Chemical Plaque Control Techniques
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What is one primary benefit of controlled-release devices in periodontal treatment?

  • Increased risk of side effects
  • Less effective than topical applications
  • Higher concentration in plasma
  • More constant and prolonged concentration profiles (correct)

Which of the following is NOT indicated for the use of systemic antibiotics in periodontal conditions?

  • Routine plaque control (correct)
  • Severe cases of ANUG
  • Refractory periodontitis
  • Multiple abscess and gross infection

What is the primary reason systemic antibiotics may be less effective in treating periodontal pockets?

  • They promote bacterial resistance
  • They are primarily excreted through urine
  • Only a small portion of the dose reaches the target area (correct)
  • They target the immune system instead of bacteria

How does penicillin function as an antibacterial agent?

<p>Inhibits bacterial cell wall synthesis (D)</p> Signup and view all the answers

Which of the following is a potential disadvantage of using systemic antibiotics?

<p>Limited action against localized infections (A)</p> Signup and view all the answers

Which of the following is a commercial preparation containing doxycycline for periodontal treatment?

<p>Atridox (C)</p> Signup and view all the answers

What is a key contraindication for prescribing systemic antibiotics?

<p>Impaired renal or hepatic function (B)</p> Signup and view all the answers

In what scenario would metronidazole specifically be indicated for use in periodontitis?

<p>When infection spreads and causes facial swelling (A)</p> Signup and view all the answers

What is required for a drug to be effective in treating periodontal disease?

<p>It must reach the area affected by the disease and maintain a high local concentration. (D)</p> Signup and view all the answers

Why can't mouth rinses or supragingival irrigation deliver agents to deeper parts of periodontal defects predictably?

<p>They cannot penetrate effectively to deeper tissues. (D)</p> Signup and view all the answers

What is one of the significant challenges in drug delivery to periodontal pockets?

<p>Rapid washout of agents by gingival fluid. (A)</p> Signup and view all the answers

What role do controlled-release devices play in periodontal treatment?

<p>They administer therapeutic levels of drug for prolonged periods. (A)</p> Signup and view all the answers

When delivering medication locally to periodontal pockets, what is essential for maintaining its effectiveness?

<p>It should remain in the pocket long enough to exert its effects. (B)</p> Signup and view all the answers

What is the primary goal of locally delivered products in periodontal therapy?

<p>To eliminate pathogenic organisms or alter the inflammatory response. (B)</p> Signup and view all the answers

What is one of the three criteria necessary for effective periodontal treatment?

<p>It must reach the intended site of action. (D)</p> Signup and view all the answers

During drug delivery, how often is the gingival crevicular fluid replaced in a 5 mm periodontal pocket?

<p>40 times per hour (A)</p> Signup and view all the answers

What is a primary advantage of local therapy over systemic antibiotic therapy for periodontal disease?

<p>It is less likely to cause adverse drug reactions. (D)</p> Signup and view all the answers

What is a challenge associated with subgingival irrigation using antimicrobial agents?

<p>The continual flow of crevicular fluid rapidly clears agents from the area. (A)</p> Signup and view all the answers

Which of the following local delivery methods may provide sustained release of antibacterial agents?

<p>Drug-containing ointments and gels. (D)</p> Signup and view all the answers

What is a disadvantage of systemic antibiotic therapy in treating periodontal infections?

<p>A small portion of the total dose reaches the subgingival microflora. (A)</p> Signup and view all the answers

How is tetracycline unique in its application for periodontal treatments?

<p>It is adsorbed by the root surfaces and released over time. (A)</p> Signup and view all the answers

What delivery method permits direct placement of antimicrobial agents into periodontal pockets?

<p>Controlled-release delivery systems. (A)</p> Signup and view all the answers

What is a reported disadvantage of using controlled-release devices for periodontal treatment?

<p>They may produce adverse reactions in the periodontal tissue. (A)</p> Signup and view all the answers

What characteristic do systemic antibiotics have that local therapies do not?

<p>Ability to reach widely distributed microorganisms. (C)</p> Signup and view all the answers

Which of the following agents is commonly used for subgingival irrigation?

<p>Chlorhexidine. (A)</p> Signup and view all the answers

Flashcards

Effective drug delivery in periodontal pockets

Requires maintaining a high local concentration of the drug for an extended period, countering the flushing action of crevicular fluid.

Subgingival irrigation

Washing the periodontal pockets with a solution, but usually not effective at delivering medication and maintaining high local concentration

Controlled-release devices

Delivery systems that release drugs gradually over time, maintaining therapeutic levels at the infection site for prolonged periods.

Drug reservoir

A localized area where a drug is stored and gradually released. This is useful to counteract the crevicular fluid flow.

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Criteria for effective local delivery

The drug must reach the targeted site, remain at a sufficient concentration, and have a sufficient duration of active effect to alter the inflammatory or eliminate the pathogen.

