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Periodontology Exam 4.
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Periodontology Exam 4. Periodontology Exam 4. Periodontology Exam 4.
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Periodontology Exam 4Paradontax - haleon company; not ADA sealed
Paradontax with stannous fluoride is an anti cavity and anti gingivitis toothpaste that helps with
bleeding gums - 0.454 stannous fluoride, removes plaque more effectively than a sodium
monofluorophosphate (SMFP) toothpaste, removing 3 times more plaque build up
Paradontax Mouthrinse - contains 0.07 cetylpyrindinium chloride, CPC, a clinically proven anti
gingivitis ingredient, which kills 99.9% of plaque bacteria
Delivery of Chemical Agents in Periodontal Patients: Systemic Delivery - such as taking an antibiotic;
the chemotherapeutic agent is delivered into the body by swallowing, its circulated throughout the
body into the blood and eventually to the gingival crevicular fluid where it will meet up with the
bacterial microorganisms, once it reaches the site which is the base of the periodontal pocket, the
agent will work on the bacterial microorganisms either inhibiting or killing them
Delivery of Chemical Agents in Periodontal Patients: Topical/ Local Delivery - occurs when the
chemotherapeutic agent is delivered directly into the patient's mouth and locally delivered into the
periodontal pocket. when using this, the chemotherapeutic agent is impregnated in what is referred
to as a controlled release device and is placed into the periodontal pocket. it remains in the
periodontal pocket for several days and it will release the medication slowly over a period of time
Controlled Released - most common is tetracycline or chlorhexidine; can come in the form of fibrous
gels or chips; stays in the pocket over a period of time
Things to Consider When Using Chemical Agents in Periodontal Patients: Biofilm Resistance - biofilm
is a complex microbial community, resistant to chemical agents
extracellular matrix: biofilm is covered by this; creates a barrier so the chemical agents are not able
to contact the bacteria to disable or kill it
Things to Consider When Using Chemical Agents in Periodontal Patients: Microbial Reservoir -
patients may have these; a niche or cubbyhole or a secure place or location where the bacteria can
hide; hard to reach and hard to remove. bacteria will repopulate the newly cleaned gingival tissues
and periodontal pockets
Microbial Reservoirs that may occur in a patient's mouth - in protected sights such as furcations
,on residual calculus deposits not removed during therapy
within the connective tissue
in dentinal tubules
protected by irregularities in tooth surfaces
protected by bulky restorations
Mechanical removal is the most effective way to - accomplish biofilm removal; patient needs to use
toothbrush, floss, interproximal brush, and any other oral hygiene device to mechanically remove
the biofilm.
biofilm is removed at appointments with instruments
There are no biofilm agents that can - halt or stop periodontitis, but there are chemical agents out
there that can be used as a comprehensive treatment for periodontal patients
Criteria of an Effective Chemical Agent: Must reach the site of disease activity - the chemical agent
must reach the base of the pocket
Criteria of an Effective Chemical Agent: Must be - bacteriostatic or bactericidal
Bacteriostatic - inhibit or slow down the bacterial growth, allowing the immune
system to inactivate the bacteria
Bactericidal - disrupt the cell wall of the bacteria and bacteria will be killed
Criteria of an Effective Chemical Agent: Substantivity - must have the ability to remain in place long
enough to be effective
,Comparison of Drug Delivery Systems for Management of Periodontitis - STUDY THIS CHART
Chemical Agents Effective Against Periodontitis - no chemical agent that can stop periodontitis;
chemical agents are a good adjunctive therapy for patients with periodontal disease
Overview of Some of the Chemical Agents Used in Biofilm Control/ Chemotherapeutic Agents -
STUDY THIS CHART
What is an antibiotic? - a medication used to help fight infections either because they kill bacteria or
because they can inhibit the growth of the bacteria
What is a systemic antibiotic? - one that is taken orally; can also be injected but not in dentistry. in
dentistry, we do not inject systemic antibiotics. the patient is written a prescription for a pill that
they will swallow; shown to help control periodontal disease
Antibiotic Resistance - occurs when the bacteria are not affected by the antibiotic; bacteria do not
respond well to the antibiotic. the antibiotic is unable to kill or inhibit the microorganisms. patients
can build resistance if antibiotics are taken too frequently or for too long a period of time
In periodontal disease patients, we do not make a practice of giving them antibiotics due to the fact
that - we do not want them to build antibiotic resistance, and most periodontal patients respond
well to conventional mechanical periodontal therapy and do not need antibiotics
Most patients respond well to conventional mechanical periodontal therapy/ treatment, putting
them on antibiotics needs to be evaluated by the dentist. They need to look at the risks and the
benefits that will result for the patient if they are going to prescribe these - mechanical periodontal
therapy is referring to periodontal instrumentation, surgical procedures, control of local contributing
factors, and patients self care
Systemic Antibodies to Control Biofilm: Not for all patients, but Refractory Periodontal Conditions - is
a situation where systemic antibiotics
may assist the patient in better control of the periodontitis
Tetracycline - this is the drug of choice because of their properties; broad spectrum bacteriostatic
antibiotic
, Benefits of Tetracyclines: Higher concentrations of the drug are found in the - gingival crevicular
fluids and reach the area where the antimicrobials are harboring
Benefits of Tetracyclines: Are effective against - aggregatibacter actinomycetemcomitans (Aa) a
bacteria common in some periodontal disease conditions
Benefits of Tetracyclines: Inhibit the action of collagenase - this is one of the enzymes responsible for
the breakdown of the periodontium in periodontitis patients
Benefits of Tetracyclines: Subantimicrobial Dose - some tetracycline family members can be used as
a sub antimicrobial dose; the most commonly used in this is doxycycline in a 20mg tablet taken twice
a day. taking doxycycline is used as an adjunctive to periodontal instrumentation
Benefits of Tetracyclines: Subantimicrobial Dose: Effects of taking doxycycline over a long period of
time has not proven to have - antibiotic resistance
we do not usually put patients on these because of the worldwide antibiotic resistance issue
periodontal disease can be resistant to antibiotics, and this seems to be more as the biofilm agents
age and as they grow
Benefits of Tetracyclines: Examples of Systemic Antibiotics Studied for Use in Periodontal Care -
penicillin and amoxicillin
tetracyclines and tetracycline family drugs are the ones used most frequently
azithromycin
erythromycin
metronidazole
clindamycin
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