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AU14 - Periodontology Exam 1 > 09/24 - Classifictaion of Periodontal Diseases > Flashcards

09/24 - Classifictaion of Periodontal Diseases Flashcards

1
Q

Successful management of periodontal disease depends on the ability of a clinician to do what 3 things?

A
  • accurate diagnosis of periodontal disease
  • predict the effect of the systemic status of the patient on the course of the disease
  • confirm the prediction with assessment of therapeutic outcomes
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2
Q

What is the definition of periodontal diseases?

A

a diverse family of complex and distinct pathological entities found within the periodontium that are the result of a variety of etiologies; encompasses both gingival diseases and destructive periodontal diseases

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3
Q

What are the 6 characteristics common to all gingival diseases?

A
  • signs and symptoms that are confined to the gingiva
  • the presence of dental plaque to initiate and/or exacerbate the severity of the lesion
  • clinical signs of inflammation
  • clinical signs and symptoms associated with stable attachment levels on a periodontium with no loss of attachment
  • reversibility of the disease by removing the etiology(ies)
  • possible role as a precursor to attachment loss around teeth
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4
Q

True or false: Not all periodontitis becomes gingivitis, but most gingivitis started as periodontitis.

A

FALSE: Not all gingivitis becomes periodontitis, but most periodontitis started as gingivitis.

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5
Q

What are the 4 systemic factors that can modify gingival disease?

A
  • the endocrine system (endocrinotropic)
  • blood dyscrasias
  • medications
  • nutrition
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6
Q

What are the 5 endocrinotropic gingival diseases?

A
  • puberty-associated gingivitis
  • menstrual cycle-associated gingivitis
  • pregnancy-associated gingivitis
  • pregnancy-associated pyogenic granuloma
  • diabetes mellitus-associated gingivitis
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7
Q

What gingival disease is associated with blood dyscrasias? Describe it.

A
  • leukemia-associated gingivitis
  • gingival lesions are primarily found in acute leukemia; reductions in dental plaque can limit the severity of the lesion
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8
Q

What gingival disease is modified by nutrition? Describe it.

A
  • ascorbic acid-deficiency gingivitis
  • malnourished individuals have a compromised host defense system which may make individuals susceptible to infectious diseases; human studies have failed to show a relationship between nutrition and periodontal diseases
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9
Q

What are the 4 types of destructive periodontal diseases?

A
  • chronic periodontitis
  • aggressive periodontitis
  • periodontitis as a manifestation of systemic diseases
  • necrotizing periodontal diseases
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10
Q

What are the (5) clinical manifestations of chronic periodontitis?

A
  • pocket formation
  • loss of attachment
  • bleeding/suppuration
  • bone loss
  • tooth mobility and drifting
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11
Q

What age group is chronic periodontitis most common in? What type of calculus is associated with chronic periodontitis?

A
  • adults (although it can occur in children and adolescents)

- subgingival calculus

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12
Q

What is the speed of progression of chronic periodontitis? What is it associated with or modified by?

A
  • slow to moderate progression

- local predisposing factors (ex. tooth-related), systemic disease, or environmental factors

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13
Q

What are the 2 ways to classify chronic periodontitis?

A
  • EXTENT: localized (if 30% mouth)

- SEVERITY: slight (1-2 mm CAL), moderate (3-4 mm CAL), and severe (5+ mm CAL)

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14
Q

How is aggressive periodontitis classified?

A

localized or generalized

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15
Q

What are the (3) common features of aggressive periodontitis?

A
  • systemically healthy
  • rapid attachment loss and bone destruction
  • familial aggregation
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16
Q

What are the (6) secondary features of aggressive periodontitis?

A
  • generally, but may not be universally, present
  • microbial deposits are inconsistent with the amount of periodontal destruction
  • elevated Actinobaccillus actinomycetemcomitans and Porphyromonas gingivalis
  • phagocyte abnormalities
  • hyper-responsive macrophage phenotype
  • progression may be self-arresting
17
Q

What age group is most affected by localized aggressive periodontitis? What type of serum antibody response is present toward infecting agents? Where is the disease localized?

A
  • usually around puberty
  • robust serum antibody response
  • localized first molar/incisor presentation (interproximal attachment loss on at least 2 permanent teeth, one of which is a molar; involving no more than 2 teeth other than first molars and incisors)
18
Q

What age group is most affected by generalized aggressive periodontitis? What type of serum antibody response is present toward infecting agents? Describe the location and progression of the disease.

A
  • usually affects persons under 30 but patients may be older
  • poor serum antibody response
  • generalized interproximal attachment loss affecting at least 3 permanent teeth other than first molars and incisors
  • pronounced episodic nature of destruction of attachment and bone (happens every few years and then stops)
19
Q

What types of disorders is periodontitis associated with?

A
  • hematologic disorders

- genetic disorders

20
Q

Describe the periodontium in a patient with Down syndrome.

A
  • severe inflammation
  • accelerated attachment loss
  • PMN chemotaxis and killing defects
21
Q

Describe the periodontium in a patient with Papillon-Lefevre syndrome.

A

rapid periodontal destruction around primary and permanent teeth which occurs before puberty

22
Q

Describe the periodontium in a patient with Chediak-Higachi syndrome.

A

rapid periodontal destruction around primary and permanent teeth which occurs before puberty

23
Q

Describe the periodontium in a patient with Ehlers-Danlos syndrome (Types IV and VIII).

A

aggressive periodontitis (primary and permanent dentition); fragility of gingiva, excessive hemorrhage

24
Q

What are the 2 types of necrotizing periodontal disease? What is the difference between the two?

A
  • NECROTIZING ULCERATIVE GINGIVITIS (NUG): limited to gingival tissues
  • NECROTIZING ULCERATIVE PERIODONTITIS (NUP): lesion confined to periodontal tissues
25
Q

Describe the early clinical signs of necrotizing periodontal disease.

A
  • necrotic lesion of the papilla initially, then progressing to gingival margin
  • punched-out appearance
  • spontaneous bleeding
  • pain
26
Q

Describe the signs of an advanced necrotizing periodontal disease lesion.

A
  • lack of deep pockets
  • merging of papillary and marginal involvement
  • characterisitc fetor (smell)
  • central necrosis results in crater formation
  • involvement of periodontal ligament and alveolar bone (NUG -> NUP)
27
Q

For necrotizing ulcerative periodontitis, involvement of palatal mucosa is called ___. There is involvement of regional ___. It is typically related to ___ and may develop into ___.

A
  • necrotizing stomatitis
  • regional lymph nodes
  • severely compromised immune system
  • life-threatening situation
28
Q

Describe the (3) symptoms of necrotizing ulcerative periodontitis.

A
  • fever and malaise
  • white membrane of desquamated cells, bacteria, and saliva proteins
  • membrane can be easily removed
29
Q

Differentiate between gingival, periodontal, and pericoronal abscesses.

A
  • GINGIVAL: localized, acute inflammation/vital pulp; marginal and interdental tissues
  • PERIODONTAL: localized, acute, or chronic inflammation, vital pulp; moderate/deep pockets and possible bone destruction
  • PERICORONAL: localized, acute inflammation, vital pulp; crown of partially erupted tooth

AU14 - Periodontology Exam 1 (11 decks)

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