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Periodontics

How do you treat a periodontal abscess?

This Urgent care Scenario is presented by the JCDA Oasis Team in collaboration with Dr. Ignacio Christian Marquez, Associate Professor in the Division of Periodontics, Department of Dental Clinical Sciences, Faculty of Dentistry at Dalhousie University Periodontal Abscess Localized, purulent infection within the tissues adjacent to the periodontal pocket that may lead to the destruction of periodontal ligament and alveolar bone.     Investigation Inquire about any history of chronic periodontitis and the nature of any recent dental/periodontal interventions. Determine the existence of a periodontal pocket. Confirm the presence of purulent exudate. Obtain radiographic evidence of bone loss. However, the lack ...

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How can I promote esthetic papilla formation between adjacent implant-supported restorations on upper anterior teeth?

The following verbatim question was submitted by a practising dentist: My patient had implants to replace 11 and 21. I have placed contoured healing abutments and temporary crowns with the contact 4-5 mm above the bone (2 mm gingiva and 2 mm space). These have been in place 4 months and although the papilla has filled in between the laterals, the tissues are still flat between the 11 and 21 despite the fact that a periodontist placed the implants doing a graft to “bulk up”   the tissue. The patient is not overly concerned; however, you can see the area when he smiles, so ...

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How do I manage postoperative bleeding following periodontal surgery?

(Peer-reviewed content that will appear in the JCDA OASIS “point of care” searchable database at www.jcdaoasis.ca – which will be introduced at the beginning of 2013) How do I manage postoperative bleeding following periodontal surgery? Brennan Mui, Thomas T. Nguyen, Simon D. Tran Postoperative bleeding may present immediately, within the first 24 hours following periodontal surgery, or as delayed postoperative bleeding up to 7-10 days following surgery. Excessive bleeding may occur following routine periodontal surgical procedures, such as pocket reduction surgery or grafting, if stable hemostasis cannot be initially achieved. Normally, hemostasis is achieved within 30 to 60 minutes after surgical procedures ...

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Is there an accepted protocol for managing peri-implantitis?

(Content under development) The following question was submitted by a practising dentist: Is there an accepted protocol for the treatment/management of peri-implantitis and associated bone loss? JCDA Editorial Consultant Dr. Anastasia Cholakis of the University of Manitoba provided these initial comments for consideration: At this time, prevention of peri-implantitis seems to be the safest bet. According to the latest consensus of the 7th European Workshop on Periodontology “clinical and radiographic data should routinely be obtained after prosthesis installation on implants in order to establish a baseline for the diagnosis of peri-implantitis during maintenance of implant patients.” A proper in-office peri-implant maintenance protocol ...

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Does deep periodontal pocket disinfection with a soft tissue diode laser work?

(Content under development) The following question was submitted by a practising dentist: What clinical evidence is available for the efficacy of deep periodontal pocket disinfection with a soft tissue diode laser? What protocols are proven and recommended in terms of frequency of treatment? JCDA Editorial Consultant Dr. Debora Matthews of Dalhousie University provided this initial response for consideration:  There are two issues related to this question. The first is, does a soft tissue diode laser disinfect periodontal pockets (pocket disinfection therapy, or PDT)? The more important question, however, is whether diode lasers provide any additional clinical benefit over traditional scaling ...

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