lunalovegood's version from 2015-10-08 02:07


Question Answer
Systemic Factors - smoking, diabetes, _____ etc.obesity
Studies on effectiveness of OHI consistently reveal that pt. adherence to PROPER DAILY oral hygiene regimens generally remains ____ (poor, astounding improvement)poor
A pt's behavior is influential, even _____, to the the success of perio therapy.critical
Pt. behavior - motivate ____ rather than impose externally, connect oral habits to something your pt. ____.internally, values
T/F - Possible motivators - esthetics, halitosis, general health, preventing disease recurrence, convince pt. you think oral hygiene is important.T
Learning Ladder - _____, awareness, self-interest, involvement, action, habit.unawareness (we spend $3bil on OH aids, marketing spends $300mil)
When do you teach OHI?FIRST, before providing treatment (tell, show, do plaque, pictures, personalize, pt. more receptive)
Do you have to teach toothbrush and flossing at the same time?no, you should have them master brushing then go on to flossing...
Dental Pellicle - ____ protein layer from saliva, crevicular fluid.glycoprotein
Bacterial colonization occurs within a few ____ (minutes, hours, days) of cleaning tooth surface.hours
Dental plaque is an orderly structure with between ____ and ____ different bacterial species.400-1000
"Brushing is stupid. Can I just use a water pick?"no, dental plaque is resistant to water rinsing or sprays
Specific Plaque Hypothesis - S. Sanguis, F. nucleatum, P. intermedia, Campylobacter spp., and A. naeslundi bacteria are associated with ___.gingivitis
Specific Plaque Hypothesis - P. gingivalis, T forsythensis, P. intermedia, E. corrodens, C. rectus, T. denticola are associated with ...chronic periodontitis
Specific Plaque Hypothesis - Name the bacteria associated with Aggresive Periodontitis.Aggregatibacter actinomycetemcomitans
Biofilm --> _________-_________ days - colonization of pellicle, gram-positive cocci, mainly streptococci.1-2 days
Biofilm --> _________-_________ days - cocci dominant, increasing numbers of gram + filamentous and rod-shaped, extracellular slime layer protects bacteria.2-4 days
Biofilm --> _________-_________ days - more filamentous! mixed and diverse flora! thickening biofilm at gingival margin! GRAM-NEGATIVE vibrios and spirochetes.4-7 days
Biofilm --> _________-_________ days - more GRAM-NEGATIVE! vibrios and spirochetes! Anaerobes! Virulence factors! First see WBCs! Mushroom shaped microcolonies! GI observed.7-14 days
Biofilm --> _________-_________ days - vibrios, spirochetes, cocci, filamentous! DENSE PACKING of filamentous perpendicular to tooth in palisade layers. Gingivitis EVIDENT.14+ days
Attached plaque- tooth surface, epithelium. Unattached plaque- within _ _________ and on _________.connective tissue, bone
Ideally, plaque and gingivitis scores should be below _________%.20
Kressin 2003 - brushing at least ONCE a day resulted in _________% reduction of risk of tooth loss.49
Kressin 2003 - subclinical signs of GI appear within _________ days of plaque accumulation.4 days
T/F - Kressin 2003 - MINIMUM frequency of tooth cleaning to reverse gingivitis is 1x per day or even every other day.T
Kresssin 2003 - After onset of gingivitis, gingiva will heal in _________-_________ days with daily brushing.7-10 days
Good Toothbrush - _________ or _________ rows of multi-tufted, soft bristles.3-4 rows
Good Toothbrush - bristles made of ____. Diameter 0.007-0.008.Nylon (I can totally eyeball 0.007mm diameter bristles!)
Good Toothbrush - the shape of the bristles should be ____ at the end.rounded
Toothpaste - silica, alumina, dicalcium phosphate and calcium carbonate are all ...abrasives
Toothpaste - ______ affect consistency and control of extrinsic dental staining. Little/no enamel wear, maybe dentin abrasion. Non-hydrated alumina being the exception.abrasives
Dicalcium phosphate?abrasive
Calcium Carbonate?abrasive
Non-hydrated alumina?some sort of exception in the abrasives category ....
