20: Plaque Control and Non-surgical Periodontal Therapy

20

Plaque control and non-surgical periodontal therapy

Figure 20.1 Terms in use relating to plaque and calculus removal.

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Figure 20.2 (a) Hand instruments.(b) Ultrasonic instruments.

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Figure 20.3 Two classic studies demonstrating the effectiveness of plaque control (Lovdal et al., 1961; Badersten et al., 1984).

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Figure 20.4 Non-surgical periodontal therapy in a 46-year-old lady with deep pockets on UR3 and UR4, which bled on probing; she experienced occlusal trauma on UR4 following extraction of UL7 and LL7. (a) UR3 probing depth (PD) of >7 mm. (b) Angular vertical infrabony defects UR3 and UR4. (c, d) Root surface debridement (RSD) of UR3 using a hoe, following ultrasonic. (e) RSD being finished on UR3 using a curette to create a clean smooth root surface; occlusal adjustment was undertaken on UR4 as part of the initial therapy. (f) PD at 2 years follow up is less than 4 mm on UR3 (shown) and UR4. (g, h) Bone level stability and corticated crest on UR3 at 2 years (g) and 5 years (h) follow up.

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Figure 20.5 Toothbrushing advice to patient.

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Figure 20.6 Potential use of powered toothbrushes: points to consider.

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Figure 20.7 Pharmacological plaque control agents.

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Figure 20.8 Use of chlorhexidine mouthwash.

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Plaque is the primary aetiological factor in the periodontal diseases. Periodontal therapy is then directed at cleaning the root surfaces and removing plaque retention factors. Patient homecare – including toothbrushing, interdental cleaning and adjunctive pharmacological agents delivered as toothpastes and mouthwashes – is necessary after periodontal therapy to maintain the health of the periodontium. Good communication with the patient is essential to establish good hygiene practices (Chapter 21).

Non-surgical periodontal therapy

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Jan 14, 2015 | Posted by in Periodontics | Comments Off on 20: Plaque Control and Non-surgical Periodontal Therapy
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