Supportive Periodontal Therapy & Maintenance Flashcards

Approximately what percentage of SPT patients experience recurrence of periodontitis despite regular maintenance visits?

Answer: 20–30%

Research indicates approximately 20–30% of SPT patients experience some degree of disease recurrence even with regular recall, underscoring the importance of ongoing risk assessment.

Which approach to subgingival debridement is MOST effective during SPT maintenance visits for residual pockets?

Answer: Ultrasonic instrumentation combined with hand scaling

Combining ultrasonic instrumentation with hand scaling provides the most thorough removal of biofilm and calculus from residual pockets, as each modality accesses areas the other may miss.

A patient at their 4-month SPT visit presents with localized reactivation at two posterior sites with 6mm pocketing and 2mm attachment loss. What is the BEST course of action?

Answer: Provide site-specific retreatment and refer to a periodontist to evaluate for surgical intervention

Localized reactivation with 6mm pocketing and attachment loss requires targeted retreatment and periodontist consultation to determine if surgical therapy is indicated.

How does tobacco smoking most significantly affect outcomes in supportive periodontal therapy?

Answer: Smoking masks bleeding on probing and impairs immune response, increasing recurrence risk despite apparent clinical stability

Nicotine-induced vasoconstriction suppresses gingival bleeding (masking active disease), while smoking impairs neutrophil function and tissue healing, worsening SPT prognosis.

Which interdental cleaning aid is MOST effective for SPT patients with open embrasures (type III papilla)?

Answer: Interdental brush sized to fit the embrasure

Interdental brushes are most effective for open embrasures because they conform to wider interproximal concavities and remove biofilm from root surfaces where the papilla is absent or reduced.

Which of the following MUST be documented at every SPT visit?

Answer: Probing depths, bleeding on probing, plaque score, treatment provided, and any clinical changes since the last visit

Comprehensive SPT documentation including objective periodontal data, clinical findings, and treatment rendered is required to detect disease trends and maintain legal and ethical accountability.

Which adjunctive therapy is most appropriate for high-risk SPT patients with persistent pocketing of ≥5mm that fails to respond to repeated mechanical debridement?

Answer: Locally delivered antimicrobials (e.g., minocycline microspheres or doxycycline gel) placed in affected sites

Locally delivered antimicrobials applied directly into persistent pockets can reduce subgingival pathogen levels and pocket depth as a site-specific adjunct to mechanical debridement in high-risk SPT patients.