Periodontal FAQ’s

Scott A. Reef, DDS, MSD and Justin J. Villanueva, DMD, MSD, DHL – Periodontal Associates of Lafayette

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QUESTION:

A connective tissue graft can be used to cover gingival recession, decrease sensitivity and improve aesthetics. Where is the most common place to obtain the connective tissue used for the graft?

ANSWER:

The palate is the most common place to obtain connective tissue grafts. A small incision is made in the palate and tissue is removed, according to the amount needed for the recession area. Sutures may or may not be needed in this area.

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QUESTION:

There are several medications that can cause the gingiva to enlarge. Can you name one of them?

ANSWER:

Drug induced gingival enlargement is a well-known phenomenon. Phenytoin (Delantin) is well known to cause this reaction. Immunosuppressants such as Cyclosporine and calcium channel blockers used to treat high blood pressure such as Nifedipine and Verapamil also cause gingival enlargement.

If you have a patient with enlarged gingiva, be sure to check the medication list and possibly contact the prescribing physician to see if there is another medication the patient may take that will not cause this problem. Sometimes the enlargement will resolve after the medication is discontinued, most times the tissue will need a gingivoplasty for it to return to a normal contour. If the patient must stay on the medication, a gingivoplasty may still be performed, but there is a chance for recurrence.

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QUESTION:

What distinguishes Periodontitis from Gingivitis?

ANSWER:

Both are inflammatory diseases of the periodontal tissue. Periodontitis is characterized by a loss of clinical attachment due to the destruction of the periodontal ligament and supporting bone structure. There is no loss of attachment with gingivitis and it is reversible.

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QUESTION:

What is the active ingredient in Arestin?

ANSWER:

Arestin is a localized antibiotic designed to treat localized periodontal disease by inserting it into the gingival crevice. The active ingredient is minocycline hydrochloride, a form of tetracycline.

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QUESTION:

After a patient has scaling and root planing, when is the appropriate time to re-evaluate?

ANSWER:

Four to six weeks after the last scaling and root planing.

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QUESTION:

In general, how many furcations are there on maxillary molars?

ANSWER:

Three – buccal, mesial and distal.

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QUESTION:

In general, how many roots do lower molars have:

ANSWER:

Lower molars generally have two roots, one mesial and one distal. Sometimes, however, we see lower molars with three or even four roots!!

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QUESTION:

What is the literal meaning of PERIODONTITIS ?

ANSWER:

PERI = around, ODONT = tooth, ITITS = inflammation / So this in the inflammatory disease that affects the surrounding supporting structures of the teeth.

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 QUESTION:

If tooth #19 is described as having a grade III furcation, what does that mean?

ANSWER:

There is a complete bone loss between the mesial and distal roots. Furcations are the areas where roots on multi-rooted teeth converge. Bone loss in these areas is described as Grade I – just in furcation entrance, Grade II – can probe into the furcation but not all the way through, Grade III – Bone loss all the way through the furcation.

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