1) is ACTH and CRH the same thing(main stress hormones)
2)This one may be for Sophie, or if anyone else wants to answer go for it
but say we have a patient that is new to our clinic but they have previously had periodontal treatment at another clinic and we have the notes of their pocket depths etc and they had moderate generalised perio as thier diagnosis, and we are seeing them say 2 years after their initial perio exam(coz they had to go away and travel for work but they maintained good oral health habits etc) adn we do thier charts and theyhave no new pockets and no gingival inflammation and they bone loss has not increased any more... But they still have their original moderate bone loss.. Do we say their diagnosis is still moderate generalised perio(even though its not progressing atthat time??)
I know we cant measure activity of perio via diagnostic tests etc and so im guessing we would just say moderate generalised perio but i justwanted some clarification
(hope my little scanario makes sense):D
3) can we use Azithromycin to treat ANUG
4) is localised periodontitis always agressive??
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4 comments:
1) Yes they are both stress hormones but they are not the SAME. CRH (corticotropin releasing hormone) is the primary stress hormone released by the hypothalamus in response to stress. It acts on the anterior pituitary gland which then releases ACTH (adrenocorticotropic hormone, also know as corticotropin) which acts on the adrenal cortex to create cortisol and other glucocorticoids.
3) Yes you can use Azithromycin to treat ANUG, you can also use Metronidazole (which is best) and Penicillin (amoxcil, amoxcillin).
2) Well, in this case they would be classified as in periodontal health. Going back to Hirsch's semester one lectures, periodontal health is the absence of clinical inflammation, can include attachment loss due to dehiscence or previously treated periodontitis. Hope this makes sense!
4) I would say no, it isn't localised isn't always aggresive. If you think about it, endo-perio lesions (like chronic apical periodontitis) aren't usually (or should I say aren't always) rapid, unpredictable and I don't think they always have poor response to treatment.
But I could be wrong here...you never know with perio :p
ohhh ok yea i didn't think about the endo-perio kind of lesions.. i think your right now time with the localised aggressive perio.. that would just make it too simple..
And with my little case scenario thing-whatyou said is where i got my question from coz like as you said they are in periodontal health but what do you write in the diagnosis box, coz if you put perio health and then chart all these pockets that doesn't look right and they still obviously need treatment...?? can we put like periodontal health-maintenance in the diagnosis box?? does that make sense??
Hi guys .. I have been following your discussions with interest here.
1. Mia is right re: ACTH and CRH
2. Yes again re ANUG.
3. Scenario: If you had their previous radiographs and charts, and things have remained the same, but there are still pockets that haven't resolved, then its not that stable really is it? I would say that there would still be some inflammation in pockets >4mm. So, you would classify them as still having mod chronic perio. However, if there are no pockets, e.g., perio has resolved.. then there is periodontal health in the absence of clinical inflammation, so you could refer to it as 'stabilised chronic moderate perio' as there would still be obvious attachment loss, e.g. recession but no BOP or residual pocket depths. Does this make sense?
4.)Tim is correct.
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