Subgingival instrumentation: do we really know it? - Prof Filippo Graziani LIVE
TLDRThe webinar, led by Professor Filippo Graziani, delves into the intricacies of periodontal treatment, emphasizing the importance of proper instrumentation techniques in maintaining oral health. Graziani discusses various methods such as debridement, scaling, and root planing, and clarifies misconceptions surrounding these terms. He highlights the role of different instruments, including ultrasonic and manual tools, in achieving effective treatment outcomes. The lecture also addresses the impact of the COVID-19 pandemic on dental practices, suggesting a shift towards manual instrumentation to minimize aerosol production. Graziani further explores the use of regenerative materials in non-surgical treatments to enhance healing and potentially reduce the need for surgical interventions. The discussion underscores the significance of patient factors, such as smoking habits and tooth type, in determining treatment success. The webinar concludes with an interactive Q&A session, providing attendees with an opportunity to engage with the speaker and gain insights into evidence-based periodontal care.
Takeaways
- π **Positive Expectations**: Despite challenging times, maintaining a positive outlook is crucial, and the COVID-19 crisis has led to the discovery of powerful online tools for e-learning and staying updated in various fields.
- π **Importance of Continuing Education**: The pandemic has accelerated the trend of attending numerous courses in a short time, highlighting the value of continuous learning in professional development.
- π **Awards and Recognition**: Professor Filippo Graziani's achievements, including international awards and his role in founding the Perio Campus, emphasize the significance of academic and clinical excellence.
- π¨ββοΈ **Clinical Expertise**: Filippo's expertise in Periodontology and his ability to balance humor and professionalism in his approach to teaching and patient care are key aspects of his success.
- π **Understanding Instrumentation**: Clarifying the differences between debridement, scaling, and root planing is essential for effective periodontal treatment, and using the right instruments for each is critical.
- π **Role of Ultrasonic Instruments**: Ultrasonic instruments are efficient for both scaling and root planing, but their use requires an understanding of their mechanics and movement for optimal results.
- π **Manual Instrumentation Resurgence**: Due to the pandemic, there is a shift towards manual instrumentation to minimize aerosol production, which may increase treatment time but is necessary for safety.
- π‘ **Goal-Oriented Treatment**: The focus should be on the treatment goal rather than the instrument used, as the instrument is merely a tool to achieve the desired clinical outcome.
- π« **Limitations of Plastic Instruments**: Plastic instruments are not recommended for clinical use due to their ineffectiveness in comparison to ultrasonic and manual instruments.
- β±οΈ **Time Considerations in Treatment**: The choice between full-mouth and quadrant treatments may be influenced by factors such as patient's medical status, distance traveled for treatment, and the presence of comorbidities.
- π **Regenerative Approaches**: The use of regenerative materials in a flapless approach following non-surgical treatment can enhance results and reduce the need for surgical interventions.
Q & A
What are the three main types of subgingival instrumentation?
-The three main types of subgingival instrumentation are debridement, scaling, and root planing. Debridement involves the removal of soft deposits, scaling refers to the removal of calcified deposits (calculus), and root planing is the reshaping of the root surface.
What is the primary goal of periodontal treatment?
-The primary goal of periodontal treatment is to remove plaque, which is the main cause of periodontal disease. This is achieved through various types of instrumentation, with the aim of restoring the health of the periodontium and preventing further damage.
Why is it important to choose the right instrument for the type of periodontal treatment?
-Choosing the right instrument is crucial because it ensures the effectiveness of the treatment. Different instruments are designed for different types of instrumentation, and using the appropriate tool can lead to better patient outcomes, minimize discomfort, and reduce the risk of damage to the tooth or gum tissue.
What are the considerations when deciding between full-mouth and quadrant treatments?
-Factors to consider include the patient's medical history, the severity of periodontal disease, the patient's ability to maintain oral hygiene, the presence of comorbidities, and logistical factors such as the patient's ability to attend multiple appointments.
How does the use of an air polisher compare to ultrasonic and manual instruments in terms of safety and effectiveness?
-Air polishers are generally safe but have been reported to potentially cause issues like emphysema if used improperly. In terms of effectiveness, plastic instruments (air polishers) are not as effective as ultrasonic or manual instruments for subgingival debridement. Ultrasonic instruments are efficient for both scaling and root planing, while manual instruments are preferred for precision and control, especially in deep or narrow pockets.
What is the role of antibiotics in non-surgical periodontal treatment?
-Antibiotics are not typically prescribed as a routine part of non-surgical periodontal treatment. However, in specific cases, such as when there is a high risk of bacterial infection or in patients with certain comorbidities, a short course of antibiotics may be prescribed toθΎ ε© (aid) the treatment.
How does the concept of biological width relate to periodontal treatment?
-Biological width is the distance from the bottom of the gingival sulcus to the alveolar bone crest. It should not be impacted by proper periodontal treatment. The goal is to perform instrumentation above the connective tissue attachment to avoid damaging the biological width and to allow for the formation of a long junctional epithelium, which can lead to pocket closure.
What are the factors that influence the healing process after periodontal treatment?
-Factors that influence healing include the patient's smoking status, the type of tooth (single-rooted or multi-rooted), the presence of plaque, and the patient's overall health and compliance with post-treatment oral hygiene instructions.
What is the significance of the 'Perio Campus Herald' mentioned by Professor Graziani?
-The 'Perio Campus Herald' is a new initiative by Professor Graziani that aims to provide a platform for the periodontology community to share knowledge and learn from each other. It represents a new way of communicating and teaching periodontology.
Why is it recommended to minimize the use of anesthesia during periodontal treatment?