Toothpaste - what's the most common detergents?sodium lauryl sulfate (but it gives Cassie canker sores!!!)
Toothpaste - _____ give the foaming feel properties. They dissolve active ingredients and have antimicrobial and plaque inhibitory properties.detergents
Toothpaste - name 2 thickeners.silica and gums
Toothpaste - name 1 sweetenerssaccharine
Toothpaste - name 2 humectantsglycerine and sorbitol (humectants prevent toothpaste drying)
Tooth paste - triclosan, stannous fluoride and chlorhexidine are for...plaque control
Triclosan?plaque control
Stannous fluoride?plaque control
Chlorhexidine?plaque control
PYROphosphates?anticalculus agent (you must burn the calculus)
POLYphosphates?whitening agent (Polly want white teeth? SQUAK!)
Strontium?desensitizing agent
Potassium salts?desensitizing agent
Toothbrush - a _____ (larger, smaller) handle is easier to hold.larger
Replace your toothbrush if the bristles flare, you got sick, or it's been _________-_________ months.2-3 months
The most effective brushing force for children and adults is ___g.300g (I know EXACTLY what 300g of brushing force feels like...)
Toothbrushing - quality or quantity?quality (quality reduces disease more than frequency)
Horizontal, vertical, circular, sulcular, vibratory, and roll are all techniques of ___.toothbrushing (none shown to be superior, you want complete removal of plaque in least possible time.)
T/F - Take advantage of the positive parts of existing brushing technique.T
Brushing for 1 minute removes ~_________% of plaque, most ppl only remove about _________% of plaque.39%, 50%
2 minutes of electric toothbrushing can be as effective as _________ minutes of manual.6 minutes
Bass Technique - 45 degrees, gentle ___ pressure, short back and forth motions, _________-_________ strokes in same position.vibratory, 15-20 strokes
Are power toothbrushes good for ortho patients?yes! (manual dexterity needers, small children, handicapped, hospitalized)
Power tooth brushing movements - reciprocal, elliptical, and ___.combined
Healthy papillae - floss, small woodstick. Moderate papillary recession - floss, woodstick or small ___ brush.interdental
Complete loss of papilla - ____ ____interdental brush
Wide embrassure space, diastema, EXT, distals of molar - single-tufted, _________-tufted brush or gauze strip.end-tufted
_________% of adults occasionally floss. _________% floss daily.12%, 2%
Christou 1998 - ____ ___ is more effective than floss.interdental brush
Graves 1989 - Brushing + flossing is __x as effective in reducing interproximal bleeding than brushing alone.2x
Use ___-___ inches of floss. Wrap around middle fingers until about _________ inches in hands.12-18 inches, 2 inches
Flossing removes subgingival plaque _________-_________ mm apical to tip of papilla.2-3.5mm
T/F - You can soften wooden sticks in warm water to make more flexible for cleaning embrasure space.T
Crowded, overlapping teeth, or linguals of mandibular posteriors, furcation concavities and isolated recession areas use...end-tufted brush
Irrigation Devices - useful for pts with ortho, extensive crown and bridge work. Add 1 TbSp clorox each time. Average pocket penetration with subgingival tip ___% of pockets <6mm and ___% of pockets > 7mm.90%, 64%
Irrigation Devices - is pulsating water flow or continuous stream more effective?pulsating water flow
Name the 2 ADA accepted mouth rinses for gingivitis prevention.Listerine and Chlorhexidine gluconate (Peridex, PerioGard)
Chlorhexidine gluconate (bisguanide?plaque control, antimicrobial (bacteriostatic and bactericidal for + and - aerobic and anaerobic and fungi and viruses)
