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Perio > 3rd Section > Flashcards

3rd Section Flashcards

1
Q

T/F patient’s old radiographs and perio charts are important

A

True

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2
Q

Fremitus:

A

Movement in occlusion

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3
Q

Diagnosis is affected by what 9 things

A 
Probing depth
Gingival recession
CAL
Keratinized gingiva
BOP
Furcation involvement
Mobility
Fremitus
Bone defects
Casey
Kariya
Gets
More
For
Five
Bucks
By
Playing
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4
Q

CPITN probe increments

A
  1. 5 (Ball)
  2. 5
  3. 5
  4. 5
  5. 5
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5
Q

Williams probe increments

A 
1.2
3
5
7
8
9
10
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6
Q

Mucogingival defect

A

When probe is at or past MGJ

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7
Q

Furcation involvement I-III

A

I - indent into furcation
II- most of the way through furcation
III - through and through

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8
Q

Furcation involvement is measured using

A

Nabers probe

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9
Q

Classic two walled defect

A

Crater

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10
Q

3 clinical signs that indicate health

A

Probing depth 1 to 3 mm
No history of attachment loss
No clinical signs of inflammation

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11
Q

Dental plaque induced gingivitis requirements (4)

A

≤3 mm probing depth
BoP
No gingival recession
Red/edematous soft tissue

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12
Q

3 things to have periodontitis

A

≥ 4 mm probing depth
Attachment loss
Clinical signs of inflammation

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13
Q

What determines if perio is slight, moderate or severe

A

How much CAL

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14
Q

Incidental attachment loss is also called

A

Gingival recession

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15
Q

Order of general perio treatment

A 
Exam
Diagnosis
Risk factors for future
Prognosis
Treatment alternatives
Informed consent
Therapy (non-surgical)
Re-evaluation
Maintenance
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16
Q

Osseointegration:

How is rigid fixation different:

A

Direct attachment of bone to implant

It is just the clinical term to define osseointegration

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17
Q

T/F 100% bone to implant connection exists

A

FALSE - more like 60%

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18
Q

Important factors for osseointegration

A 
Biocomp. Of implant
Design of implant
Surface of implant
Status of host bed
Surgical technique at insertion
Loading conditions
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19
Q

4 steps of implant insertion procedure

A

Incision
Mucoperiosteal flap elevation
Preparation of a bed in bone
Insertion of titanium device

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20
Q

3 ways to surgically manipulate alveolar bone for implants

A

Anatomical location
Augmentation techniques
Condensation

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21
Q

Bone healing at 24 hrs vs 1 week

A

24 - resorption at cortical bone, woven bone formation, blood clot, proliferation of vasculature into newly forming granulation tissue

1 week - reparative macrophage and undifferentiated mesenchymal cells. Modeling at the apical trabecular region and at the Furcation sites of a screw shaped implant

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22
Q

When can new bone first be detected at furcation sites of implant surface

A

2 weeks

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23
Q

Plateau effect of bone stability happens after when

A

6 weeks

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24
Q

What is jumping distance, what is the ideal range

A

Distance b/t implant and bone that can be filled with new bone

20-40 um

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25
Q

Healing period for max and mand. For osseointegration

A

Max - 6 months

Mand - 3 months

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26
Q

4 types of implant surfaces

A

Titanium plasma sprayed
Sand blasted acid etched
hydroxyapatite
Tricalcium phosphate

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27
Q

Implant needs how much thickness around it

A

1mm minimum

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28
Q

Minimum bone thickness b/t two implants

A

3mm

29
Q

Minimum bone thickness b/t implant and adjacent tooth

A

4 mm

30
Q

Coronal part of an implant should be placed _ apical to the adjacent CEJ

A

~5mm

31
Q

Implant can be placed with max of _˚ angle

A

20˚

32
Q

On an implant, what is the thickness of barrier epithelium?

Zone of connective tissue?

A

Barrier - 2 mm

ZoCT - 1-1.5 mm

33
Q

Collagen fiber bundle run _ to implant surface

A

Parallel

34
Q

Zone adjacent to implant surface is high in _

Zone lateral to that one _

A

Fibroblasts

Collagen fibers and blood vessels

35
Q

Blood supply to bone around implants comes from _

A

Supraperiosteal blood vessels

36
Q

Submerged vs. non-submerged tech

A

Sub - two stage implant placement

Non-submerged - one stage

37
Q

Micro gap b/t implant and abutment is usually located at _

A

Alveolar crest

38
Q

Biologic width exists around what type of implants?

How thick?

