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Published byNathaniel Reynolds Modified over 8 years ago
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Periodontics
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Periodontitis Periodontist Dentist specializes in treating tissues around the tooth. Peri = around Dont = tooth Periodontal tissues (Periodontium) Gingiva Sulcus Epithelial attachment Bone (alveolar) Lamina dura PDL Periodontal ligament Sharpey’s fibers Cementum Surrounds the root
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Periodontitis Signs / symptoms Swollen gums Shiny gums Red gums Bleeding Plaque Calculus Recession Maloclussion
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Periodontitis Causes Poor oral hygiene Plaque Calculus Poor diet Lack of sleep Genetics Medications / drugs Stress Bruxism
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Periodontal stages Stage I Gingivitis Inflammation of the gingiva. Not true perio Must have pockets! Stage II Early perio Pocket formation 4 -5 mm No mobility
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Periodontal stages Stage III Moderate perio 4 – 6 mm pockets Recession Bone loss Mobility
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Periodontal stages Stage IV Advanced perio 6+ mm pockets Mod – severe recession Severe bone loss Furcation involvement Mod- severe mobility
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Refractory periodontitis ANUG Acute Necrotizing Ulcerative Gingivitis Aka Vincent’s Disease “trench mouth” Really bad perio… Additional signs/symptoms PAIN Dead tissue Sores Metallic taste ‘Death Breath’
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Mobility Movement of the tooth within the socket. Scale of 0 – 4 0 = normal 1 = slight 2 = moderate 3 = severe
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Diagnosis Extraoral exam Skin, lips, TMJ Intraoral exam Color Size Texture Consistency Of all tissues Radiographs X-rays Vertical BWX Pano Indicate Bone loss Vertical Horizontal Diseased tissue abscesses
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Radiographs
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Periodontal probing Measures the sulcus / pocket depth. Instrument? Periodontal probe 0 – 3 mm = healthy 6 readings / measurements around the tooth. Anterior teeth F, MF, DF L, ML, DL Posterior teeth B, MB, DB L, ML, DL
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Periodontal probing
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Treatment Full Mouth Debridement Too much calculus to probe. Root Planing Smoothing root surface Calculus Dead cementum Gingival curettage Scraping the gums Remove dead / diseased gingival tissue.
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Treatment Prophylaxis Fine scale and polishing. Remove Calculus Sub-gingival Supra-gingival Stain Extrinsic Soft depostis Plaque stain
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Surgical Treatment Flap surgery Used to gain access to the bone. Allows other procedures to be completed. Alveoplasty Reshaping the alveolar bone Ostectomy Bone removal Additive osseous surgery. Bone graft.
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Surgical Treatment Gingivectomy Surgical removal of the gums Gingivoplasty Reshaping / recontouring the gums Scallop
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Mucogingival Surgery Frenectomy Removal of the frenum and attachment to bone. Tongue tied Anklyoglossia Gingival grafting Tissue is taken from one site and place on another. Palate
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Periodontal instruments Periodontal probe Measures the sulcus Ultrasonic scaler Used with hand scaling to remove gross calculus Scaler Removes gross calculus supragingival Curette Root planing Curettage Sub-gingival calculus Pocket marker Marks tissue for incision Periosteal elevator Separates tissue from bone
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Periodontal instruments Rongeurs Cut / trim bone Periodontal knives Cut / incise tissue Orban Kirkland Bard parker and #15 blade. Electrosurgery machines. Uses electric current to incise tissue. Lasers Many different uses in periodontics.
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Periodontal dressing “Band-aid” for the gums after perio treatment Protects tissue w/ chewing Support for mobile teeth Holds ‘flaps’ in place Stay on about 1 week Please reference pics in your textbook on pgs. 525, 526, 527
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Conclusion Understanding signs and symptoms of perio is a very important part of your job. Being able to explain different treatments and procedures to your patients increases your value to your dentist. Any questions??????????
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