DENT3060 Lecture Notes - Lecture 23: Extracellular Polymeric Substance, Chronic Periodontitis, Dental Plaque
Document Summary
Screening: psr (>2 sextants score 3+, full periodontal charting & risk assessment required) (active) tx phase: systemic phase, hygienic phase: ohi, supra/subgingival debridement, reassessment, corrective phase: periodontal surgical tx/implant/endo/pros/ortho. Maintenance phase: periodontal risk assessment (pra) + supportive periodontal therapy (spt) Goals of periodontal tx: preserve natural dentition, periodontium, peri-implant tissues, maintain/improve periodontal/peri-implant health, comfort, aesthetics, function. Biofilms difficult therapeutic targets, mechanical removal only efficient way plaque removed. Extracellular polymeric substance: enable bacteria to adhere to surface & each other: eps, proteins, lipids, polymers. Water channels: circulate metabolites & establish nutrient gradients. Organisms grown in biofilms >1000x resistant to atb than same cells grown in planktonic state. Current oh aids cannot clean subgingivally & cannot remove predisposing factors e. g. calculus. Remove supra/subgingival plaque + predisposing (plaque retentive) factors e. g. calculus. Scaling in >5mm pockets ineffective, surgical access necessary. Nst parameters improve initial months, little change past next 12 months. Conclusion: good oh, adequate debridement, regular maintenance/recall successful even in.
