2017 disease classification

Question 1

1. Define gingival health

Answer 1

• absence of BoP
• absence of erthema and edema
• absence of patient symptoms
• absence of attachment and bone loss
• Physiological bone levels range from 1.0 to 3.0mm apical to the CEJ
• For an intact periodontium and a reduced and stable periodontium, gingival health is defined as <10% bleeding sites and no pocket depth exceeding 3mm

Question 2

2. Describe plaque-induced gingivitis (localised/generalised gingivitis)

Answer 2

• Associated with dental biofilm alone
• mediated by systemic or local risk factors
• drug influenced gingival enlargement

Question 3

what BPE scores might plaque induced gingivitis get

Answer 3

2s

Question 4

what modifying factors can be included with plaque induced gingivits diagnosis

Answer 4

• puberty
• pregnancy epulis
• poor restorative margins
• drug influenced gingival enlargement

Question 5

3. What are non-plaque induced gingival diseases

Answer 5

• genetic/developmental e.g hereditary gingival fibromatosis
• specific infections e.g. herpetic gingival stomatitis, candida albicans
• inflammatory/immune conditions e.g lichen planus (more common, biopsy), benign mucous membrane pemphigoid, vitamin C deficiency

Question 6

5. What comes under necrotising periodontal disease

Answer 6

• Necrotising gingivits (NG)
• Necrotising periodontitis (NP)
• Necrotising Stomatitis (NS)

Question 7

Describe necrotising gingivitis (NG)

Answer 7

• necrosis and ulcer in the interdental papilla
• gingival bleeding
• pain
• pseudomembrane formation
• halitosis
• extraoral - regional lymphadenopathy / fever
• in children, pain and halitosis less frequent, whereas fever, lymphadenopathy, and sialorrhea were more frequent

Question 8

Describe necrotising periodontitis

Answer 8

• in addition to signs and symptoms of NG
• periodontal attachment and bone destruction
• frequent extraoral signs
• in severely immune-compromised patients, bone sequestrum may occur

Question 9

Describe necrotising stomatitis (NS)

Answer 9

• bone denudation extended through the alveolar mucosa
• larger areas of osteitis and bone sequestrum

Question 10

6. What counts as periodontitis as manifestation of systemic disease

Answer 10

• classification based on the primary systemic disease
• mainly rare diseases that affect the course of periodontitis resulting in the early presentation of severe periodontitis
  
  • papillon lefevre syndrome
  • leucocyte adhesion deficiency
  • hypophosphatasia
  • down’s syndrome
  • Ehlers-danlos

Question 11

7. What are systemic diseases of conditions affecting the periodontal tissues

Answer 11

• mainly rare contitions affecting the periodontal supporting tissues independently of dental plaque biofilm-induced inflammation i.e. condition itself causing breakdown
• group of conditions which result in the breakdown of periodontal tissues and some of which may mimic the clinical presentation of periodontitis
  
  • squamous cell carcinoma
  • langerhans cell histiocytosis

Question 12

8. For periodontal abscess what do you do to diagnose

Answer 12

• work out what is causing it
• most have exisitng disease
• present with pus draining through pocket or sinus

Question 13

9. Periodontal endodonic lesions. What do you do

Answer 13

• need to work out if there is root damage or not
• then need to work out what the root damage is
• if no root damage, then need to work out why…

Question 14

10. Mucogingival deformities and conditions. What to do

Answer 14

Decide on the type of recession you have

• Recession type 1 (RT1): gingival recession with no loss or inter-proximal aspects of the tooth
• Recession type 2 (RT2): gingival recession associated with loss of interproximal attachment. The amount of interproximal attachment loss (measured from the interproximal CDJ to the depth of the interproximal sulcus/pocket) is less than or equal to the buccal attachment loss (measured from the buccal CEJ to the apical end of the buccal sulcus/pocket).
• Recession type 3 (RT3): gingival recession associated with loss of interproximal attachment. The amount of interproximal attachment loss (measured from the interproximal CEJ to the apical end of the sulcus/pocket) is greater than the bucca attachment loss (measured from the buccal CEJ to the apical end of the buccal sulcus/pocket).