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Decision Making Related to Nonsurgical Periodontal Therapy

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Diana Macri

on 27 March 2016

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Transcript of Decision Making Related to Nonsurgical Periodontal Therapy

plaque removal
plaque control
supragingival scaling
subgingival scaling
root planing
use of adjunctive agents
Decision Making Related to Nonsurgical Periodontal Therapy
Oral prophylaxis
Host modulation therapy
Therapeutic endpoint
Clinical endpoint
Periodontal diagnosis
Disease severity
Disease activity
Phases of
Phase I
Phase II
Phase III
Phase IV
Therapeutic procedures:
Self-care education
Manual and mechanized instrumentation: scaling and root planing, periodontal debridement
Chemotherapeutic interventions
Pain-control strategies
Stain removal, as needed

Expected Outcomes
Change in the type of microbial colonization

2 weeks after perio debridement; the time required for initial reduction in clinical signs of inflammation
4-6 week-reeval- Box 30-2 Factors to consider for reevaluation
to preserve, maintain and improve the natural dentition, implants and peridontium
to achieve function, health, comfort, aesthetics
The removal and control of oral biofilm through self-care and professional periodontal debridement
**the absence of inflammation characterizes health!!**
AAP classification
Variables in care planning approaches:
Classification and diagnosis of periodontitis
Severity of periodontitis
Systemic health or disease of client
Client’s human needs
Practitioner’s philosophy of care

Subgingival therapy does not significantly affect other areas (e.g., tongue, tonsillar area) that might be a source for reemerging periodontal bacteria
Minimal or no bone repair occurs after scaling and root planing

species seen in aggressive perio are not eradicated
clinical endpoint
therapeutic endpoint
Perio Maintenance Therapy
PM continues for the life of the dentition or its implant replacements
Clients with gingivitis and periodontitis have a chronic disease entity that must be controlled by frequent periodontal care and daily self-care

Table 30-3 p. 543, Suggested PM Intervals

What is NSPT?
Important Concepts:
NSPT has been shown to arrest periodontitis
The main focus of NSPT is oral self-care education (client's responsibility) and the mechanical removal of biofilm and biofilm retentive factors (clinician's responsibility)
The hyperinflammatory response of the host is responsible for the destruction of collagen and bone (i.e. periodontitis)
The goal of periodontal surgery is to enhance access so that clinician and client can keep areas clean
Quadrant periodontal debridement, full-mouth debridement and full-mouth disinfection (FMD) are all viable approaches
"Treatment plans are developed according to professional standards and client needs, not according to the provisions of the client's insurance policy" (Darby, p.544)
Procedure Codes for NSPT (created by the ADA)

274 Bitewings – four (4) radiographic images
277 Vertical bitewings – seven (7) to eight (8) radiographic images
210 Intraoral complete series of radiographic images
Full transcript