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23 Periodontology > 2 - Classification of Periodontal Diseases and Conditions > Flashcards

2 - Classification of Periodontal Diseases and Conditions Flashcards

1
Q

what are the 2 categories of periodontal health (2018)

A
  1. clinical gingival health (INTACT periodontium)
  2. clinical gingival health on a REDUCED periodontium (stable periodontitis patient)
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2
Q

what kind of patient has an absence of CLINICAL periodontal inflammation

A

clinical gingival health (intact periodontium)

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3
Q

do patients with intact periodontium have:
- No BOP, redness, swelling
- physiological immune surveillance present

A

YES

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4
Q

do patients with intact periodontium have loss of attachment or bone loss

A

NO

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5
Q

what kind of patient has periodontitis that is successfully treated?

A

clinical gingival health on reduced periodontium (stable periodontits patient)

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6
Q

describe patients with stable periodontitis

A
  1. minimal BOP
  2. PDs </= 4 mm
  3. lack of progressive destruction
  4. control of local and systemic contributing factors
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7
Q

what are the types of dental biofilm induced gingivitis

A
  1. localized gingivitis: 10-30% BOP
  2. generalized gingivitis: >30% BOP
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8
Q

is induced dental biofilm drug influenced?

A

YES

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9
Q

gingivitis on ___ periodontium has a return of inflammation to the gingival margin of reduced periodontium (BOP)

A

reduced

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10
Q

what is gingivitis modified by

A
  1. systemic factors
  2. oral factors
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11
Q

what are systemic factors

A

puberty, pregnancy, diabetes, leukemia, smoking, malnutrition, drugs

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12
Q

what are oral factors

A

overhanging restoration, subgingival restoration, hyposalivation

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13
Q

what is this

A

pyogenic granuloma (modified by pregnancy)

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14
Q

what is this

A

drug influenced gingival enlargement - phenytoin

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15
Q

what gingival enlargement appears due to pregnancy

A

pyogenic granuloma

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16
Q

differece between localized and generalized drug-influenced gingival enlargement

A

localized = single tooth or group of teeth
generlized = throughout mouth

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17
Q

difference between mild, moderate, and severe drug influenced gingival enlargement

A

mild = papilla
moderate = papilla + marginal gingiva
severe = papilla + marginal gingiva + attached gingiva

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18
Q

what are drugs associated w/ gingival enlargement

A
  1. antiepileptic drugs
  2. calcium channel-blocking drugs (antihypertensives)
  3. immunoregulating drugs
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19
Q

what are examples of antiepilectic drugs

A
  1. phenytoin (Dilantin)
  2. sodium valproate
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20
Q

what are examples of antihypertensives

A

calcium channel blocking drugs:
1. nifedipine
2. amlodipine
3. felodipine
4. verapamil
5. diltiazem