Phenolic-related essential oils (Listerine) ?plaque control
Cetylpyridinium chloride (CPC) - quaternary ammonium compound?plaque control
Sanguinarine?plaque control (it's an herbal extract)
Povidone iodine?plaque control
Amine alcohol?antiadhesive (acts at pellicle to prevent bacterial attachment - in PerioShield)
Chlorhexidine Gluconate use ___% oral rinse.0.12%
Antiseptic, dicationic, poorly adsorbed by GI tract, very low toxicity, basic perio therapy, used for plaque control postsurgery...chlorhexidine gluconate
Damages bacterial cell wall increasing the permeability and coagulation of its cytoplasmic components, adsorbed into teeth and mucosa for sustained action...chlorhexidine gluconate (good substantivity)
Side effects- can stain tongue and teeth, change taste sensation, or rarely ulceration, desquamation of gingiva, and parotid swelling...chlorhexidine gluconate
T/F - Peridex mouth wash is 0.12% chlorhexidine and 11.6% alcohol.T
Chlorhexindine Gluconate - rinse with ___mL twice a day for 1min. Do not rinse, ___, or drink immediately following. Wait ___ minutes between brushing and rinsing with CG due to CG interaction with _________ _________ _________.15 min, eat, 30 min, sodium lauryl sulfate
Chlorhexidine Gluconate - _________% reduction in PI, _________-_________% reduction in GI and bacterial count reduced TO _________-_________% of baseline for at least SEVEN HOURS after a single rinse.60%, 30-40%, 10-20%
Which rinse reduces plaque, gingivitis, and BOP the most?chlorhexidine gluconate (better than essential oils, cetylpyridinium, and delmopinol)
Listerine may reduce plaque _________-_________ % when used with brushing.20-30%
High alcohol content, disrupts bacterial cell wall, inhibits bacterial enzymes, poor substantivity ...Listerine
Eucalyptol 0.092%, thymol 0.064%, Methyl Salicylate 0.060%, menthol 0.042% ...Listerine (ALSO ALCOHOL IS 21.6% !!!)
_____ is a chlorophenol.triclosan
What is NOT available in mouthwash in US, only available as dentifrice.triclosan
T/F - Triclosan is combined with zinc citrate to increase substantivity in mouthwash.T
T/F - Dentifrice is 0.3% triclosan + 2% methoxyethylene/maleic acid copolymer which increases substantivity.T
T/F - With Triclosan, anti-inflammatory properties may relate to decreased prostaglandin and leukotriene synthesis.T
T/F - Biotene used to have enzymes that Destefano liked, but then they got bought out, so no longer... sigh.T
How is PerioBiotic toothpaste like yogurt?probiotics (introduces nice oral flora - no pathogenic potential - hopefully will take over - antipathogenic)
Lactobacillus paracasei ?antipathogenic agent (in the PerioBiotic toothpaste)
_________ _________ - removing cementum or surface dentin that is rough, or calculus, or contaminated with toxins and microorganisms until smooth surface.root planing
T/F - Goal of Perio - <20% PI, <20% BOP, <4mm PD, stable CAL.T
When do you do ROOT PLANING?CAL > equal to 1mm, PD >4mm + BOP, or subgingival calculus/rough root surfaces
ROOT PLANING - 4-6mm pockets - expect to reduce pockets by ___mm. Gain 0.55mm of attachment.1.29mm
ROOT PLANING - >7mm pockets - expect to reduce pockets by ___ mm. Gain 1.29mm of attachment.2.16mm
T/F - SRP Curette efficacy is 3.73mm. Instrument limit 6.21mm. More than 60% molar sites still had calculus. More than 90% of >5mm pockets still had calculus.T
SRP -sharpen instruments every _________-___ strokes.4-40 strokes (that's... uh quite the range)
SRP -average working time per tooth is __minutes.35 mintutes (WHAT?!?!?!?!?)
