Non-Surgical Therapy Flashcards

Which parameter is the most reliable clinical indicator of disease activity (ongoing attachment loss) in a periodontal pocket during non-surgical therapy monitoring?

Answer: Bleeding on probing (BOP) combined with clinical attachment level (CAL) changes

Persistent BOP combined with CAL changes over time is the most reliable indicator of active periodontal disease; probing depth alone does not distinguish active from stable disease.

Which of the following best describes the concept of 'supportive periodontal therapy' (SPT) following active non-surgical therapy?

Answer: Regular periodontal maintenance visits to monitor, reinforce hygiene, and remove supra/subgingival deposits to prevent recurrence

SPT involves periodic re-evaluation, reinforcement of oral hygiene, and professional debridement at intervals tailored to disease risk to prevent recurrence of periodontitis.

A patient presents with a 6 mm isolated pocket on the mesial of tooth #3 with no bone loss radiographically. After SRP, the most likely finding at re-evaluation is:

Answer: Pocket reduction primarily due to gingival tissue shrinkage (recession) and reduced edema

Pocket reduction after SRP in pseudo-pockets results primarily from resolution of gingival inflammation, reduced edema, and tissue shrinkage rather than regeneration of lost structures.

Which of the following is the most evidence-based approach to deciding on systemic antibiotics as an adjunct to SRP?

Answer: Reserve for selected cases (Stage III/IV Grade C, poor initial response, specific pathogen burden) to minimize resistance

Systemic antibiotics should be targeted to specific indications to maximize benefit and minimize risks of adverse effects and antibiotic resistance development.

During non-surgical therapy, what is the clinical significance of furcation class (Hamp classification) when considering treatment prognosis?

Answer: Class III furcation-involved teeth have the worst prognosis after SRP due to inaccessible root surfaces

Class III (through-and-through) furcations are largely inaccessible to hand and ultrasonic instruments, resulting in incomplete debridement and a guarded-to-poor prognosis for non-surgical therapy.

Which of the following chemical plaque control agents has been shown to have the strongest evidence for reducing gingivitis when used as a twice-daily adjunct to mechanical oral hygiene?

Answer: Chlorhexidine gluconate 0.12%

Chlorhexidine gluconate 0.12% oral rinse has the strongest body of evidence for chemical plaque control and gingivitis reduction, and is considered the 'gold standard' antiplaque agent.

Laser-assisted non-surgical periodontal therapy (e.g., Nd:YAG, Er:YAG) is best characterized as:

Answer: An adjunctive modality that may offer modest clinical benefits but lacks evidence to replace conventional SRP

Current systematic reviews indicate laser therapy may offer modest adjunctive benefits to SRP, but evidence is insufficient to establish it as a replacement for conventional non-surgical debridement.