3. Periodontology Flashcards
Definition of early colonisers
Definition of late colonisers
Cause of periodontal disease
Periodontal microbiology in health (3)
Periodontal microbiology in gingivitis (3)
Periodontal microbiology in periodontitis (2)
Function of MMPs (3)
Control of alveolar bone resorption (2)
Control of osteoclastogenesis (2)
Commensal species that modify environment and cause bacterial interactions
Gram -ve bacteria, require established biofilm
Plaque biofilm
In health, PRRs recognise PAMPS –> release of pro-inflammatory mediators, increasing phagocytic activity, and blood flow, as well as causing vasodilation, and immune cell migration
In gingivitis there is an increase in PRR stimulation –> increased production of pro-inflammatory mediators –> inflammation
In periodontitis, the oral biofilm extends into the pocket and the adaptive immune response predominates, featuring MMPs
Amplification of pro-inflammatory mediators, CT destruction and alveolar bone resorption
RANKL/OPG - a high RANKL/OPG ration favours osteoclastogenesis
RANKL binds RANK –> mRANKL on osteoblast –> sRANKL (inflammation and bone metabolism) –> bone loss
Periodontal disease risk factors (5)
Actions of smoking on periodontal health (5)
Antibody functions (2)
Periodontal disease risk determinants (3)
Smoking, diabetes, drugs, stress, systemic disease
Causes vasoconstriction of gingival blood vessels, gingival keratinisation, impaired antibody production, impaired PMN function, increased cytokine production
Phagocytosis, inhibition of adhesion/invasion
Genes, gender, socioeconomic status
Periodontal treatment (2)
Examples of local plaque retention factors (2)
Features of gingival health (5)
Features of gingivitis (4)
Definition of biofilm
Functions of biofilm (2)
Removal of biofilm involves
Non-surgical, antibiotics
Restorations, calculus
Knife-edged/scalloped, flat, firm, no bleeding/pain, pink/pale
Inflammation (plaque-induced), red, BoP, recession
One or more communities of micro-organisms embedded in glycoalyx attached to a solid surface
Facilitates uptake of nutrients and removal of metabolic products
Mechanical disruption
CRT/HPT
Function of CRT (3) Definition of periodontitis Components of CRT (5) Components of HPT (5) Definition of scaling Definition of debridement Components of RSD (2)
Arrest disease, regenerate lost tissue, maintain long-term periodontal health
Loss of attachment and true pocket formation with colonisation of root surface
Extract non-restorable teeth, HPT, caries management, endodontics, provisional prostheses
DHE, OHI, scaling and RSD, removal of other plaque retention factors, re-evaluation
Removal of plaque and calculus from tooth surface
Removal of dead, contaminated or adherent tissue/foreign material
Scaling and root planing
Effect of supragingival plaque control alone
Effect of subgingival plaque control alone (2)
Effect of supragingival and subgingival plaque control (4)
Periodontal treatment success is measured by (6)
What causes a gain in attachment (2)
Why does treatment fail (3)
Reduction in inflammation
Initial reduction in inflammation and pocket depth, before recolonisation
Reduction in inflammation and pocket depth, increase in attachment, change in sub gingival microbial flora
Good OH, no BoP, no pockets >4mm, reduction in proving depth, gain in attachment, no change in furcation/mobility
Long junctional epithelium formation and improved tissue tone
Poor compliance, inadequate debridement, host factors (smoking)
Clinical attachment loss calculation
Probing depth + gingival margin level
+ if recession; - if above ACJ
BPE scores
Differences between CPITN/BPE and PCP-12 probes (2)
BPE 0 BPE 1 BPE 2 BPE 3 BPE 4 BPE with *
Further treatment for: BPE 0 BPE 1 BPE 2 BPE 3 BPE 4 BPE with *
Grading of furcation involvement and descriptions (3)
Grading on tooth mobility and description (4)
CPITN probe - 0.5 mm diameter ball-end and black banding (3.5-5.5mm and 8.5-11.5mm). PCP-12 - no ball-end, black banding (3-6mm and 9-12mm)
BPE 0 - no pockets >3.5mm, no calculus/overhands, no BoP
BPE 1 - no pockets >3.5mm, no calculus/overhands, BoP
BPE 2 - no pockets>3.5mm, calculus/other plaque retentive factors present
BPE 3 - pockets 3.5-5.5mm (black band partially visible)
BPE 4 - pockets >5.5mm (black band entirely within pocket)
- furcation involvement/detectable by probing
Treatment for:
BPE 0 - none/OHI, review
BPE 1 - PGI, OHI
BPE 2 - PGI, OHI, removal of plaque retention factors
BPE 3 - PGI, OHI, removal of plaque retention factors. Full periodontal chart (6 point pocket chart after treatment)
BPE 4 - as before, but full periodontal chart before and after treatment
BPE with * - depends on BPE score
I - up to 3mm horizontal attachment loss
II - > 3mm horizontal attachment loss
3 - through-and-through
0 - physiological mobility at crown level (approx. width of PDL)
1 - < 1mm
2 - 1-2mm
3 - > 2mm and/or rotation or depression
Periodontal instrumentation
Mini-sickle
Columbia Curette
Gracey Curette (grey) Gracey Curette (green) Gracey Curette (orange) Gracey Curette (blue)
Hoe scaler (red) Hoe scaler (yellow)
Right-handed operator seating positions for:
Lower anteriors
UR post./LR post. buccal, LL post. lingual
Upper palatal, UR ant. labial, UL, LL post. buccal, LR post. lingual
Double-ended point scaler with two cutting edges on each blade for buccal and lingual embrasure surfaces supra-gingivally and within the pocket orifice
Double-ended universal curette with 2 cutting edges on each blade for subgingival scaling anywhere in the mouth but with limited access to deep pockets
Double-ended curette, each blade having a single cutting edge. Designed specifically for fine/deep sub-gingival scaling of upper and lower anterior teeth
Double-ended curette, each blade having a single cutting edge. Specifically designed for fine/deep sub-gingival scaling of buccal/lingual surfaces of posterior teeth
Double-ended curette, each blade having a single cutting edge. Specifically designed for fine/deep sub-gingival scaling of mesial surfaces of posterior teeth
Double-ended curette, each blade having a single cutting edge. Specifically designed for fine/deep sub-gingival scaling of the distal surfaces of posterior teeth
Double-ended instrument for gross supra- and sub-gingival scaling mainly on buccal and lingual surfaces
Double-ended instrument for gross supra- and sub-gingival scaling mainly on mesial and distal surfaces
7 o’clock
9 o’clock
11 o’clock
