13. Periodontal Disease

Question 1

3

Bacterial plaque in the periodontal disease mechanism release _____ and stimulate _______.

Question 2

3

Bacterial plaque releasing exotoxins and stimulating host inflammatory responses have what effect on junctional epithelium, pockets, and bone?

Question 3

4

Where does inflammatory destruction begin in periodontitis?

Question 4

4

Periodontitis results in loss of bone at the ______ and _____ of the PDL.

Question 5

4

Is periodontitis horizontal or vertical bone loss?

Question 6

5

How is asssessment of periodontal disease done? What is done first and then what is done as an adjunct?

Question 7

6-7

What are 10 periodontal conditions assessed during radiographic assessment of periodontal conditions?

Question 8

8

What are three imaging modalities for periodontitis?

Question 9

9

What two things comprise intraoral imaging for periodontitis?

Question 10

9

What provides the highest spatial resolution of any imaging modality?

Question 11

9

What should be considered the primary imaging choice for characterizing periodontal disease? Why is this?

Question 12

9

What does PA imaging help evaluate when it comes to periodontitis?

Question 13

10

In a bitewing image, the plane of the image receptor is oriented ____ to the long axis of the tooth and the x-ray beam is directed _____ to the long axis of the tooth.

Question 14

10

The teeth are depicted int heir correct position relative to the alveolar process in a bitewing when there is no overlapping of ________ or ______, and when the buccal and lingual cusps of molars are ______.

Question 15

13

In patients with moderate to severe clinical attachment loss, horizontal bite wings may not depict ______. So, the receptor is reoriented at _____; same size 2 image receptors are used and are oriented such that the long axis of the receptor is in a _____ orientation.

Question 16

14

What is a limitation of intraoral imaging for periodontal disease?

Question 17

14

Where is bone loss often not seen with intraoral images?

Question 18

14

WIth intraoral imaging, 2D images usually _____ bone loss.

Question 19

14

Intraoral images do not show any ______ changes.

Question 20

16

What are two disadvantages of panoramic images?

Question 21

16

Should panoramic imaging be used as a primary imaging tool for periodontal disease?

Question 22

17

CBCTs give the ability to ____ visualize __________.

Question 23

17

Is there any anatomic superimposition in CBCT?

Question 24

17

Does CBCT allow better visualization of periodontal defects?

Question 25

18

What are two disadvantages of CBCT?

Question 26

18

Does current evidence support the routine use of CBCT for imaging of the periodontium?

Question 27

20

In normal anatomy, what overlies the crest of the alveolar process?

Question 28

20

What is the height of the alveolar crest relative to the levels of the CEJs of adjacent teeth?

Question 29

21

Between posterior teeth, the alveolar crest is oriented _____ to an _______.

Question 30

21

Between anterior teeth, the alveolar crest is a ________ that may have a ______.

Question 31

23

What are the changes in morphology of the supporting bone in periodontal disease?

Question 32

23

What are changes to the trabecular density and pattern in periodontitis?

Question 33

24

What are the early changes in the alveolar process in periodontal disease?

Question 34

24

What early changes in the alveolar process are seen in the anterior region in periodontal disease?

Question 35

24

What early changes in the alveolar process are seen in the posterior region in periodontal disease?

Question 36

24

The changes in morphology of the alveolar process in periodontal disease may be described as:

• ______
• ______
• _______

Question 37

26

Horizontal bone loss is the loss of alveolar bone where the crest is _______ (crest is more apical than ______mm) - parallel to the line joining CEJ.

Question 38

26

What may the appearance of the alveolar crest be when the CEJs of adjacent teeth are at different horizontal levels?

Question 39

27

What is considered minimal crestal bone loss? Moderate? Severe?

Question 40

28

Vertical bone loss is the appearance of bone loss that is localized at ___________.

Question 41

28

Is vertical bone loss associated with early or late stages of periodontitis?

Question 42

28

Radiographically how does the outline of the remaining alveolar process typically appear?

Question 43

30

What is the term for two walled trough-like depressions that develop in the crest of the alveolar process between adjacent teeth?

Question 44

30

With interdental craters, the cancellous bone between _______ is resorbed.

Question 45

30

Radiographically, how do interdental craters appear?

Question 46

30

Are interdental craters more common in the anterior or the posterior?

Question 47

32

How is a buccal or lingual cortical plate loss seen radiographically?

Question 48

32

What shape is buccal or lingual cortical plate loss?

Question 49

32

For a buccal or lingual cortical plate loss, depth of radiolucency is directed _____ in relation to the tooth.

Question 50

34

Progressive periodontal disease and associated bone oss may extend to _____ of multirooted teeth.

Question 51

34

What is strong evidence of furcation involvement?

Question 52

35

What becomes prominent in mandibular molars if there has been sufficient loss of bone on either the lingual or buccal surface?

Question 53

35

Why is maxillary molar root furcation involvement not as sharply defined on radiographs?

Question 54

35

What is the shape of a maxillary molar furcation?

Question 55

37

What are important tools to identify potential involved furcation sites?

Question 56

38

What two things do radiolucent changes reflect?

Question 57

38

What are radiopaque changes due to to?

Question 58

38

Usually, bone reaction is a mixture of _____ and ____.

Question 59

41

Where do periodontal abscesses originate?

Question 60

41

What causes a periodontal abscess?

Question 61

41

If a periodontal abscess is acute, is there a radiographic change?

Question 62

41

If a periodontal abscess persists past the acute stage, does a radiolucent region appear?

Question 63

41

The radiolucent lesion for a periodontal abscess may be a focal, round area of radiolucency with loss of ______.

Question 64

43

Where is calculus most commonly seen?

Question 65

45

What is a endo-perio lesion?

Question 66

47

What shape may an endo-perio lesion be?

Question 67

48

What are two good indicators of stabilization of periodontal disease?

Question 68

51

What are malignant neoplasms associated with periodontitis?

Question 69

51

How do malignant neoplasms affect the PDL space?

Question 70

51

How do malignant neoplasms affect the lamina dura?

Question 71

52

Malignancies can be confused with _________.

Question 72

53

How may Langerhans Cell Histioocytosis often manifest? (First two bullets)

Question 73

53

Where is the epicenter of bone destruction for Langerhans Cell Histiocytosis?