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23 Periodontology > 10 - Periodontitis > Flashcards

10 - Periodontitis Flashcards

1
Q

what is a multifactorial inflammatory disease associated with plaque biofilms

A

periodontitis

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2
Q

what is characterized by progressive destruction of periodontal supporting tissues

A

periodontitis

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3
Q

what is clinically detachable attachment loss, often accompanied by pocket formation, alveolar bone loss, and gingival bleeding

A

periodontitis

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4
Q

clinical features of periodontitis

A
  1. changes in color, contour, consistency of gingiva
  2. erythema
  3. blunted papillae
  4. rolled gingival marins
  5. flattened or cratered papillae
  6. erythema
  7. edema
  8. rolled gingival margins
  9. gingival recession
  10. calculus
  11. loss of attach
  12. BOP
  13. overhanging restoration
  14. pathologic tooth migration
  15. open contacts
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5
Q

what are factors that involve pathologic tooth migration

A
  1. inflammation
  2. loss of atachment and bone
  3. traumatic occlusion
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6
Q

what do open contacts lead to

A

food impaction

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7
Q

what are radiographic features of periodontitis

A
  1. bone loss (horizontal and/or vertical)
  2. furcation involvement
  3. calculus
  4. overhanging restoration
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8
Q

what this

A

furcation arrows

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9
Q

what are the 2018 classifications of periodontitis

A
  1. periodontitis
  2. periodontitis
  3. periodontitis as a manifestation of systemic disease
  4. no longer a disease entity
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10
Q

what classification:

Most common form of periodontitis
Prevalent in adults
Amount of attachment loss consistent with amount of plaque and calculus
Slow to moderate rate of progression

A

Chronic periodontitis 1999

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11
Q

what classification:

Localized: circumpubertal onset, 1st molars and/or incisor teeth
Generalized: usually affects <35 y/o attachment loss at 1st molars and incisors plus at least 3 other teth

A

aggresive perio 1999

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12
Q

local aggressive periodontitis (1999) is now called what

A

molar/inisor pattern periodontitis

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13
Q

what is the case definition of periodontitis

A

Interproximal CAL at 2 or more non-adjacent
teeth

-OR-

Buccal/Lingual CAL ≥3 mm with pocketing >3 mm at 2 or more teeth

CAL not attributable to: recession, subgingival caries, endo lesion, root fracture

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14
Q

goals of periodontitis staging

A
  1. classify severity and extent
  2. assess complexity
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15
Q

Stage I

A
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16
Q

Stage II

A
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17
Q

Stage III

A
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18
Q

Stage IV

A
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19
Q

at what stage is scaling and root planing involved

A

stage III periodontitis

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20
Q

what does a 0 pocket depth look like

A
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21
Q

at what stage could a patient have bite collapse, severe ridge defects

A

stage IV periodontitis

22
Q

does extraction of hopeless teeth decrease stage of disease?

A

NO

23
Q

tooth loss due to periodontitis is at least what stage

A

Stage III

24
Q

can you reduce stages of periodontitis?

A

NO!

UNLESS regeneration is successful in establishing new bone and new attachment

25
Q

what is added to stage as a descriptor?

A

extent and distribution

26
Q

what are the different categories of extent and distribution

A

Localized (<30%)
Generalized (>/= 30%)
Molar-Incisor Pattern

27
Q

goals of periodontitis grading

A
  1. estimate future risk of periodontitis progression
  2. estimate potential health impact of periodontitis
28
Q

describe disease progression of perio

A
  • rate: usually slow to moderate
  • modified by systemic, environmental facotrs
29
Q

what is the asynchrous, multiple burst model

A

episodic bursts of disease activity followed by periods of inactivity or remision

30
Q

what are risk factors for more rapid disease progression

A

diabetes and smoking

31
Q

what are genetic factors that cause perio? this increases tooth loss by what factor?

A
  1. genetic variation in IL-1 genotype -> 2.7x increase risk of tooth loss
  2. IL-1 genotype polymorphism AND smoking -> 7.7x increase risk of tooth loss
32
Q

Grade A

A
33
Q

Grade B

A
34
Q

Grade C

A
35
Q

what grade automatically if patient smoeks <10 cig/day and has HbA1c <7%

A

grade B

36
Q

what is patient default grade?

A

B

but then look for something that increases or decreases grade then modify from B

37
Q

quick way to determine grade

A

A: % bone loss is < AGE/4
C: % bone loss is > AGE

38
Q

what are 3 steps to staging and grading a patient

A
  1. initial case overview to assess disease
  2. establish stage
  3. establish grade
39
Q

what is part of step 1: initial case overview to assess disease

A
  • full mouth probing depths
  • full mouth radiographs
  • missing teeth
40
Q

what is part of step 2: establish stage

A
  • Determine maximum CAL or RBL
  • Confirm RBL patterns
  • Assess tooth loss due to periodontitis
  • Evaluate case complexity factors (e.g., severe CAL frequency, surgical challenges)
41
Q

what is part of step 3: establish grade

A
  • Based on existing data
  • Based on calculated RBL (% of root length x 100) divided by age
  • Assess risk factors (e.g., smoking, diabetes, other)
42
Q

what does stage reflect

A
  • Severity of the disease at the most affected area (Expressed through attachment loss and bone loss)
  • Tooth loss that has occurred as a result of periodontitis
  • Anticipated complexity of treatment required
43
Q

is stage based on the most severe area of periodontitis

A

YES

BUT expand the description with additional information

44
Q

can multiple stages be assigned to the patient?

A

NO! stage is patient-based, not tooth based

45
Q

Extent/Distribution: describes the % of teeth at the ___ level.

A

stage-defining severity

46
Q

steps to determining diagnosis

A
  1. case overview
  2. establish stage
  3. establish grade
47
Q

what are the therapeutic goals/targets

A
  1. Control local and systemic modifying factors
  2. Minimize inflammation
  3. Stabilize attachment and bone
48
Q

Restoration to pre-disease attachment and bone levels is [likely OR unlikely] at majority of sites

A

unlikely

49
Q

what can you observe if periodontitis is successfully treated

A
  1. Minimal BOP
  2. Improved PD and attachment levels
  3. Long-term lack of progressive destruction
  4. Control of local and systemic contributing factors (Oral hygiene, Smoking, Diabetes)
50
Q

what medications are drugs influenced
gingival enlargement

A

“pine” medications -> e.g. amlodipine

23 Periodontology (13 decks)

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