T/F - deep PD, root concavities, furcations, diabetes, stress, pregnancy, blood dyscrasis, smoking and immunodeficiencies can all limit the effectiveness of SRP.T
Periodontitis, but no SRP - 82.8% sites unchanged, ___% significant, 11.5% shallower.5.7%
Why don't we SRP <4mm pockets?Because SRP in pockets 4.2mm or less results in CAL
SRP - changes flora from gram - to gram +, reduces ___ bacteria in plaque, reduces Black-pigmented bacteroides, reduces levels of endotoxin.motile
8-10% of pts are non-responders (>___% of refractory pts are smokers) and _________% of furcations DO NOT respond.90%, 22%
T/F - Anticipate the need for perio surgery when pockets are >5mm.T
SH 5/33 ?anterior sickle / jacquette
31/32 ?posterior jacquette (I've been calling it Jack Head this whole time... sigh)
13/14 Columbia?Universal Curette
Univesal Curette - Blade face at _________ degrees to lower shank. Working angulation _________-_________ degrees.90, 60-80
Gracey Curette - Blade face LATERALLY OFFSET _________-_________ degrees from the shank. Orient _________ degrees to root surface. Angle of _________ to _________ degrees to the stone.60-70, 60, 100-110
Gracey Curette - _________/_________ all F and L, proximal surfaces of anterior...7/8
Gracey Curette - _________/_________ mesial of posteriors, closer surfaces of anteriors...11/12
Gracey Curette - _________/_________ distal of posteriors, away surfaces of anteriors...13/14
Converts electric current to mechanical vibration...ultrasonic scalers
T/F - Frequency of ultrasonic scalers is 24KHz or 42KHz (cycles/second)T
Piezoelectric motion ____. Magnetostrictive motion ____.linear, elliptical (manetostrictive is cavitron)
T/F - Ultrasonic scalers and pacemakers - inhibition of atrial and ventricular pacing with use of electrosurgical unit up to a distance of 10cm. Inhibition of pacing by magnetostrictive units up to 37.5cm, range of 12cm, 23cm in second study.T , but I have no idea what any of this means.
Ultrasonics - the greater the frequency, the higher the energy output, but the smaller area of the tip
T/F - Ultrasonics - 25kHz active area 4.3mm. 50kHz active area 2.3mm.T
T/F - Piezoelectric devices create greater root damage compared to magnetostrictive scalers.T
Heavy supragingival calculus use a ____, universal tip (P-10). For subgingival debridement or FURCATIONS use a ____ , area specific tip.larger, finer
Ultrasonic - Tune the instrument - ___ power, ____ mist. (lowest, maximum)lowest power, maximum mist
Ultrasonic Technique - Bleed air from lines, insert tip into handpiece, _________ the instrument, prepare the pt (sounds, antiseptic mouthrinse, local anesthesia)tune
T/F - Ultrasonics use 36.6% less time, cause less soft tissue trauma, BUT more root damage. Average gain in CAL, reduction of PD and BOP. Better for Class 2 and 3 furcations.T
Do supragingival or subgingival pathogens recolonize rapidly?supragingival (subgingival remain suppressed for several months after debridement)
Arestin is 1mg of _____ microencapsulated in polyglycolide polymer. Bioabsorbable microscapsules. Inject into perio pocket. 2 year shelf life.Minocycline (studies say 0.3mm greater attachment when used, basically all research indicates NOT proven superior to old-fashioned methods...yet)
T/F - MMPs do lots of destruction. So inhibit them. MMP inhibitor = Periostat LOW DOSE DOXYCYCLINE.T
T/F: You can modulate host destructive agents with MMP inhibitors (Periostat), anti-inflammatory COX inhibitors / NSAIDs , and bone-sparing agents... bisphosphonates...T (SOMEWHERE ELSE they told us don't bisphosphonate up around surgery because of jaw osteonecrosis UGGGGGGGGGGGH)
Does Periostat have an effect on bacteria?no no no no no! (MMP inhibitor, low dose doxycycline)

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