… A child under … d.Additional corrective therapy (surgical phase): During this stage of periodontal treatment the bone damage that is already done to the alveolar bone due to the periodontal disease is surgically corrected. Fundamental phase . Softer bristles have greater flexibility, and have been shown to reach further interproximally and subgingivally. denture brushes – which may be used with partial or complete dentures. When people struggle to pay for housing, transportation, food, clothing, and medicine, dental care might be restricted … During this surgical phase of the periodontal treatment, the periodontist will select the most appropriate surgical technique for your lesions, depending on the type and severity of the damages that were not eradicated during the first phase of the treatment (root scaling and laser application). sites of gingival recession, furcations and large interdental spaces, orthodontic toothbrushes – which have a V-shaped indentation along the head of bristles to accommodate the components of fixed orthodontic appliances. This may be because of better mechanical cleaning, although the novelty of using a powered toothbrush may also improve compliance, especially in children. Aim: The aim of the present study was to investigate the effect of a 3-month strict oral hygiene phase on key parameters of periodontitis: plaque, bleeding on probing (BOP) and probing pocket depth (PPD). Periodontal treatment includes the following phases: a. supportive periodontal therapy (SPT Trimeric … Initial/ hygiene phase. The majority of patients use a “horizontal scrub” technique, which does not clean effectively around gingival margins and can lead to tooth wear. 4. The gingival pathology is caused by the dental plaque due to poor oral hygiene . Circular heads have an oscillating motion. Scaling, root planing, instruction in oral hygiene and occlusal adjustment were completed during four to six sessions for each patient. Reynolds M, Aichelmann-Reidy M, et al. Fig 2-1 A small number of the wide range of manual toothbrushes that are available on the market. Powered by Leader School. In the private practice setting, the treatment of patients with periodontal disease is best accomplished within the structure of a uniform and … Scaling and Root Planing. Dahlen, Lindhe, Sato, Hanamura, and Okamoto reported a substantial reduction in supragingival plaque and BOP after 3 months of supervised oral hygiene (4–8 supervision visits), using soft toothbrushes, interdental brushes and triangular toothpicks among 23 patients with moderate signs of periodontitis, and 2 years … Materials and methods: Forty-four patients with severe periodontal disease were randomly allocated to a test or a control group. The Charters’ method is useful for gentle gingival cleaning, particularly during healing immediately after periodontal surgery and for patients with necrotising gingivitis in whom the painful symptoms have resolved. For this purpose ultra sounds and curettes are utilized. Effective plaque control results in resolution of gingival inflammation and is fundamentally important in all periodontal therapy. It is, however, unrealistic to expect patients to achieve a plaque-free dentition. - Duration: 27:49. Many adjunctive treatment modalities have been clinically used and investigated for their efficacy. Indeed, many clinical studies have confirmed that most patients, even with intensive hygiene phase therapy and regular re-enforcement of plaque control measures, will still have about 10–15% of tooth surfaces with residual plaque deposits. Abrasives (approximately 20–40% of the content) enhance plaque removal, but may result in damage to the tooth surface if there is overzealous brushing. Bundles of bristles are arranged in rows in a rectangular head or in a circular pattern mounted in a round head. Both, the time at which the laser will be applied during the periodontal treatment and the type of laser to be used – and in which way – are individually chosen by the periodontist. Numerous studies have confirmed that, for most patients, powered brushes are more effective than manual toothbrushes. Systemic Antibiotics - In some cases, systemic antibiotics (orally administered) that specifically target periodontal pathogens are prescribed at the time of SRP procedures. In order to achieve this, patients must be made aware that they are different from the general population with respect to their susceptibility to periodontitis and, consequently, they must achieve exceptionally high standards of homecare if treatment is to succeed. Patients refuse treatment for a variety of reasons, but one of the main ones is finances. Homecare, plaque control programmes and hygiene phase therapy are crucial components of non-surgical periodontal therapy. A typical, conventional, manual toothbrush is likely to conform to the following standards: brush head dimensions – 1.5–2.5cm long and 0.15–0.75cm wide. All Rights Reserved.Eirini Georgiou additional measures such as periodontal surgery, and/or endodontic therapy, implant surgery, restorative, orthodontic and/or prosthetic treatment • Maintenance phase (care), i.e. As dentists, we use special instruments to clean teeth below the gumline and disrupt any plaque growing below the gumline. Patients who have deep pockets (gaps between gum and teeth) or have need for crown lengthening are good candidates for this first phase of surgical treatment. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Non-surgical periodontal treatment does have its limitations. 