risk, diagnosis, prognosis and treatment plan

2. Risk is the probability that an
individual will get a specific disease
in a given period. The risk of
developing the disease will vary from
individual to individual

10.  SMOKER ≥100 cigarettes in their lifetime &
currently smoke ( red & orange complex)
 FORMER SMOKER ≥ 100 cigarettes in their
lifetime & do not currently smoke
 NONSMOKER have not smoked 100 cigarettes
in their lifetime & do not currently smoke

16.  video

17.  Exaggerated inflammatory response of gingiva
to local factors
 PUBERTY – increased levels of P.intermedia
and capnocytophaga
 MENSURATION - increased gingival bleeding

18. Increased susceptibility to mechanical irritants
Immune suppression
Dilation of gingival microvasculature, circulatory stasis
Cellular proliferation, permeability of vasculature, pattern of collagen turnover
& metabolic breakdown of folate
Increased progesterone levels
P.intermedia

19. PREGNANCY TUMOR

20. •Flat position
may cause
hypotension and
Hypoxia.
•Place a small
pillow under
right hip - left
lateral
displacement.
• Head above
feet. 2
0

21. SUPINE POSITION AFTER 5TH MONTH
UTERUS COMPRESSES THE INFERIOR
VENACAVA
↑VOL. BLOOD
↓RETURN TO THE HEART
REDUCED PERFUSION OF UTERUS
FETAL HYPOXIA
2
1

22. Dr. Nitika Jain 8/31/2012
2
2

23. Dr. Nitika Jain 8/31/2012
2
3

24. Menopause
• No ovulation.
• No menstrual cycle.
• No estrogen and progestron formed by the ovary.
Changes due to menopause occur in:
• Sex organ
• Endocrine.
• Bone-Osteoporosis
• Metabolic
• CVS
• Lipid profile
• Hypertension, etc
2
4

25. • Reduction in epithelial keratinization so
thinning of oral mucosa.
• Reduction in salivary glandflow.
• Drying of oral tissue (burningmouth)
• Redness and abnormal palness of
gingivaltissues.
• Bleeding on probing and brushing.
• Gingival recession.
• Altered taste sensation.
• Alveolar bone loss.
• Alveolar ridge resorption.
Clinical findings in periodontaltissues-
• Poor wound Healing.
• Reduced bone mineral content in jaws.
• Increased periodontitis and tooth loss.
Effects of osteoporosis in
periodontal tissues-
• Estrogen deficiency-
• Inc. osteoclastic activity.
• Dec. bone matrix.
• Decreases deposition od bone
calcium and phosphate.
Bone metabolism-
2
5

29. PROBING DEPTH = GINGIVAL MARGIN TO BASE OF THE SULCUS
CAL = CEJ TO BASE OF THE SULCUS

30. DEGREE 1 – mobility of crown of 0.2
to 1mm in a horizontal direction
DGREE 2 – mobility of crown of 1 – 2
mm in a horizontal direction.
DEGREE 3 – mobility of croen of >
2mm in horizontal & vertical
direction.( depressible in socket)

36.  (1) rapid attachment loss and bone destruction in an otherwise clinically healthy
patient
 (2) a familialaggregation.
 3)These patients often present with limited microbial deposits that seem
inconsistent with the severity of tissue destruction.
 Causative bacteria - Aggregatibacter actinomycetemcomitans

 Affects <30 yrs
 LAP – Localized first molar or incisor disease with proximal attachment
loss on at least two permanent teeth, one of which is a first molar
 GAP- Generalized proximal attachment loss that affects at least three
teeth other than the first molars and incisors

37.  Gingival inflammation
 Periodontal pocket
 Mobility
 Loss of clinical ttachment
 Gingival recession
 Furcation involvement
 Occasional suppuration

43. MILLERS
CLASSIFICATION TREATMENT
1. Free gingival autograft
2. Free connective tissue autograft
3. Pedicle autografts
• Laterally (horizontally) positioned pedicle
flap
• Coronally positioned flap; includes
semilunar pedicle(Tarnow)
4. Subepithelial connective tissue graft
(Langer)
5. Guided tissue regeneration (GTR)
6. Pouch and tunnel technique (coronally
advanced tunnel
technique

