Pocket between 308/309 and 408/409- best approach?

RE: Pocket between 308/309 and 408/409- best approach?

Evelyn Barbour-Hill — Tue, 24 Jan 2017 19:16:47 GMT

[quote user="Iain Richards"]The "Boomtown Rats" were a popular beat combo [/quote]

I thought they were a pop group.

Like this one, but not as good.

www.youtube.com/watch

(P. McC taking the vocal, doing what he did best, long before he got delusions that he was a Great Musician and a National Treasure)

RE: Pocket between 308/309 and 408/409- best approach?

Evelyn Barbour-Hill — Tue, 24 Jan 2017 18:59:07 GMT

It's so annoying that we can't get Doxirobe, whereas it's in common use in the USA. Strangely presented product, with that funny squirt-from-syringe-to-syringe mixing. I'm sure they could put it in capsules to go in a capsule mixer, or maybe in a syringe with a mixing tip.

Anyway, no, there's no real equivalent. The tetracycline threads I mentioned are used in human dentistry. I'm still using my tetracycline application but now I'm turning to Sanos and I'm quite hopeful. This sort of thing is not what Sanos is actually designed for, though.

Maybe Rachel Perry or Peter Southerden will be along with some ideas soon.

I'm not quite sure how you are relating this to antimicrobial resistance worries. Do you mean people are turning to systemic antimicrobials? I hope nobody is doing that. Please don't.

RE: Pocket between 308/309 and 408/409- best approach?

Iain Richards — Tue, 24 Jan 2017 18:44:03 GMT

Plaque Trap - wasn't that a Boomtown Rats hit?

Iain

PS Evelyn, The "Boomtown Rats" were a popular beat combo in the late 70s early 80s

RE: Pocket between 308/309 and 408/409- best approach?

Mark Welsh — Tue, 24 Jan 2017 13:25:18 GMT

Hi Evelyn.

I wondered if I could ask you a little bit more about Doxirobe. Because of the recent focus on use of antimicrobials and resistance I am interested in finding an alternative to Doxirobe. I don't suppose you know of any? I have contacted Pfizer and other pharma companies but have not not yet landed upon anything yet.

kind regards

Mark

RE: Pocket between 308/309 and 408/409- best approach?

Holly Norman — Sun, 23 Aug 2015 13:29:55 GMT

That's a brilliant answer, thank you so much Evelyn.

RE: Pocket between 308/309 and 408/409- best approach?

Evelyn Barbour-Hill — Fri, 21 Aug 2015 18:29:31 GMT

[quote user="Holly Dale"]Or am I just being extraction- happy?[/quote]

Could be!

The distal roots of 308 and 408 can be hell to extract. Not that that's an excuse to not extract, if extraction is indicated.

"Normal".... well, it depends upon your definition of normal. True, it's commonly seen and there may be little or no inflammation; so, the periodontium is healed, or healthy, or stabilised (whatever you want to call it) at this level– it may or may not later have another acute episode of periodontitis (periodontitis does progress in this manner).

The whole problem arises from crowding: the 8 is tight up against the 9, and often rotated a tiny bit, forming a plaque trap. (The "plaque trap" features strongly in my concept of periodontal disease especially when explaining it to clients.) I don't think that is in itself a good reason to extract the 8 however. It does mean it's an important spot to attend to in brushing or other oral hygiene.

Complete absence of gingiva between the 8 and 9 is not normal or healthy, nor is a probing depth of 3-6mm. But it may be currently healthy at that level. However that pocket is going to accumulate plaque and there may be a resurgence of disease.

In the cases you describe: periodontal ultrasonic antibacterial debridement is indicated, and home care aimed at that particular site. If there's inflammation, or if there's visible loss of gingival width on the distal of the 8 or the mesial of the 9, consider extraction, but you still don't necessarily have to go for extraction: it depends upon degree of disease, the general periodontal state of the whole mouth, the owner's attitude to and abilities in oral hygiene, so many factors. You decide each upon its merits.

When I do extract the 8 in order to help the 9, I like to mobilise the gingiva and suture it snugly against the 9, thus re-covering the exposed mesial root. This will heal nicely at that level since the plaque trap has been eliminated.

When there's inflammation and a little gingival depth loss, but not enough to require the extraction, local antibiotic treatment of the pocket is, in my opinion, indicated although I'm not sure how much good it does. We don't have Doxirobe any more, but I have tried filling the pocket with tetracycline (a tiny drop od Terramycin Q100) with, I think, beneficial effect. Human dentistry has oxytetracycline-impregnated cords and similar things, but they would be I think unacceptably expensive for our patients (and they need removing subsequently).

Note: there are area in periodontics in which opinions differ, with no single correct answer, and this is one of those areas.

RE: Pocket between 308/309 and 408/409- best approach?

Holly Norman — Fri, 21 Aug 2015 14:14:46 GMT

Or am I just being extraction- happy?