1. Local drug delivery
    1. Periochip
      1. 2.5 mg (36%) of chlorhexidine gluconate
      2. Dimensions: 4mm * 5mm* 0.35 mm
      3. Slow release over 7-10 days
      4. Indicated for pocket depth >5mm
      5. Dissolves in 1 week
    2. Actisite
      1. Contains 25% w/w tetracycline HCL powder
      2. Diameter of fibre= 0.5mm with tetracycline 12.7 mg/ 9 inches
      3. Periodontal plus AB: Bio- resorbable form of fibre, does not need removal; biodegrades within 7 days
    3. Atridox
      1. Contains 42.5 mg Doxycycline, available as a 10% doxycycline in syringeable gel
      2. Biodegradable
      3. Shows active antibacterial levels in pocket even after 7 days
    4. Arestin
      1. Contains 2% minocycline as bio-resorbable microspheres
    5. Periocol-CG
      1. 2.5 mg chlorhexidine in collagen membrane
      2. Bioresorbable : resorbs after 30 days
    6. Chlo-site
      1. Contains 1.5% chlorhexidine of xanthan type
    7. Elyzol 25% gel
      1. Contains metronidazole 25% (oil based)
      2. Applied as a viscous consistency to the pocket where it liquefies by body heat & then hardens again on contact with saliva
    8. Dentamycin & periocline
      1. Contains 2% minocycline
  2. Plaque Control Agents
    1. Classification of chemical plaque control agents
      1. 1st generation
        1. e.g.: Antibiotics, Phenol, Quaternary ammonium compounds & Sanguinarine, Triclosan
        2. Show poor retention in mouth
      2. 2nd generation
        1. e.g. Bisbiguanides ( chlorhexidine)
        2. Better retained, higher anti- plaque activity than 1st generation
      3. 3rd generation
        1. e.g.: Delmopinol cause weaker binding of plaque to tooth surface, thus easier plaque removal during brushing
        2. Block binding of microorganisms to tooth or each other
    2. Classification of mechanical plaque control
      1. 1. Tooth brushes
        1. a) Manual tooth brush
        2. b) Electric tooth brush
      2. 2. Interdental aids
        1. a) Dental floss
        2. b) Triangular tooth pics
        3. c) Interdental brushes
        4. d) Yarn
        5. e) Superfloss
        6. f) Perio-Aid
        7. g) Pipe cleansers
      3. 3. Aids for gingival stimulation
        1. a. Rubber tip stimulator
        2. b) Balsa wood edge
      4. 4. Others
        1. a) Gauze strips
        2. b) Pipe cleansers
      5. 5. Aids for edentulous & partially edentulous patients
        1. a) Denture & partial clasp brushes
        2. b) Cleansing solutions
    3. Various Brushing Techniques
      1. Classification according to pattern of motion while brushing 1. Roll—> Roll method or modified Stillman technique 2. Vibratory—> Stillman, charters or bass techniques 3. Circular—> Fones technique 4. Vertical —> Leonard technique 5. Horizontal—> Scrub technique
        1. 1) Modified stillmann technique: used in gingival recession 2) Charter’s : Healing wound after surgery or pt who wear RPD or Orthodontic appliance 3) Bass Technique : Routine technique with/ without periodontal disease 4) Fones : In Childrens
      2. Scrub technique is probably the simplest & most common method of brushing
      3. Patient with periodontal diseases —> Sulcular technique
      4. Roll technique—> least effective
    4. ADA specifications for adult toothbrush
      1. Length= 1 to 1.25 inches
      2. Width= 5/16 to 3/8 inches
      3. Surface area= 2.54 to 3.2 cm
      4. No. Of rows= 2 to 4 rows of bristles
      5. No. Of tufts= 5-12 per row
      6. No. Of bristles= 80 to 85 per tuft
    5. Brush are classified as follows based on width of these bristles
      1. Soft : 0.007 inch/ 0.2 mm
      2. Medium: 0.012 inch/ 0.3 mm
      3. Hard: 0.014 inch/ 0.4mm
  3. Sonic & Ultrasonic scalers
    1. Parameter
      1. .
      2. Magnetostrictive
      3. Piezoelectric
    2. Tip action
      1. Orbital
      2. Elliptical
      3. Linear
    3. Active Tip surfaces
      1. 4 active surfaces
      2. 2 active surfaces
    4. Energy conversion
      1. Metal rod or stack of metal sheets
      2. Crystals activated by ceramic handpiece
    5. Space requirement
      1. High
      2. High
      3. Low
    6. Heat production
      1. High
      2. High
      3. Low
    7. Noise level
      1. Medium
      2. Medium
      3. High
    8. Frequency
      1. 2000-6500 cycles/ sec
      2. 20000- 45,000 cyc/sec
      3. 20,000- 45,000 cyc/sec
  4. Merins classification
    1. Used for : patient recall
    2. Merins classification of patients for recall and maintenance
      1. Class A patients Excellent results maintained for 1 yr or more 1. Good oral hygiene, minimal calculus 2. No occlusal problem / complicated prosthesis 3. No remaining pockets & >50% of alveolar bone support for every tooth
      2. Class B patients Good results maintained for 1 yr or more, but associated risk factors are there: 1. Poor oral hygiene, calculus deposits 2. Systemic disease/ smoking habit causing periodontal destruction 3. Residual pockets, BOP seen 4. Teeth with <50% bone support 5. Positive family history
      3. Class C patients Periodontal therapy has partially been successful with poor results, risk factors same as class B but more severe 1. Poor oral hygiene 2. Many teeth with less than 50% bone support 3. Periodontal surgery indicated but not performed due to medical,psychological, or financial reasons.
    3. Recall visits advised by Merin
      1. Class A : 6 months- 1 year
      2. Class B : 3-4 months
      3. Class C: 1-3 months
      4. First year recall ( routine therapy): 3 months
      5. First year recall ( difficult case with complications): 1-2 months