hvordan oppnå sykdomskontroll?medlemssiden.tannpleier.no/wp-content/uploads/2016/... ·...
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NTpF Fagkonferanse 2015 Sandefjord
Hvordan oppnåsykdomskontroll? Ragnar Håkstad
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❖ Plakkontroll
❖ Pasientkommunikasjon
❖ Periodontal instrumentering
❖ Pasientoppfølging (vedlikeholdsbehandling)
❖ Tannpleiere
Hvordan oppnå en vellykketbehandling?
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Hvordan oppnå en vellykket behandling?
Plakkontroll
Clinical Periodontology and Implant Dentistry, 2008, 5th Edition, By Jan Lindhe
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Tannbørsting
❖ Vanlig tannbørste ca. 50% plakkreduksjon med
tannpuss sammenlignet med ikke tannpuss
❖ Elektrisk tannbørste (oscillerende/roterende) gir noe
mindre plakk og gingivitt (fjerner 7% mer plakk (Deery C.
et. al 2004)
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Solobørste
❖ Når 2-3 mm subgingivalt
❖ Gingivale retraksjoner
❖ Uryddig tannstilling,
inverteringer og skråstilte
tenner
❖ Furkasjoner
❖ Lingualflater og fasialflater og
underkjeve front
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Approksimalt
❖ Vanlig tannbørste er ikke godt nok
❖ Individualiser til den enkelte
❖ Hva pasienten er vant til og om dette fungerer
❖ Størrelse på aproksimalrommene og rotflateanatomi
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Tanntråd forskning
❖ Lav «complience» trolig på grunn
av pasientens evne og
motivasjon (Van der Weijden GA
et al 2005)
❖ Tanntråd virker å ha liten
ytterligere effekt sammenlignet
med bruk av tannbørste
(Periodontology 2000, 55, 2011)
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Tannstikker
Tannstikker kan presse vekk gingiva og fjerne subgingivalt plakk.
Denne egenskapen kan være en fordel med tannstikke
Periodontology 2000, 55, 2011
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Periodontology 2000, 55, 2011
Mellomromsbørste
Significant difference:
PLI: 8 studier
PPD: 2 studier
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Mellomromsbørster
❖ Kan fjerne plakk 2 mm
subgingivalt (Værhaug J. et al
1976)
❖ Hos unge personer med intakte
papiller kan ikke
interdentalbørste brukes
❖ Som komplement til
tannbørstingen er
interdentalbørsten bedre
sammenlignet med tanntråd
(Slot et al 2008)
http://www.tepe.com
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http://www.tepe.com
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Plakkinnfarging
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Plakkinnfarging3. kvadrant lingualt
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Hygieneinstruksjon
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Hygieneinstruksjon
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Hygieneinstruksjon
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Pasientkommunikasjon
Hvordan oppnå en vellykket behandling?
http://tunheim.com
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Periodontal instrumentering
Hvordan oppnå en vellykket behandling?
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Grep og fiksering
Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Instrumentenes konstruksjon
Hvordan oppnå en vellykket behandling?
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Sigd
Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Universalkyrette
Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Graceykyrette
Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Sliping
Hvordan oppnå en vellykket behandling?
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Måle lommer
Hvordan oppnå en vellykket behandling?
Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation, Seventh Edition
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VedlikeholdsbehandlingEtterkontroll
Fortsatt inflammasjon Fortsatt progresjonFriskt
Støttebehandling GenereltLokalt
Videre utredning
Differensial
diagnose eventuelt
andre
Ny målrettet
behandling
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Vedlikeholdsbehandling
http://www.perio-tools.com/pra/en/
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Tannpleier som ressurs