2021 Flashcards
Define the term ‘alveolar bone proper’ as the term relates to periodontal tissues
Describe the function, structure and radiographic features of this bone (4)
- Alveolar bone proper is the thin lamella of bone which provides attachment for tooth via Sharpey’s fibres
- It is perforated to allow ingress of nerves and blood vessels
- Appears radiographically as lamina dura
- Lends support to the tooth
Outline 3 types of pathogenic synergy which contribute to periodontal disease (3)
Any 3 from:
- Bacteria can signal each other
- Bacteria can transfer genes
- Synergy for co-adhesion
- Production of ECM
- Providing nutrients for each other
- Provide attachment to the pellicle
Name 1 periodontal pathogen that contributes to pathogenic synergy and state its role in this process (2)
P. gingivalis / F. nucleatum
F. nucleatum binds to plasminogen and P. gingivalis produces proteolytic enzymes which convert it into plasmin, to facilitate evasion of host defences
Name 5 bacterial pathogens associated with periodontal disease (5)
- Fusobacterium nucleatum
- Porphyromonas gingivalis
- Treponema denticola
- Tanerella forsythia
- Prevotella intermedia
Outline the roles of RANK ligand and OPG in regulation of osteoclast activation (5)
- RANK ligand (member of TNF superfamily) expressed on osteoblast surface
- Receptor expressed on precursor for osteoclast cells
- Once bound, stimulation of osteoclast activity as it induces differentiation
- OPG secreted by osteoblasts and inhibits RANK ligand activity
- Osteoclastogenic molecules stimulate expression of RANK ligand and blunt production of OPG
List 4 antibacterial actions of saliva (4)
- Inhibition of attachment of bacteria
- Washing action
- Kills bacteria by peroxidase system
- Kills bacteria by lysozymes
List 2 causes for xerostomia (2)
- Drug induced (antihypertensives and antidepressants)
2. Head and neck radiation
Describe the features of WHO probe (2)
- Tapered probe with ball ended tip
2. Black band from 3.5 to 5.5mm
Outline 3 uses for WHO probe (3)
- Examine presence of plaque
- Detection of sub-gingival plaque
- Measure pocket depths
Describe how stage of periodontal condition is determined (2)
- Amount of interproximal bone loss at worst site as seen on radiograph
- Measured from CEJ to root apex
Describe how grade of periodontal condition is determined (2)
- Ratio of bone loss to age at worst site
2. Calculated by dividing maximum bone loss by age
List 6 factors which can increase plaque retention on teeth (6)
- Sub-gingival calculus
- Dentures
- Xerostomia
- Dental anomalies / Tooth angulation
- Fixed appliances
- Poor restoration margins
Describe the Bass technique for toothbrushing (5)
- Brush placed at 45 degrees to gingiva
- Firm but light pressure, slightly under gum line
- Use circular movements on each tooth, brushing all surfaces
- Brush for 30 seconds in each quadrant
- Brush tongue
Name mechanism of action of 2 types of ultrasonic scalers (2)
- Peizoelectric - Vibrations caused by oscillation of quartz to produce linear tip movement
- Magnetostrictive - Vibrations caused by magnets to produce eliptical tip movement
Name 3 mechanisms by which ultrasonic scalers can remove deposits from tooth surface (3)
- Mechanical energy
- Irrigation
- Cavitation