-Minimizing the use of anesthesia is recommended to reduce invasiveness and discomfort for the patient. With advancements in instruments and techniques, such as the use of mini micro tips and magnification or microscopes, treatments can be performed with less need for anesthesia, leading to a more comfortable experience for the patient.
How does the presence of a furcation in a molar affect the decision to proceed with non-surgical or surgical treatment?
-A furcation, or the area where the roots of a molar split, can make non-surgical treatment less effective if it is involved in periodontal disease. If a deep pocket is associated with a furcation defect, it is often an indication for surgical treatment to effectively address the issue.
Outlines
π Introduction and Acknowledgement of Prof. Filippo Graziani
The first paragraph introduces the speaker, Professor Filippo Graziani, highlighting his academic and clinical achievements. It emphasizes the impact of the COVID-19 crisis on educational activities and how it has shifted towards online learning. The speaker, Professor Graziani, is praised for his teaching, clinical work, and contributions to the field of Periodontology. The introduction also mentions the format of the lecture, which will include a Q&A session.
π¦ Misconceptions in Subgingival Instrumentation
This paragraph discusses the common misconceptions in subgingival instrumentation, such as the misuse of terms like debridement, scaling, and root planing. It clarifies the definitions and differentiates between the capabilities of various instruments, such as ultrasonic and manual tools, in removing plaque, calculus, and reshaping the root surface. The paragraph also touches on the importance of selecting the right instrument based on the treatment goal.
π Clinical Practice and Instrumentation Techniques
The third paragraph delves into the clinical practice of using ultrasonic and manual instruments, emphasizing the need for a clear understanding of the treatment goal before choosing the instrument. It discusses the mechanics of subgingival instrumentation, the importance of using the correct technique to avoid increasing treatment time, and the potential resurgence of manual instrumentation due to the pandemic's impact on aerosol production.
π₯ Full Mouth Instrumentation and Treatment Protocols
This paragraph outlines different full mouth instrumentation protocols, comparing conventional treatment methods to full mouth debridement. It highlights the decision-making process when choosing between quadrant and full mouth treatments, taking into account factors like patient's medical status, the need for antibiotics, and the presence of comorbidities. The speaker also shares recent findings on the impact of treatment length on systemic inflammation.
π Impact of Instrumentation on Biological Width and Treatment of Furcation Lesions
The fifth paragraph explores the impact of scaling on biological width, emphasizing that instrumentation should be performed above the connective tissue attachment to avoid compromising the biological width. It also discusses the treatment of furcation lesions, suggesting that endodontic treatment should be considered before periodontal surgery and that the decision to treat such lesions depends on their origin and the patient's specific conditions.
π Conclusion and Future Directions in Periodontology
The final paragraph concludes the lecture by reiterating the importance of patient management and non-surgical treatment in periodontology. It suggests that surgery is not always necessary and that non-surgical treatments can be highly effective if performed correctly. The speaker also invites the audience to explore new educational resources like the Perio Campus Herald and thanks the participants for their attention.
Mindmap
Keywords
π‘Periodontology
π‘Subgingival instrumentation
π‘Debridement
π‘Root planing
π‘Ultrasonic instruments
π‘Manual instrumentation
π‘Pocket reduction
π‘Clinical attachment level (CAL)
π‘Full mouth debridement
π‘Aesthetics in dentistry
π‘Biological width
Highlights
The importance of maintaining a positive outlook during difficult times, such as the COVID-19 crisis, and leveraging web environments for e-learning and staying updated.
Introduction of Professor Filippo Graziani, a renowned expert in Periodontology, highlighting his academic and clinical achievements.
Emphasis on the distinction between debridement, scaling, and root planing in periodontal treatment and the common misconceptions surrounding these terms.
The role of ultrasonic, manual, and laser instruments in periodontal treatment and their specific applications.
Discussion on the effectiveness of debridement in closing pockets and the historical context of plaque removal's impact on periodontal health.
Insight into the use of photodynamic therapy for treating residual pockets during supportive periodontal therapy.
The preference for manual instrumentation during the pandemic to minimize aerosol production and the potential shift towards manual treatments.
Clinical tips for using curettes effectively in periodontal treatment, including the number of strokes and the importance of a sharp instrument.
The impact of patient factors, such as smoking and tooth type, on the healing process and treatment outcomes in periodontal therapy.
The concept of full mouth disinfection and its application in periodontal treatment, including the use of antibiotics and the timing of treatment.
The use of EDTA and enamel matrix derivatives in a flapless approach to enhance non-surgical periodontal treatment outcomes.
The potential for non-surgical periodontal treatment to reduce the need for surgical interventions in certain cases.
The importance of patient management and the role of non-surgical treatment in achieving periodontal health, with surgery being a last resort.
The influence of comorbidities on treatment decisions, including the consideration of acute phase response in patients with cardiovascular problems.
Recommendations for the use of specific instruments, such as mini micro curettes, to minimize invasiveness and improve treatment efficacy.
The introduction of the Perio Campus Herald, a new community-driven journal for periodontology, as a resource for further learning and engagement.
Transcripts
Browse More Related Video
Periodontics | Non-Surgical Therapy | INBDE, ADAT
Periodontics | Adjunctive Therapy | INBDE, ADAT
Periodontics | Surgical Therapy | INBDE, ADAT
Cavitron Insert Portfolio | Dentsply Sirona
Cavitron Plus Set-Up Guide/Tutorial With Insert Overview | Dentsply Sirona
Periodontics | Treatment Planning | INBDE, ADAT
5.0 / 5 (0 votes)
Thanks for rating: