Class III Moderate Periodontitis with Halitosis
By: Jamie Rotunno, RDH
February 8, 2018
The Challenge:
To reduce periodontal pathogens, a significant cause for the periodontal inflammation and halitosis.
The Background:
- Age: 61
- Sex: M
- Last Dental Exam: 3 months ago
- Home Care: Manual toothbrush daily and flossing on & off
- Chief Complaint: Halitosis
- Periodontal Assessment: Type III generalized with localized Type IV periodontitis. Patient has history of periodontal therapy in past with 3 month re-care intervals. The patient had generalized heavy, bleeding on probing and tissue was bulbous & erythematous.
The Solution:
- Date of Pre MyPerioPath®, Celsus One™ and OraRisk® HPV on 7/13/2017
- Periodontal Therapy: Initially recommended 12 hrs of non-surgical periodontal therapy due to Celsus One High Inflammation Index. However, only 4 hrs were needed due to patient’s home care compliance (see Home Care below). The therapy consisted of microsonics, irrigation and laser therapy.
- Systemic Antibiotic Used: It was considered but due to the patient's favorable response to non-surgical, it was never administered.
- Home Care: PerioProtect™ trays 2-3x/day with a vibramycin (doxycycline gel) for 6 weeks initially. Following the non-surgical periodontal therapy, PerioProtect trays 2x/day with 1.7% peroxide gel, Waterpik® daily and electric toothbrush 2x/day.
- Date of MyPerioProgress® (post-therapy test): 11/09/2017
The Result:
Clinically there was a significant decrease in bleeding on probing and pocket depth reduction was amazing. The MyPerioProgress showed pathogen reduction from 8 above reference line to 0. I enjoy seeing the patient’s reaction when they realize they have some control over what is happening. When they do the expected increased home care and reduce therapy time, they are thrilled. This re-enforces home care for maintenance. In this case, the patient’s partner was tested and revealed periodontal pathogens very similar to this patient, however the partner has refused treatment at this time. This places our patient at risk for relapse especially due to the Celsus One results.
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