Non-Surgical Therapy Flashcards

Which of the following best describes the rationale for the 4–8 week re-evaluation interval after completion of SRP?

Answer: To allow tissue healing and resolution of inflammation before reassessing residual disease

A 4–8 week interval allows sufficient time for tissue healing, resolution of edema, and reduction of probing depths before reassessing the need for further therapy.

Minocycline microspheres (Arestin) are classified as what type of delivery system when used as an adjunct to SRP?

Answer: Local sustained-release antibiotic

Arestin delivers minocycline locally into the periodontal pocket via bioresorbable microspheres, achieving high local concentrations while minimizing systemic exposure.

A patient with Stage II periodontitis has residual pockets of 4–5 mm at re-evaluation after SRP. According to current guidelines, the most appropriate next step is:

Answer: Re-instrumentation of residual pockets and continued supportive care

Residual 4–5 mm pockets after SRP may respond to re-instrumentation and optimization of risk factors before surgical intervention is considered.

Which of the following best explains why powered (ultrasonic) scalers can be equally effective as hand instruments for SRP?

Answer: Cavitation and acoustic microstreaming disrupt biofilm in addition to mechanical removal

Ultrasonic scalers produce cavitation and acoustic microstreaming effects that disrupt and flush the subgingival biofilm, complementing mechanical debridement.

Sub-antimicrobial dose doxycycline (SDD, Periostat 20 mg BID) exerts its periodontal benefit primarily through which mechanism?

Answer: Inhibition of host-derived matrix metalloproteinases (MMPs)

SDD at 20 mg BID does not reach bactericidal levels but suppresses host-derived MMPs (collagenase), thereby reducing collagen breakdown and attachment loss.

Which periodontal pathogen is considered the primary exogenous pathogen ('red complex' species) most strongly linked to deep, refractory periodontal pockets?

Answer: Porphyromonas gingivalis

Porphyromonas gingivalis is a keystone red-complex pathogen that produces virulence factors disrupting host immunity and is most strongly associated with severe periodontitis.

When using ultrasonic instrumentation on a patient with a cardiac pacemaker, what is the current AHA/AAP guidance?

Answer: Consult with the patient's cardiologist; modern pacemakers are generally shielded from ultrasonic interference

Modern pacemakers are shielded, but consultation with the cardiologist is recommended; older or externally worn devices may still pose a risk requiring precaution.