Podcast
Questions and Answers
Why is it difficult to determine the most efficacious approach for adjunctive therapy?
Why is it difficult to determine the most efficacious approach for adjunctive therapy?
- Because local and systemic adjunctive therapies are mutually exclusive.
- Because clinical outcomes are always unpredictable.
- Because surgical therapy is always the best option.
- Because there is not enough data available to compare different therapies. (correct)
What is often used to treat pocket sites that do not respond to nonsurgical therapy?
What is often used to treat pocket sites that do not respond to nonsurgical therapy?
- Systemic antimicrobials
- Locally delivered antimicrobials
- SRP alone
- Surgical therapy (correct)
What can improve clinical outcomes after periodontal surgery?
What can improve clinical outcomes after periodontal surgery?
- Regular dental check-ups
- SRP alone
- The use of locally delivered, controlled-release antimicrobials (correct)
- The use of systemic antimicrobials
What is peri-implantitis?
What is peri-implantitis?
What is a potential rationale for the use of locally delivered, controlled-release antimicrobials?
What is a potential rationale for the use of locally delivered, controlled-release antimicrobials?
What is a well-known risk factor for the development or progression of periodontitis?
What is a well-known risk factor for the development or progression of periodontitis?
What can enhance the efficacy of SRP in smokers?
What can enhance the efficacy of SRP in smokers?
What is a potential advantage of adjunctive therapy for patients who smoke?
What is a potential advantage of adjunctive therapy for patients who smoke?
What is a potential adverse effect of locally delivered, controlled-release antimicrobials?
What is a potential adverse effect of locally delivered, controlled-release antimicrobials?
What is SRP?
What is SRP?
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Study Notes
PerioCol-TC
- Each vial contains 25 mg of fish type I collagen impregnated with 2.0 mg of tetracycline hydrochloride, sterilized by gamma radiation.
- Releases tetracycline in vitro for 8-10 days.
- Indicated for the treatment of adult periodontitis as an adjunct to scaling and root planing (SRP) for pockets more than 5 mm deep.
- Biodegradable and does not require removal.
Doxycycline Gel
- A subgingival, controlled-release delivery product composed of a two-syringe mixing system.
- Contains 450 mg of a bioabsorbable polymeric formulation of 36.7% poly (D,L-lactide) and 50 mg of doxycycline hyclate.
- Indicated for the treatment of chronic adult periodontitis for a gain in clinical attachment, reduction in probing depth, and reduction of bleeding on probing.
- Biodegradable and does not require removal.
Ligosan Slow Release
- A 14% (w/w) resorbable doxycycline gel for periodontal application.
- Contains 260 mg of Ligosan Slow Release in single-application cylinder cartridges.
- Releases doxycycline in the GCF over 12 days.
- Mechanical hygiene in the area should be avoided for 7 days.
Minocycline Microspheres
- A subgingival, controlled-release delivery system containing the antibiotic minocycline hydrochloride.
- Each cartridge delivers minocycline hydrochloride equivalent to 1 mg of minocycline free base.
- Indicated as an adjunct to SRP for the reduction of pocket depth in patients with adult periodontitis and as part of a periodontal maintenance program.
- Biodegradable and does not require removal.
Rationale for Local Delivery and Controlled Release
- Chronic adult periodontitis is a multifactorial disease involving susceptible hosts, pathogenic oral plaque microorganisms, and behavioral or environmental factors.
- Local delivery and controlled release of antimicrobials can enhance the clinical efficacy of SRP.
Clinical Indications
- Combination adjunctive therapy with locally delivered, controlled-release antimicrobials and systemic therapy with low-dose doxycycline can enhance the clinical efficacy of SRP.
- Locally delivered, controlled-release antimicrobials can improve clinical outcomes after periodontal surgery in regenerative and non-regenerative settings.
- Peri-implantitis can be treated with locally delivered, controlled-release antimicrobials targeting the local microflora.
Tobacco Smoking
- Smoking is a risk factor for periodontitis and can limit the effectiveness of periodontal therapy.
- Adjunctive therapy with locally delivered, controlled-release antimicrobials can enhance the efficacy of SRP in smokers.
Adverse Effects and Cautions
- Potential for hypersensitivity reactions.
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