Non-Surgical Therapy Flashcards

The 'one-stage full-mouth disinfection' protocol (Quirynen) differs from quadrant-by-quadrant SRP primarily in that it:

Answer: Treats all quadrants within 24 hours combined with antiseptic protocol to prevent reinfection from untreated sites

Full-mouth disinfection treats all sites within 24 hours and uses chlorhexidine irrigation to prevent cross-contamination from untreated reservoirs to treated sites.

In the context of non-surgical therapy for necrotizing periodontal disease (NUG/NUP), which treatment sequence is most appropriate during the acute phase?

Answer: Gentle supragingival debridement, patient instructions, and oral rinse; defer SRP until acute phase resolves

During the acute phase of NUG/NUP, gentle supragingival cleaning and antimicrobial rinses manage acute symptoms; aggressive SRP is deferred until inflammation resolves to avoid systemic spread.

Which root surface characteristic after SRP is most associated with favorable cell attachment and re-attachment during healing?

Answer: Clean, biocompatible cementum with exposed collagen fibers

Removal of calculus, endotoxin, and the smear layer exposes clean cementum with collagen fibers, which promotes fibroblast and PDL cell attachment during healing.

A 45-year-old patient is on amlodipine for hypertension and presents with gingival enlargement. Which non-surgical intervention is the first priority?

Answer: Rigorous plaque control instruction and thorough SRP to eliminate inflammation

Drug-influenced gingival enlargement is exacerbated by plaque; eliminating inflammation through meticulous oral hygiene and SRP often reduces enlargement and may avoid surgical intervention.

Which evidence-based adjunct to SRP has demonstrated statistically significant, though clinically modest, improvements in pocket depth reduction compared to SRP alone?

Answer: Locally delivered sustained-release antimicrobials (e.g., Arestin, Atridox)

Multiple systematic reviews show that locally delivered sustained-release antimicrobials (Arestin, Atridox, PerioChip) provide statistically significant but modest (0.2–0.5 mm) additional pocket depth reduction over SRP alone.

Root planing has traditionally aimed to produce a 'hard, glassy' root surface. Current evidence regarding excessive root planing suggests:

Answer: Excessive root planing unnecessarily removes cementum and may compromise healing; biofilm disruption is the primary goal

Endotoxin is superficially adherent to root surfaces, so removing all cementum is not necessary; the current goal is biofilm and calculus removal while preserving cementum for healing.

For a patient with aggressive periodontitis (now classified as Stage III/IV Grade C), what systemic antibiotic combination has the strongest evidence as an adjunct to SRP?

Answer: Amoxicillin 500 mg + metronidazole 500 mg TID for 7–14 days

The amoxicillin + metronidazole combination has the strongest evidence base as a systemic adjunct to SRP in Grade C (formerly aggressive) periodontitis, targeting A. actinomycetemcomitans and anaerobes.