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Gingival crevicular fluid (GCF)

Fluid in periodontal pockets that flushes out the drugs.

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Sustained-release device

A system designed to prolong retention of chemotherapeutic agents in periodontal pockets and ensure regular and steady release of the agent at therapeutic levels.

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Subgingival Irrigation

A method of delivering solutions to periodontal pockets using mechanized hand-pieces, irrigators, or syringes

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Irrigation solutions

Antiseptics (e.g., chlorhexidine, stannous fluoride, phenols) or antibiotics (e.g., tetracycline) used in subgingival irrigation

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Controlled-release devices

Devices that slowly release antimicrobial agents in periodontal pockets

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Systemic antibiotics

Antibiotics administered orally that circulate throughout the body

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Local drug delivery

Application of medications directly to localized infected areas in the gums

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Subgingival irrigation limitations

Inability to maintain sufficient concentrations of antimicrobials over a long period, due to the rapid removal of the solution by the crevicular fluid.

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Systemic antibiotic limitations

Widespread distribution of drug means that only a small portion reaches the targeted gum pocket, and adverse drug reactions are more likely.

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Local therapy advantages

Allows medications to concentrate at the source of infection in the gums without widespread distribution to the rest of the body.

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Tetracycline Adsorption

Tetracycline becomes attached to the tooth's root surface.

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Controlled-release devices

Medicines designed to release drugs slowly and steadily over time, unlike systemic or topical drugs.

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Systemic application

Drug delivery method where the drug spreads throughout the body's systems.

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Topical application

Drug delivery method where the drug is applied directly to the affected area.

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Plasma concentration

The amount of a drug present in the blood plasma.

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Side effects

Unwanted and undesirable effects of a medicine on the body.

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Actisite

A commercial controlled-release device containing Tetracycline HCl.

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PerioChip

A controlled-release device containing 2.5 mg Chlorhexidine Gluconate for periodontal treatment.

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Atridox*

A controlled-release device containing Doxycycline.

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Arestin

A controlled-release device containing Minocycline HCl, a 1 mg dosage.

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Dentomycin

A 2% minocycline ointment and microspheres for periodontal treatment.

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Elyzol

A Metronidazole 25% gel for treating oral infections.

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Systemic antibiotics

Antibiotics that are absorbed into the bloodstream and affect the entire body.

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ANUG

Acute Necrotizing Ulcerative Gingivitis, a severe gum infection.

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Periodontal abscess

An infection localized to the gums and surrounding tissues.

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Broad-spectrum antibiotics

Antibiotics that are effective against a wide range of bacteria.

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Refractory periodontitis

Advanced periodontal disease that does not respond to routine treatment.

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Aggressive periodontitis

A fast-progression form of periodontal disease.

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Chronic periodontitis

An ongoing, moderate form of periodontal disease.

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Penicillin

A type of antibiotic that prevents bacterial cell wall formation.

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Beta-lactam antibiotics

Class of antibiotics structurally similar to penicillin.

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Study Notes

Chemical Plaque Control

  • Adjunctive aids for subgingival plaque include subgingival irrigation, controlled-release devices, and systemic antibiotics.

Subgingival Irrigation

  • Delivers solutions deep into periodontal pockets via mechanized handpieces, irrigators, ultrasonic devices, and syringes.
  • Techniques using needles and cannulas for irrigation are effective.
  • Chlorhexidine, stannous fluoride, and phenols, as well as antibiotics, are used in irrigation solutions.
  • Tetracycline is absorbed by root surfaces, with therapeutic levels maintained for up to a week after irrigation with a 100mg/ml solution for 5 minutes.
  • Weak performances of chemotherapeutic agents are due to inability to maintain adequate concentration and rapid clearance by crevicular fluids.

Controlled-Release Devices

  • Site-specific, controlled-release delivery systems allow administration of drugs to infection sites for extended periods.
  • Active ingredients are incorporated into fibers, gels, chips, collagen film, acrylic strips, and polymers, which then release the drug over days.
  • Sufficient reservoir size is necessary to offset flushing action of crevicular fluid.

Systemic Antibiotics

  • Antibiotics reach widely distributed microorganisms in the body.

  • Only a small portion of the total dose reaches subgingival microflora.

  • Systemic antibiotics pose a higher risk of side effects compared to local delivery.

  • Metronidazole is used for severe cases of ANUG.

  • Various commercial preparations of antibiotics are available, e.g., Actisite, PerioChip, Atridox, Arestin, Dentomycin, and Elyzol.

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Related Documents

Chemical Plaque Control (Cont) PDF 2023

Description

This quiz explores various adjunctive aids for controlling subgingival plaque, including subgingival irrigation and controlled-release devices. It discusses effective techniques and the use of specific agents like chlorhexidine and tetracycline. Test your knowledge on these essential topics in periodontal therapy.

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