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21
Q

what are examples of immunoregulating drugs

A

cyclosporine

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22
Q

what is this

A

hereditary gingival fibromatosis

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23
Q

what is this

A

primary HSV-1 infection

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24
Q

what is this

A

recurrent HSV-1 infection

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25
what is this
fungal candida albicans
26
where does recurrent herpes infection occur?
lip, palate, and pts with scaling and root planing, and after greater palatine block
27
what is this an example of
plasma cell gingivitis -> reaction to cinnamon in tartar control toothpaste
28
what is this
cicatricial pemphigoid
29
what is this
lichen planus
30
what are examples of traumatic lesions
toothbrush trauma, flossing clefts, thermal injury, chemical injury, iatrogenic
31
what is this
gingival ulcerations due to toothbrush trauma
32
what is this
flossing clefts
33
what are the 2018 necrotizing periodontal diseases
NG: necrotizing gingivitis NP: necrotizing periodontitis NS: necrotizing stomatitis
34
describe pts with necrotizing periodontal disease
1. ulcerated and necrotis papillary and marginal gingiva 2. gray pseudomembrane 3. blunting and cratering of papillae 4. bleeding 5. pain and fetid breath 6. fever, malaise, lyphadenopathy
35
predisposing factors for necrotizing periodontal disease
1. bacterial etiology 2. psychological stress 3. smoking 4. immunosuppression
36
what type of periodontal diseases are observed among patients with HIV infection
NP - necrotizing periodontitis NS - necrotizing stomatitis
37
HIV infection is indicative of CD_+ counts < ___ cells/mm3
CD4+ counts less than 200 cells/mm3
38
what is this
necrotizing gingivitis
39
what is this
bone loss w/ necrotizing papilla (necrotizing periodontitis)
40
what perio disease has bone denudation, osteitis, and sequestrum and is present in severely immunocompromised patients
necrotizing stomatitis
41
what are the different years periodontitis classifications were changed
1989, 1999, 2018
42
what are the different stages in 1989 classification
1. adult periodontitis 2. early onset periodontitis (prepubertal, juvenile, rapidly progressing) 3. periodontitis associated w/ systemic disease 4. refractory periodontitis
43
what are the different stages of 1999 classification
1. chronic periodontitis 2. aggressive periodontitis 3. periodontitis as a manifestation of systemic disease 4. no fourth stage
44
what are the different stages of 2018 classification
1. periodontitis 2. periodontitis 3. periodontitis as a manigestation of systemic disease 4. no fourth stage
45
what is a multifactorial inflammatory disease associated w/ plaque biofilms
periodontitis
46
what is characterized by progressive destruction of periodontal supporting tissues
periodontitis
47
what has clinically detectable attachment loss, often accompanied by pocket formation, alveolar bone loss, and gingival bleeding
periodontitis
48
what are the system of staging and grading in 2018
staging (I-IV) grading (A-C)
49
what does CAL stand for
clinical attachment loss
50
describe CAL of each stage of 2018 periodontal staging
I: 1-2 mm II: 3-4 mm III: >/= 5 mm IV: >/= 5 mm
51
describe radiographic bone loss of each stage of 2018 periodontal staging
I: coronal 1/3 (<15%) II: corontal 1/3 (15-33%) III: >/= middle 1/3 IV: >/= middle 1/3
52
describe tooth loss of each stage of 2018 periodontal staging
I: n/a II: n/a III: less than or equal to 4 teeth IV: 5 or more teeth
53
describe the probe depth of each stage of 2018 periodontal staging
I:
54
describe the compexity of each stage of 2018 periodontal staging
I. horizontal bone loss II. horizontal bone loss III. vertical bone loss, Class II or II furcation infolvement IV. vertical bone loss, class II or II furcation involvement, secondary occlusal trauma, mobility is greater or equal to class 2, drifting, flaring, <20 teeth remain, severe ridge defects
55
if a patient loses a tooth due to periodontitis, what stage is he immediately moved to
Stage III
56
describe the radiographic bone loss or CAL for each periodontitis grade level
A - 0 mm over 5 years B - <2mm over 5 years C - >/= 2mm over 5 years
57
describe the % bone loss/age for each periodontitis grade level
A - <0.25 B - 0.25-1.0 C - >1.0
58
describe the biofilm for each periodontitis grade level
A: hevby biofilm, low destruction B: destruction commensurate with biofilm C: low biofilm, heavy destruction, rapid destruction, early onset
59
what can modifiy the periodontitis grading
smoking and diabetes
60
