Local Anesthesia
Local anesthesia is most often used during NSPT to make patients comfortable during the deep cleaning. What is the "gold standard" anesthetic?
2% Lidocaine 1:100,000
Name one form of adjunctive therapy used in some NSPT patients.
1.) Periochip
2.) Arestin
3.) Atridox
4.) Chlorhexidine
What is the #1 indicator that periodontal disease is present?
Attachment loss
After NSPT, one example of an expected clinical response is:
1.) A reduction in pocket depths
2.) Fewer bleeding sites
3.) Positive tissue response (less reddened & inflamed tissue)
Define a "working stroke" when removing hard calculus deposits during NSPT.
Overlapping, multidirectional, & shorter/biting strokes are used.
What anesthetic is contraindicated for a NSPT patient with COPD?
Prilocaine
When would adjunctive therapy be utilized?
When patients do not respond to conventional mechanical therapy, such as NSPT.
True or false: absence of bleeding is an indicator of a healthy periodontium.
False: those who smoke have little to no bleeding during periodontal assessments.
Name 3 factors influencing the need for NSPT:
1.) Deep pocket depths
2.) Smoking/tobacco use
3.) Poor maintenance of home care
4.) Medically compromised patients
5.) Stress
An instrument with a complex shank would be utilized where?
Posterior teeth
What are all of the injections needed to anesthetize the maxillary posterior teeth?
PSA
What form of adjunctive therapy contains minocycline hydrochloride?
Arestin
While completing a periodontal chart on a NSPT patient, a clinician is able to penetrate into a furcation with a Nabor's probe but does not completely pass through to the other side. What furcation grade is this?
Class II furcation
The most commonly seen form of periodontitis, rate of disease progression appears slow, usually no discomfort. NSPT is indicated.
Chronic periodontitis
There is a piece of tenacious calculus left over on the distal of tooth #16. What instrument would be best to remove this?
Gracey 13/14 or 17/18
What is the reasoning behind taking someone's blood pressure before administering local anesthesia?
To establish a baseline.
Explain what a PerioChip is.
A 4 x 5 mm degradable chip in a gelatin matrix; remains in the periodontal pocket for 7-10 days, slowly releasing the antiseptic. It may be placed every 3 months in residual pockets of 5 mm or more.
A NSPT patient has generalized inflammation of the gingiva. Where is the position of the gingiva in relation to the CEJ?
The gingiva is coronal to the CEJ.
True/false: Patients with systemic conditions that contribute to progression of periodontal diseases may be successfully treated using established periodontal treatment techniques, like NSPT. However, systemic/psychological status of the periodontal patient may alter the nature of therapy rendered and may adversely affect treatment outcomes.
Both statements are true.
When would you use tapping motions with the ultrasonic tip?
To break apart large calculus deposits.
List 2 instances in which a vasoconstrictor is absolutely contraindicated for a NSPT patient.
1.) Cocaine use within the last 24 hours
2.) Recent MI within the last 6 months
3.) Uncontrolled angina, hypertension, or other cardiovascular condition
4.) Recent coronary artery bypass surgery
Define what a thixotropic characteristic is.
A trait of Atridox: the ability of the product to convert from a gel to a hard, plastic state when it comes in contact with moisture in the pocket.
A patient who presents with 3-4 mm of bone loss on their radiographs, has between 3-5 mm probe depth readings, and generalized BOP would be what classification of periodontal disease?
Moderate periodontitis
Define "site of active disease" that would indicate a need for NSPT.
Continued apical migration of the junctional epithelium.
A scaler with a short tip and a contra-angled shank is best for:
Posterior deep pocket