2. basic treatment for periodontal disease

Basic Treatment for Periodontal Disease

Dr. Sok Chea D.D.S, F.A.D.I, F.I.C.C.D.E, F.C.S.PPost Graduate Diploma in PeriodontologyPeriodontal SpecialistCert. Periodontic (Japan)Cert. Intensive Oral Implantology (H.K)

The general process of periodontal disease

Treatment for improved Inflammation1.Tooth brush instruction (TBI)2.Scaling, Root planing3.Form adjustment of the unfit prosthesis 4.Provisional restoration for missing tooth/teeth or prosthetic problem5. Extraction

Treatment for improved occlusal problems1. Selective grinding, coronoplasty2. Temporary splint3. LOT (Limited Orthodontic Treatment: Miner Tooth Movement)

Reevaluation of initial treatment


Periodontal Surgery

Reevaluation of periodontal surgery

Final restoration

Supportive Periodontal Therapy(SPT)Maintenance

Sometime, features of Periodontitis or

periodontal abscess is a good material

for the motivation of periodontaltreatment

Motivation and education for periodontal treatment

Practical use of the Plaque Control Record (PCR)

First visit

2 weeks later

First visit 2 weeks later

Practical use of the Plaque Control Record (PCR)

First visit

2 weeks later

Instruction for plaque control

To choose the adapted tooth brush For habit or form of dentition in each patients To instruct the adapted tooth brush method for the periodontal condition in each patients

Dental Floss

Interdental brush

Ultrasonic tooth brush

Before initial preparation

After initial preparation

Effective of initial preparation

This case was done only plaque control and brushing

Cleaning and polishing brush for tooth surface

Prophylaxis paste: include 0.15% fluorides

Polishing tooth surface by rubber chip/cup

Polishing paper strips: sometime use this material in the final polishing phase at the interdental surface

Before scaling　 & polishing

After scaling & polishing


Treatment for improved Inflammation1.Tooth brush instruction (TBI)1.Tooth brush instruction (TBI)2.Scaling, Root planing2.Scaling, Root planing3.Form adjustment of the unfit3.Form adjustment of the unfit prosthesisprosthesis 4.Provisional restoration for missing tooth/teeth or prosthetic problem5. Extraction



Re-contouring of defective restoration and crown that occurred periodontal inflammation

The overhanging form is caused by plaque accumulation

After re-contouring: the crown of buccal surface become to natural smooth form

Subgingival Plaque ControlSubgingival Curettage

Subgingival Root Planing

Enamel

CalculusGingiva

Scaler

Subgingival Root Planing

• To remove the plaque, calculus and pathologic cementum at subgingiva used by hand scaler

• To make a smooth root surface used by hand scaler

• Due to the effect of root planing, the gingiva become to change a strong fibrous tissue

• Due to the effect of root planing, the occasion of infection become to decrease

Before root planing targets to periodontal abscess

After root planing. The periodontal abscess is eliminated

Before root planing in the full mouth with no surgery

After root planing. There is no inflammation and active pockets

Root treatment in subgingiva

Crown/root polishing and instruction for after treatment in subgingiva

Scaling and root planing

To remove fragment of calculus and cementum.Ablution of pollute and infect substance

Crown and root polishing

After root planing and polishing



Treatment for improved occlusal problems1.1. Selective grinding, coronoplastySelective grinding, coronoplasty2. Temporary splint3. LOT (Limited Orthodontic Treatment: Miner Tooth Movement)


Occlusal adjustmentSpot grinding

Coronal reshaping



Treatment for improved occlusal problems1. Selective grinding, coronoplasty2.2. Temporary splintTemporary splint3. LOT (Limited Orthodontic Treatment: Miner Tooth Movement)


Temporary splint used by adhesive composite resin

Occlusal adjustment

After initial preparation.

Temporary splint and provisional restoration case

First visit: Occlusal collapse was shown in all of teeth

After initial preparation

Provisional restoration by denture type was set. This denture was a fix type for stabilized teeth.

A-splint (Wire resin splint)

A-splint used by shape memory alloy

The shape memory alloy is made from mixed nickel and titanium. This alloy is able to back same shape after bend.



Treatment for improved occlusal problems1. Selective grinding, coronoplasty2. Temporary splint3.3. LOT (Limited Orthodontic LOT (Limited Orthodontic Treatment: Miner Tooth Movement)Treatment: Miner Tooth Movement)


The case of periodontitis, occlusal disharmony and esthetic problems

Extraction

Open bite case caused by occlusal disharmony

The occlusal disharmony caused by infra occlusion at posterior teeth then mandibular deviate to posterior position. This situation is pushed up anterior teeth on maxilla

Orthodontic treatment used by arch wire and brackets

4 month later after orthodontic treatment and bit raising at posterior site

After remove the orthodontic appliance, the case was set retention appliance

Final view of initial preparation includes orthodontic treatment

Up righting and muco gingival surgery case

Inclination

Buccal frenulum No attached gingiva

Temporary bridge was set before orthodontic treatment and muco gingival surgery

Muco gingival surgery at buccal site. This case was done mixed procedure of frenectomy and vestibular extension surgery

Limited orthodontic treatment was done used by double loop splinting

3 month later

5 month later




Reevaluation of initial treatmentReevaluation of initial treatment

2. basic treatment for periodontal disease

Documents