Post on 24-Feb-2016
description
Bone Defect
Main Types• Horizontal Bone Loss• Vertical bone loss/angular defect • Osseous Craters
Horizontal Bone Loss• most common pattern of bone loss in
periodontal disease• Bone reduce in height, but bone margin
perpendicular to tooth surface• Affect interdental septa, facial and lingual
plate
Vertical Bone Loss• a sign of progressive periodontal breakdown• Occur in oblique direction• Leave hollowed-out trough in bone alongside the
root• Base of defect apical to surround bone• Interdental defect can appear on r/g• Facial, lingual or palatal defect may not seen on r/g
Angular Defect• Classified by number of osseous wall
Management
• Phase I: Periodontal Therapy (non-surgical)• Phase II: Periodontal Therapy (Surgical)
• Subtractive osseous surgery• Additive osseous surgery• Osteoplasty• osteotomy
Resective Osseous Surgery
• Non-bone graft associated new attachment• Bone graft associated new attachment
Reconstructive Periodontal Surgery
OHI for patient
• Toothbrushing– Dentifrices• Anti-plaque : eg. stannous fluoride (SnF(2))
– Techniques1. Bass2. Modified bass3. Charter4. Modified stillman5. Fones
• Provides gingival stimulation (vibratory motion)
• Suitable for gingival recession (Toothbrush bristle ends not directed into sulcus)
• Less traumatic to the gingiva• Who should use this? People with
continuous gingival recession
Stillman’s method
• Chemical plaque control
FIRST GENERATION • Antibiotic, phenol, quarternary ammonium
compounds & sanguinarine
SECOND GENERATION • Bisbiguanides,(chlorhexidine)
THIRD GENERATION• Eg: delmopinol
• Chewing Gums• Interdental Brush
Smoking Cessation – 5AsASK ~ Ask patient about smoking status
ADVICE ~ Provide clear, strong advice to quit with personalized messages about the impact of smoking
ASSESS ~ Assess the willingness of the patient to make a quit attempt within the next 30 days.
ASSIST ~ Suggest and encourage the use of problem-solving methods and skills for cessation. Provide social support as part of the treatment.
ARRANGE ~ Periodically assess smoking status and, if she is a continuing smoker, encourage cessation.
Smoking Cessation - 5RsRelevance• Encourage the patient to indicate why quitting is personally relevant
Risks• Ask the patient to identify potential negative consequences of tobacco use.
Rewards• Ask the patient to identify potential benefits of stopping tobacco use.
Roadblocks• Ask the patient to identify barriers or impediments to quitting.
Repetition • The motivational intervention should be repeated every time an unmotivated
patient has an interaction with a clinician. Tobacco users who have failed in previous quit attempts should be told that most people make repeated quit attempts before they are successful.
• http://imuoralhealth.blogspot.com/2010/07/importance-and-various-tooth-brushing.html