5. If necessary, x-ray examination is also conducted, either for a specific area or the whole oral cavity. For this purpose ultra sounds and curettes are utilized. Scaling and Root Planning . Smokers’ toothpastes and tooth powders contain significantly higher proportions of abrasives and their use is not recommended. Due to the fact that periodontal disease is caused by bacteria, and since the bacteria inhabit the mouth on a permanent basis, the percentage of periodontal disease relapse increases, if frequent professional care and examination is neglected. chlorhexidine) may be added to toothpastes. Routine dental and dental hygiene treatment can occur B. 1988 Summer;43(3-5):92-4. Also consider tapping into the talents of your dental assistant. For the vast majority of patients with chronic periodontitis, this standard of tooth cleaning may be found to be acceptable. Mechanical plaque control is performed using toothbrushes, toothpaste and other cleaning aids. Plaque control programmes should be tailored to the requirements of individual patients, addressing their local risk factors at the whole mouth, tooth and site levels (see book 1 in this series, Understanding Periodontal Diseases: Assessment and Diagnostic Procedure in Practice). To be more specific, the need for surgical correction of periodontal lesions after laser treatment in our clinic is contained to be less than 1% of the cases. Some are under the patient’s control, and may, therefore, require lifestyle changes to achieve significant modification. Learn more about the periodontist Dr. Eirini Georgiou ►. Mixed Makeup Recommended for you If necessary, reinforce or change advice, Professional prophylaxis to remove residual stained plaque, Always be positive and praise the patient’s efforts. © 2020 PerioExperts.com. At the conclusion of the hygienic phase, the therapist has the opportunity to eval- uate the patient's tissue response and oral hygienic effectiveness. The traditional design of brush head operates with a side-to-side or back and forth motion. To provide a comprehensive overview of the methods that are available for the mechanical and chemical control of dental plaque. periodontal therapy is to reduce the burden of pathogenic bacteria and thereby reduce the potential for progressive inflammation and recur-rence of disease. This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque , calculus (dental) , restoration of tooth decay and correction of defective restoration as these all contribute to gingival inflammation, also known as gingivitis . Periodontists are dentistry's e​xperts in treating periodontal disease. dental hygiene treatment outcomes. e.Preservation of the treatment result (supportive periodontal therapy). four rows of “bristles” of medium texture and made from nylon polymer filaments of 10–12mm length. Fig 8-4 Disclosed plaque. Phase II: Correction of damage that has resulted from the periodontal disease. 1. programmable pacers that provide feedback to signal the amount of time that has been spent in one part (quadrant) of the mouth. Plaque control refers to the removal of plaque from tooth surfaces and gingival tissues, and prevention of new microbial growth. The Bass technique is useful for the majority of patients with or without periodontal disease (Fig 2-4). The aim of this review is to discuss the evidence behind the Clinical trials in the 1980s confirmed that plaque control may be taught effectively in two 15 minute appointments (Table 2-1). The initial phase in the traditional treatment of periodon- titis consists of nonsurgical t herapy including motivation, oral hygiene instructions and subgingival scaling [1]. Fig 2-2 Specialist toothbrushes: (left to right) a child’s toothbrush, a single tufted toothbrush and an orthodontic toothbrush used to clean around the components of fixed orthodontic appliances. phase. nonsurgical periodontal therapy, initial periodontal therapy, hygiene phase therapy, mechanic therapy and cause-related periodontal therapy. Garrett S. Periodontal regeneration around natural teeth. and ≥ 7 mm prior to treatment were compared to their posttreatment scores. The efficacy of bone replacement grafts in the treatment of periodontal osseous defects. The periodontal sta- tus at this time is compared to the pre- treatment findings, and decisions are made 6. • Systemic phase of therapy including smoking counseling • Initial (or hygiene) phase of periodontal therapy, i.e. Phase 2 is correcting any defects resulting from periodontal disease, and is the first surgical phase necessary if non-surgical therapy isn’t enough. All patients go through this stage after having completed their periodontal treatment. They usually have a dual-purpose head with tapered bristles that are much firmer than those of a conventional toothbrush. Controlling Systemic Risk Factors.Several risk factors have well established associations with both periodontal and systemic diseases, such as diabetes, smoking, stress, immunodeficiency, medications, obesity, hormones, and nutrition. After reading this chapter the practitioner should: be aware of the range of toothbrush designs and interdental cleaning aids that are available, understand the indications for using chemical plaque control. b.Cause related periodontal treatment (non surgical phase): During this phase, local anesthesia is administered and then microbial plaque and calculus that are under the gums and in contact with the teeth roots are removed. Created by Leader Online. b.Cause related periodontal treatment (non surgical phase): During this phase, local anesthesia is administered and then microbial plaque and calculus that are under the gums and in contact with the teeth roots are removed. Once the factors responsible for the periodontal disease have been controlled or eliminated, the goal of treatment becomes the correction of residual damage, thereby creating an environment that can more easily be maintained in a state of health. To prevent engaging in malpractice, and to treat your patients with their best interests in mind first, we need to be attentive to each phase of dentistry. Results of various modalities of periodontal therapy were studied in 90 subjects (mean age 45 years) with moderate to severe periodontitis. This stage can be applied either immediately after the curettage stage of the periodontal therapy, or a while after. 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