Questions and Answers
What does NSPT stand for?
Nonsurgical Periodontal Therapy
What is encompassed by the term NSPT?
Includes all nonsurgical procedures and education used to control periodontitis and gingivitis
What is the objective of NSPT?
Eliminate disease by returning periodontium to health and maintaining health with professional and patient self-care
What has NSPT also been known as?
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What are indications for use of NSPT?
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What is indicated for patients with more advanced periodontitis?
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Do patients with more advanced periodontitis ever go through NSPT?
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What are the 4 goals of NSPT?
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What is the ultimate goal of NSPT?
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What term is used to describe instrumentation of root and crown surfaces as well as removing plaque, staining, and calculus deposits?
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The instrumentation of root surfaces until they appear glassy as well as removing cementum and rough dentin impregnated with calculus or toxins is referred to as ____ ______.
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What emerging term is used to describe the removal or disruption of bacterial plaque, byproducts, and calculus from the crown and root surfaces that are within pocket spaces?
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What emerging term is used to describe subgingival microbial plaque removal?
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What type of strokes are used when root planing on root surfaces?
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Are more or less strokes used when root planing?
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Which pocket depths have the least effective percentages when scaling and root planing?
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According to research, what percent of effectiveness is there for scaling and root planing for 4-6 mm pocket depths?
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What is the % effectiveness for scaling and root planing 1-3 mm sulcus depths?
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What is the true importance of scaling and root planing?
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What is the 'endpoint' of instrumentation?
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What is the 'primary pattern' that helps to return the soft tissue to health?
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Is there formation of new bone, cementum, or a periodontal ligament when the tissue heals?
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According to research, where are the most significant gains of attachment found after scaling and root planing?
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On average, probing depths that are initially ≥7 mm have a probing depth reduction of how many mm?
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On average, probing depths that are initially 4-6 mm have a probing depth reduction of how many mm?
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What is the mean reduction of BOP following SRP (this is regardless of pocket depth)?
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When is tissue healing assessed after SRP?
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When should re-evaluation (to see how the patient is responding to the therapy) be scheduled after instrumentation?
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What are signs that the site is non-responsive to therapy?
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What is the first thing you should do if there are signs that the patient did not respond to therapy?
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What should be considered if you reinstrument and reevaluate a few weeks later and the patient is still nonresponsive to treatment?
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A formal step in NSPT designed to gather information and use in several critical clinical decisions regarding future care of patients with periodontitis is called?
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What procedures are included in the re-evaluation?
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Determining the need for additional NSPT, establish need for a periodontal maintenance program, evaluate need for periodontal surgery, evaluate the need for a referral to a periodontist is included in what process of NSPT?
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What decision should be made for a patient with aggressive periodontitis, or a patient with moderate or severe chronic periodontitis that needs surgery?
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What is the goal of establishing a periodontal maintenance program?
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What might periodontal surgery be needed for?
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Who should be placed on a periodontal maintenance program after NSPT?
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Subgingival calculus deposits that were unreachable may be accessible because of tissue shrinkage may cause the need for what?
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Is it common or uncommon for the re-evaluation to show that the patient needs additional NSPT?
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What is the patient considered in the role of self-care?
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What tissues are damaged first by periodontal diseases?
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What are critical for periodontal maintenance patients?
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Study Notes
Nonsurgical Periodontal Therapy (NSPT)
- NSPT stands for Nonsurgical Periodontal Therapy, which includes all nonsurgical procedures aimed at controlling periodontitis and gingivitis.
- Primary objective of NSPT is to eliminate periodontal disease and maintain health through professional and patient self-care.
Indications and Goals
- NSPT is indicated for ALL patients with plaque-associated gingivitis or chronic periodontitis.
- Key goals of NSPT include minimizing bacterial challenges, controlling local and systemic risk factors, and stabilizing attachment levels.
- The ultimate goal of NSPT is to stabilize attachment levels.
Procedures and Techniques
- Instrumentation methods include scaling (traditional term for removing plaque and calculus) and root planing (removal of cementum and toxins).
- Emerging terms such as periodontal debridement and deplaquing focus on removing bacterial plaque from pocket spaces and subgingival areas.
- Root planing requires long, light strokes; more strokes are often needed compared to traditional methods.
Effectiveness and Outcomes
- Efficacy of scaling and root planing varies by pocket depth:
- 1-3 mm sulcus depths show 83% effectiveness.
- 4-6 mm pockets demonstrate 43% effectiveness.
- Pockets ≥7 mm show reduced effectiveness at 32%.
Healing and Follow-Up
- True importance of scaling and root planing lies in reducing the critical mass of residual deposits.
- Endpoint of instrumentation is returning to soft tissue health, which involves the formation of a long junctional epithelium without new bone or periodontal ligament formation.
- Probing depth reductions average 2 mm for pockets ≥7 mm and 1 mm for 4-6 mm pockets.
Reevaluation and Critical Decision-Making
- Tissue healing is assessed at least one month post-SRP, and re-evaluation should occur 4-6 weeks after instrumentation.
- Non-responsive sites exhibit signs of inflammation, more attachment loss, and bleeding; initial steps include re-exploration for residual deposits.
- Critical decision-making includes determining the need for additional NSPT, evaluating surgical options, and referrals to specialists for severe cases.
Maintenance and Patient Involvement
- Periodontal maintenance programs aim to prevent recurrence and are essential for all patients with chronic periodontitis after NSPT.
- Host factors must be considered when reassessing non-responsive patients.
- Patients play a critical role in self-care, acting as co-therapists alongside professionals.
Tissue Impact and Aids
- Interdental tissues are typically the first damaged by periodontal diseases, highlighting the need for effective interdental aids in maintenance care.
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Test your knowledge on Nonsurgical Periodontal Therapy (NSPT) with these flashcards. The quiz covers key terms, definitions, and objectives related to NSPT, essential for understanding periodontal health and treatment. Perfect for dental students and professionals looking to reinforce their learning.