to diagnose chronic perio, a series of radiographs needs to be taken over time(as we cant just diagnose from one).. just curious does anyone how often it would be recommended to take each OPG/radiograph? were we ever given a rough time(obviously it will depend onpatient factors etc) but is there an estimate time like every 1-2 years??
in the module-Dr Hirsch refers us to go read other texts(articles etc)..are these articles examinable..coz ill be honest.. i havn't accessed/read them and now im thinking i maybe should have.?? has anyone else looked into these??
with perio treatment(scaling).. this is a dumb questions btw.. so calculus isn't a causative factor for perio.. So the reason that we actually remove calculus and do cleans etc is due to the calc being good at retaining plaque and bacteria(that ARE neccessary causes for periodontitis), and also to increase the ability for the patient to self clean effectively.. Is this right.. just a random thought process in my head last night..
Localised perio..can this be chronic?? im not sure why but i just always thought that local perio was severe.. and i cant really find anywhere that indicates that it is chronic..(apart from the causes such as cracked teeth, fused roots that may not get picked up right away and therfore progress in a cyclickind of way?? also in the module it is talking about localised perio..then the next session is titled treatment of severe perio..so tome this indicates thatlocalised perio is severe?? clarification...........
Why are nightgurads useful therapy in perio?? he says to organise a nightguard sooner rather than later(if indicated) but what are the indications??
Do we need to know the historicla perio indexes( i have mainly focussed on how research is currently done and just briefly why the others weren't good ie.blocked gingivitis + perio, averaged scores for whole mouth etc)..is this basically the levelof detailwe need to know?
Ok.. once again thats it for now..
happy studies guys.. oh yea.. just quickly i found this on interleukins that may help..
iL-1, iL-6, iL-12 = pro-inflammatory cytokines(have slightly different functions for each, but basically are involved in increasing bone resorption and decreasing the bone formation(very basic detail)
iL-8=chemotactic function-target cell is the PMN..
iL-10, iL-13 = anti-inflammatory-increase the # of B-cells(which decreases inflammation response) and inhibits macrophages
prostoglandin E2=hormone like fattyacid that increases inflammation and bone resorption..
pg 47-48 text book. :D
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4 comments:
I don't think Hirsch ever gave us a time because it depends on the severity of the patient's disease. I suppose at first you might take one three months after initial therapy to see if there is any improvement or progression?? But he never did give specifics so I don't think that will be in the exam.
I have never read the other articles he recommended, but I did read the pages recommended in the text, but I doubt he would have examinable material outside of the modules, he would tell us if an article was examinable I'm sure...
I would tend to agree with this. Calculus harbours bacteria (as biofilm is present on the surface of calculus), therefore it needs to removed as the biofilm on the calculus is causing the inflammation and destruction of tissues. Also, calculus cannot be removed any other way than via professional scaling, so this is necessary to ensure the patient's oral hygiene habits are in fact effective.
That's a good question, but I thought it could be chronic. Tooth-related defects (cracks) and endodontic related defects can result in a chronic sort of infection yes? Especially endo-perio as the abscess formation is a cyclic process of drainage of pus, build-up, drainage, etc. This is a chronic sort of inflammation that can be localised to specific teeth. Is this correct thinking...I dunno...sorry I can't be definitive!
Nightguards are useful for patient's suffering from bruxism or malocclusions I'm pretty sure. If the patient has TMJ issues or is under constant stress than I think a nightguard is indicated.
I'm not sure about the indices..I think we generally need to know that no universally accepted index is available, but an index would be useful for measuring perio disease.
Thanks for the cytokine shiz, very helpful!! I'm sure you'll be fine, this post is very similar to a certain one before the DCP 2 perio exam...:P
lol ahh yes timmy..after spending a whole night thinking about bds2 exam... i thinks it safe tosayiam now officially worried about bds 3
beth and i had discussions about these questions aswell and what you have said kinda mathes.excpet we said thatw ith the radiographs,w e would reckon maybe 1 yearly(coz dont want to over expose) and then maybe 2 yearly when you are in the maintenacne phase(idont think this willbe inthe exam..was just curious)
cool. i didn't read the articles but same i read over hte textbook stuff.(suprosingly helpfulwith somethings:P)
imstill not sure with the nightguards thing.. coz he has said inhis notes that it is used Tx of i thinklocalised/aggressive perio?? and im prettysure i remember in one of those delightful practice quizzes we did inclass thatwas a question-and it was tru-thatnightguards are commonly used...(whichi got wrong) but idont know why theyare used?? Ohh well hope for the best i guess.. I hope i have done enough.. its justthe wording thatgets me...
fingers & toes crossed...
Catch you in the morning..
p.s. check ur emails timmy. :D
The nightguard thing is interested, unsure as to why he'd use it for localised...aggressive I can understand cos although we haven't covered it yet, I think occlusion and bruxing can impact on perio...
I reckon in the exam it'll just be something like: 'Nightguards are a useful treatment option for chronic perio'
Have checked email and you'll get a reply soonish :p
You guys are the best bloggers ever!!!
Just quickly, you can definitely have chronic localised perio conditions.
Have a good sleep and rest up for tomorrow.
Sophie
PS Huge hanks to Tim and Nathan
You guys were brilliant today.
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