describe the periodontal grade for smokers
A: non-smoker B: smoker <10 cigarettes/day (less than half pack) C: smoker greater or equal to 10 cigs a day
61
describer the periodontal grade for diabetics
A: non-diabetic B: diabetic HbA1c <7% C: Diabetic HbA1c >/= 7%
62
what is the stage and grade of this patient
generalized Stave IV, Grade C
63
what is the stage and grade of this 14 year old pt
stage III, grade C molar-incisor pattern periodontitis
64
what diagnosis do you use when the systemic condition is the major predisposing factor
periodontitis as a manifestation of systemic disease
65
do patients who have periodontitis as a manifestation of systemic disease have an ABSENCE of large amounts of plaque and calculus
YES
66
what are examples of periodontitis as a manifestation of systemic diseases? who contributes to the greatest amount?
1. hematologic disorders 2. genetic disorders (mostly) 3. neoplasms and other disorders
67
if patient has a hematologic or genetic disorder or neoplasms AND periodontitis, what does the patient have?
systemic manifestation of disease
68
what is this
pt has cyclic neutropenia - manifestation of systemic disease
69
what are systemic diseases/conditions that affect periodontal supporting tissues
1. DM 2. smoking 3. obesity 4. osteoporosis 5. rheumatoid arthritis 6. stress and depression 7. medications
70
what is a localized acute and purulent infection within the gingival wall of periodontal pocket
periodontal abseces
71
what periodontal disease affects supporting structures of periodontium (PDL, bone)? is this a slow or rapid destruction?
periodontal abscess - rapid destruction
72
what are signs and symptoms of periodontal abscess
pain, swelling, tooth elevation, suppuration, BOP, mobility
73
what does EPL stand for
endodontic periodontal lesions
74
EPL involves what tissues
pulp and periodontal tissues
75
what are acute EPLs
associated w/ trauma (root fracture) or iatrogenic (endodontic perforation)
76
what are chronic EPLs
associated with pulpal infection or deep periodontal pockets reaching apex
77
etiology of EPL
- pulpal infection that secondarily affects periodontium - progressing periodontitis that secondarily affects the pulp (less common) - both event concomitantly = COMBINED LESION
78
signs and symptoms of EPLs
- deep perio pocket near apex - negative/altered response to pulp vitality tests - bone resorption (apical and/or furcation) - pain (spontaneous, percussion, palpation) - suppuration - mobililty - sinus tract
79
what are mucogingival deformities? what is the most common?
1. gingival recession (most common) 2. lack of keratinized gingiva 3. decreased vestibular depth 4. aberrant frenum 5. gingival excess 6. abnormal color
80
what is this example of
mucogingival deformities = gingival recession
81
what is this an example of
mucogingival deformities = lack of keratinized gingiva
82
what are causes of gingival recession
- aggressive tooth brushing - tooth malposition - aberrant frenum attachment - iatrogenic factors (restorations, prosthesis, ortho) - rooth planing shallow sites - periodontitis
83
what is this
aberrant frenum
84
what are examples of gingival excess mucogingival deformities
pseudopocket inconsistent gingival margin excessibe gingival display gingival enlargement
85
what is this example of
excessive gingival display
86
occlusal trauma results in injury to what
tissue changes withing PDL, alveolar bone and cementum
87
what type of occlusal trauma: excessive occlusal forces; normal periodontal support
primary occlusal trauma
88
what type of occlusal trauma nocrmal or excessive occlusal forcesl teeth with reduced periodontal support
secondary occlusal trauma
89
what is this example of
widened PDL = primary occlusal trauma
90
what are tooth and prosthesis related factors that cause perio
1. impinged supracrestal attached tissues 2. overhang 3. subgingival margin 4. partial removable dental prostheses
91
tooth-related factors predisposed patients to what
plaque-induced gingival diseases of periodontitis
92
what is this
placement of crown margin within supracrestal attached tissues causes perio
93
what is this
root fracture causing perio
94
what is this
external root resoprtion causing perio
95
what is this? why is it a problem
cervical enamel projection problem bc you can't attach to enamel or have normal JE+CT connection because it can only attach to dentin or cementum not enamel
96
what is this diagnosis (assume no bone loss and no BOP). Tooth #5 KG = 5 mm, PD = 2 mm
this means 3 mm of attachment recession diagnosis = mucogingival deformity and condition

23 Periodontology (13 decks)

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