1. Clinical periodontology
Clinical diagnosis
Roaa L. ahmed

2. History Examination of lymph nodes Oral examination Clinical diagnosis
Radiographical diagnosis

3. Oral examination
Mouth odors
Oral hygiene.
Wasting disease of the teeth
Hypersensitivity
Tooth mobility
Trauma from occlusion
Proximal contact relations
Sensitivity to percussion
Dentition with the jaws closed
Periodontal assessment
Palpation

4. Examination of the periodontium
Plaque and calculus
Gingiva , gingival index and sulcus bleeding index.

5. Microbial analysis

6. Periodontal pocket

7. Radiographical Radiographic changes

9. wedge shape radiolucent

10. reduced height

11. progressively reduced hight

12. PHASE I THERAPY
It is the first step in the procedure that constitute periodontal treatment.

13. It is achieved by: 1. Complete removal of calculus 2
It is achieved by: 1. Complete removal of calculus 2. Correction of defective restoration 3. Treatment of carious lesions 4. Institution of a comprehensive daily plaque control regimen

14. Phase I therapy has many specific goals: 1. Evaluation patient. 2
Phase I therapy has many specific goals: 1. Evaluation patient. 2. Plaque control. 3. Removal of microbial plaque. 4. use of antimicrobial agents

15. 5. Control or eliminating of contributing local factors which including: a) restorations b) prosthetic devices c) carious lesion d) Odontoplasty e) Tooth movement f) food impaction areas g) occlusal trauma h) hopeless teeth

16. Refer to specialist: 1. Extent of disease. 2. Root length 3
Refer to specialist: 1. Extent of disease Root length 3. Hypermobility 4. Difficulty of scaling and root planning 5. Restorative work 6. Age of the patient 7. Resolution by shrinkage.

17. A) Self-performed plaque control 1. Tooth brushing
2. Interdental cleaning aids
3. Chemical plaque control

18. Tooth brushing methods
1. The roll method (modified stillman technique)
2. Vibrating method (bass,stillman,charter technique)
3. Circular method (the fones technique)
4. Vertical method (the leonard technique)
5. Horizontal method (the scrub technique)

19. Bass method

20. The modified stillman method:

21. Charter method

22. Powered toothbrushes
1. Children
2. mental disabilities
3. Hospitalized patients
4. fixed orthodontic appliances

23. 2. Interdental cleaning aids

24. Chemical plaque control

25. Scaling and root planning
Scaling: It is removal of plaque and calcified deposits from the crown of the tooth.
Root planning: it is removal of plaque and calcified deposits from the root surface of the tooth, removal of altered cementum from subgingival root surface and debridement of the soft tissue lining the pocket.

26. Scaling and curettage instruments
Sickle scaler used to remove supragingival calculus.

27. Currettes

28. Ulterasonic and sonic

29. Periodontal endoscope

30. Cleansing and polishing instruments

31. effective instrumentation is governed by:
1) Poroper position
2) optimal visibility
3) Sharp and clean instruments
4) Knowledge of instrument design 5) Proper grasp
6) Maintaining a clean field.
7) Instrument stabilization.

32. Supra and sub gingival irrigation

33. Chemotherapeutic agent
Chemotherapeutic agents: chemical substances that provides a clinical therapeutic benefit.

34. Guidelines for use antibiotics in periodontal therapy:
1. Clinical diagnosis
2. Continuing disease activity
3. microbiological sampling
4. periodontal surgery
5. patient's medical status.
6. not be used as a monotherapy.

35. reduce collagen and bone destruction as well as the antibiotic effect
Tetracycline
reduce collagen and bone destruction
as well as the antibiotic effect
Tetracycline used as adjunctive in treatment of localized aggressive periodontitis
((doxycycline 100mg twice daily the first day then 100mg once daily for one week))

36. Metronidazole
Clinically used to treat gingivitis, acute necrotizing ulcerative gingivitis, chronic periodontitis and aggressive periodontitis.250mg twice daily for one week.