A

Around unloaded and loaded NON-SUBMERGED one-part titanium implants

3 mm

39
Q

Clinical parameters to evaluate peri-implant health

A
  1. No mobility
  2. Radiograph
  3. Absence of bone loss (≥0.2 mm/yr) after first year
  4. Absence of pain, complain, infection
  5. Functional and esthetic acceptance by pt and dr.
  6. Success rate of 94-98% (5 yr), 90-94% (10 yr)
40
Q

3 techniques to evaluate dental implants

A

Peri-implant probing
Mobility
Radiographs

41
Q

Conditions associated with
Ailing implant:

Failing implant:

Failed implant

A

A: peri-implant mucositis
Peri-implantitis

Fing: peri-implantitis

Fed: peri-implantitis w/ mobility and complete loss of osseointegration

42
Q

Peri-implant mucositis vs. peri-implantitis

A

Mucositis: reversible inflammation of the mucosa around the implant

implantitis: inflamm. Associated w/ loss of supporting bone around an implant IN FUNCTION

43
Q

Peri-implantitis vs. periodontitis

A

PI - neutrophils surrounding implant, direct contact b/t plaque on implant and inflamed connective tissue

Both not seen in periodontitis

44
Q

Bacterial plaque is a _ in PI and mucositis

A

Primary etiologic factor

45
Q

Main type of bacteria that cause PI and mucositis

A

Gram - anaerobic

46
Q

T/F implants and teeth can have a different microbiota

A

TRUE

47
Q

Occlusal trauma is a _ etiological factor for periodontal disease, and can be a _ etiological factor for peri-implant disease

A

2˚ for perio

1˚ for peri-implant

48
Q

What does bruxism do to implants

A

Complicates implant healing

49
Q

Class 1-4 peri-implantitis

A
  1. Slight horizontal bone loss, minimal peri-implant defects
  2. Moderate horizontal bone loss, isolated vertical defects
  3. Moderate to advanced horizontal bone loss, broad circular bony defects
  4. Advanced horizontal bone loss, broad, circumferential vertical defects, loss of oral and/or vestibular bony wall
50
Q

Treatment for class 1-4 peri-implantitis

A
  1. Surgical reduction of pocket depth, cleaning
  2. Repositioning more apically, implantoplasty, bone defects restored by GTR if necessary
  3. GTR
51
Q

T/F BOP shows risk for future disease

A

FALSE, indicates inflammation now

52
Q

Goal after scaling/root planing

A

No Probe depths >5 mm

53
Q

Treatment goal for Furcation involvement is _

A

≤3mm

54
Q

4 phases of therapy (what they contain too)

A 
Systemic
 -eliminate/decrease influence of systemic conditions
 -protection from infectious hazards
Initial hygiene phase
 -removal or retentive factors
 -removal of deposits
 -patient motivation
Corrective phase
 -perio/implant surgery
 -endo, restorative, prosthetic therapy
Maintenance phase
 -supportive periodontal therapy
 -prevention/caries control
55
Q

How long to wait to re-evaluate after scaling/root planing

A

4-6 weeks, takes around 6 weeks to regenerate collagen

56
Q

When is prognosis established

A

After diagnosis is made, before treatment plan is established

57
Q

Prognosis determinants are divided into 4 categories:

A

Overall clinical factors (age, compliance)

Systemic/environmental factors (smoking, systemic disease)

Local Factors (plaque, anatomic factors)

Prosthetic/Restorative Factors (abutment, caries, root resorption)

58
Q

Overall vs. individual tooth prognosis

A

O: age, severity of disease, systemic factors, smoking, compliance

I: mobility, probe depth, bone loss, Furcation inv., local factors

59
Q

BBB vs McGuire and Nunn classification

A

BBB: good, questionable, hopeless

MN: Very good, good, fair, poor, hopeless

60
Q

Criteria of the McGuire and Nunn classification for:

Good
Fair
Poor
Hopeless

(Including: Aloss, Furcation, mobility, maintenance/pt cooperation, systemic factors)

A

Good:

  • 25% Aloss and/or Class I Furcation
  • adequate remaining bone support
  • can control etiologic factors
  • patient cooperation
  • no systemic environmental factors OR well controlled systemic factors

Fair:

  • 25-50% Aloss
  • grade I or easily accessible grade II Furcation
  • adequate maintenance possible
  • few systemic complications

Poor

  • > 50% Aloss
  • Bad II or III Furcation
  • Class 2 mobility
  • difficult to maintain areas/ low pt compliance
  • systemic/environmental factors

Hopeless

  • > 75% Aloss
  • Tooth mobility 2+
  • II and III Furcation
  • difficult maintenance/ doubtful pt compliance
  • root proximity
61
Q

Disease severity is classified according to what 2 parameters

A

Level of clinical attachment

Radiographic examination

62
Q

Which is more important: pocket depth or attachment level, why?

A

Attachment level, pocket depth isn’t necessarily related to bone loss, but attachment loss is

63
Q

_ is the primary etiologic factor associated with perio

A

Bacterial plaque

64
Q

Which tooth anatomy usually causes a poor prognosis

A

Short, tapered roots and large crowns

65
Q

3 main causes of tooth mobility

A

Loss of alv. bone

Inflammation in PDL

Trauma from occlusion

66
Q

If inflammation can be controlled, slight to moderate perio prognosis is:

A

Good

67
Q

Hypophosphatasia:

A

Decreased levels of alkaline phosphatase, severe alveolar bone loss, premature loss of teeth and connective tissue disorder

68
Q

NUG:
Reversible?
Prognosis?

Difference in NUP
Who gets NUP

A

Tissue destruction is not reversible
Good except in repeated episodes which is fair

NUP extends to periodontal ligament and alveolar bone
Immunocompromised get NUP, have to treat systemic conditions too

Perio (3 decks)

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