50. DISCLOSING AGENTS

52. MECHANISM OF ACTION

54. COMPONENT
PASTE &
GEL %
POWDER
%
MATERIALS PURPOSE
ABRASIVE 20-55 90-98
•Ca CARBONATE
•DIBASIC Ca PO4
DIHYDRATE
•HYDRATED ALUMINA
•HYDRATED SILICA
•SODIUM BICAR
•MIXTURES OF ANY
REMOVAL OF
PLAQUE /
STAIN &
POLISHING
DETERGENTS 1-2 1-6 Na LAURYAL SULFATE
DEBRIS
REMOVAL
COLORANTS 1-2 1-2 FOOD COLORANTS APPEARANCE

55. FLAVORING 1 - 2 1 - 2
• OILS OF SPEARMINT
• PEPPERMINT
• WINTERGREEN
• CINNAMON
FLAVOR
HUMECTANT
20 -
35
0
• SORBITOL
• GLYCERINE
MAINTAINS
MOISTURE CONTENT
WATER
15 -
25
0 DEIONIZED WATER SUSPENSION AGENT
BINDER 3 0 CARRAGEENAN
THICKENER,
PREVENTS LIQUID-
SOLID SEPARATION

56. FLOURIDE 0-1 0
1. Na MONOFLUROPHOSPHATE
2. Na FLUORIDE
3. STANNOUS FLUORIDE
CARIES
PREVENTION
ANTICALCULUS 0-1 0
• DISODIUM PYROPHOSPHATE
• TETRASODIUM
PYROPHOSPHATE
• TETRAPOTASSIUM
PYROPHOSPHATE
 CALCULUS
FORMATION
DESENSITIZING
AGENTS
0-5 0
POTASSIUM NITRATE
STRONTIUM CHLORIDE
OCCLUSION
OF
DENTINAL
TUBULES

57.  LOCAL
 SYSTEMIC
 HMT
video

58.  HAND INSTRUMENTS (video)
 SONIC & ULTRASONIC INSTRUMENTS


59.  Indications
 • Supragingival debridement of
dental calculus and extrinsic stain

• Subgingival debridement of
calculus, oral biofilm, root surface
constituents, and periodontal
pathogens
 • Removal of orthodontic cement
 • Gingival and periodontal
conditions and diseases
 • Surgical interventions
 • Margination (reduces amalgam
overhangs)
 Precautions
• Unshielded pacemakers

• Infectious diseases: human
immunodeficiency virus, hepatitis,
tuberculosis (active stages)
 • Demineralized tooth surface
 • Exposed dentin (especially associated
with sensitivity)
 • Restorative materials (porcelain,
amalgam, gold, composite)
 • Titanium implant abutments unless
using special insert, e.g.,
Quixonic SofTip Prophy Tips
 • Children (primary teeth)
 • Immunosuppression from disease or
chemotherapy
 • Uncontrolled diabetes mellitus
Contraindications
• Chronic pulmonary disease: asthma,
emphysema, cystic fibrosis,
pneumonia
• Cardiovascular disease with secondary
pulmonary disease
• Swallowing difficulty (dysphagia)

62. 1. Vertical grooving
2. Radicular blending
3. Flattening interproximal bone
4. Gradualizing marginal bone
video
OSTEOPLASTY
OSTECTOMY

64. Prognosis can be divided into
 Overall prognosis
 Individual tooth prognosis

70.  BIOLOGIC WIDTH
video

71. COMPLEMENTARY
TREATMENT STRATEGIES IN
PERIODONTICS

74. Dental implants

75. NEVER DO IMPLANTS FOR GROWING CHILDREN

76.  Ti O2 is essential for the nucleation process that
forms CaPO4 precipitates, leading to
mineralised bone formation.
Osseointegration modifications
•
•Sandblasting with Al2O3
•Etching with H3PO4
•Plasma spraying