6. Periodontal Pocket Formation and Bone Loss Flashcards
5
What kind of radiograph is needed for all patients in periodontal clinic?
5
What do periapical radiographs do?
5
What technique is used for periapical radiographs?
5
What is a horizontal bitewing used for?
5
What is a vertical bitewing used for?
5
What are bitewings best used to evaluate?
5
What type of radiograph has the least interproximal bone distortion?
6
What are the two definitions for periodontal pockets?
7
What is another name for a Gingival Pocket?
7
How is a gingival pocket formed?
7
When does a periodontal pocket form?
8
What are the three classifications of pockets?
9
What are the 2 types of periodontal pockets?
9
Where is the bottom of the pocket of a suprabony pocket relative to the alveolar bone?
9
Where is the bottom of an intrabony pocket relative to the alveolar bone?
9
For an intrabony periodontal pocket, the pocket wall lies between the ______ and the ______.
10
What is the initial lesion in the development of periodontitis?
11
What is the first step of pocket formation?
11
What fibers are destroyed when there is inflammation in the connective tissue wall of the gingival sulcus?
11
What does the junctional epithelium do as a result of loss of gingival collagen fibers?
13
What happens to the cementum facing the pocket wall when there is pocket formation?
13
What two things do bacteria penetrate when the cementum facing the pocket wall becomes exposed to the oral environment?
14
Scaling an root planing should remove _____ of the cementum to _______.
14
Bacteria may evade the host defense and scaling and root planing efforts by ________.
16
What is the formula for Clinical Attachment Loss?
19
Gingival margin position is relative to the _____.
21
What is it called when the gingival margin is apical to the CEJ?
21
Is the number for gingival margin when there is recession negative or positive?
21
Is the number for the gingival margin when the gingival margin is coronal to the CEJ negative or positive?
21
What is the number for the gingival margin when the gingival margin is at the CEJ?
24
What instrument do you use to detect a subgingival CEJ?
24
Detecting Subgingival CEJs:
- Insert pribe into the ____ to feel for the CEJ.
- Hold the probe at a ____ angle when detecting CEJs.
- Measure where the gingival margin _____.
- Record gingival margin as a _____ number.
25
What is the gingival margin a negative or positive number when the interdental papilla fills the interproximal space?
26
Is the interproximal gingival margin negative or positive when there is gingival recession and there is an open interproximal space?
27
What is the clinical attachment loss value when the probe depth is 6 mm and the GM is -2mm?
32
Clinical attachment loss tells you how much attachment loss there is from the _____. It is the distance from the ____ to the ______.
33
Periodontal disease activity goes through periods of ______ and ______.
33
Does periodontal destruction occur in all areas of the mouth at the same time?
35
What marks the transition from gingivitis to periodontitis?
36
The mechanism of bone destruction is ____ and ____ mediated.
36
Bacterial products such as ____ induce the differentiation of osteoclasts in the mechanism of bone destruction.
36
What are three host factors released by inflammatory cells that induce bone resorption?
37
What is the critical distance for the radius of action where there is locally produced bone resorption? What if the radius is greater than this distance?
38
Alveolar bone responds to inflammation by ____ and ____. Periodontal bone loss occurs when ____ dominates ____.
39
What are 6 factors that increase the risk for periodontal bone loss?
40
Smoking Effects on Periodontitis:
- ______ risk for periodontitis
- _____ dependent
- _____ important
- ____ Years
41
What is the formula for Pack Years for smokers?
42
What is the most common bone destruction pattern?
42
In which dimension is bone lost in horizontal bone loss?
42
In horizontal bone loss, the bone margin remains ____ to the root.
42
In which direction is bone lost in verticular (angular) bone loss?
42
Vertical bone loss leads to the formation of which type of periodontal pockets?
What is this an image of?
Horizontal Bone Loss
What is the slanted line an image of?
Vertical Bone Loss
48
Radiographs underestimate bone loss by up to ____ mm.
48
Normal bone levels are ____ mm from the CEJ to the osseous crest.
48
What two tissues are attached in normal bone levels? What is the name for these attached tissues?
48
How do you determine bone loss using a bitewing radiograph? (2 bullet points under “To determine bone loss”)
50
What percentage and mm measurement represents slight bone loss?
50
What percentage and mm measurement represents moderate bone loss?
50
What percentage and mm measurement represents severe bone loss?
51
Are facial and lingual bone loss easy or difficult to visualize on radiographs?
51
What should you look for when analyzing facial and lingual bone loss?
53
What is an early radiographic change in periodontitis?
55
What effect will occlusal trauma have on the PDL?
55
What type of defects will there be in bone due to occlusal trauma?
55
What effect will occlusal trauma have on the lamina dura?
55
Will Fremitus occur as a result of occlusal trauma?
58
A vertical defect can only occur if the interproximal space is wider than ____ mm.
58
Interproximal spaces less than 2.5 mm have ____ bone loss.
60
Close root proximity is measured from ____ to ____ of adjacent teeth.
60
What is the measurement for close root proximity?
60
What type of bone loss will result from close root proximity?
61
Classifications of vertical defects are based on the number of _______.
61
What are the three classifications of vertical defects?
66
Why do narrow vertical defects have a better prognosis than wide vertical defects?
66
Vertical defects must be how deep for a bone graft to be placed?
66
Can vertical defects be grafted?
66
Can horizontal defects be grafted?
67
What are osseous craters?
68
What is a positive osseous architecture?
68
What is a negative osseous architecture?
68
What is a flat osseous architecture?
71
What is the 3-4-5 rule for the location of furcations on the maxillary 1st molar?
71
What is the root trunk length?
72
What is the 3-4 rule for the location of furcations of the mandibular 1st molar?
73
When would you suspect furcation involvement for a maxillary 1st molar?
74
Where are the two furcations on a maxillary 1st premolar?
74
In what percent of cases does the maxillary first premolar have a bifurcation?
74
How far apical to the CEJ is the bifurcation of a maxillary 1st premolar?
74
What is the clinical implication of the bifurcation of a maxillary 1st premolar being 8 mm apical to the CEJ?
75
What is exostosis?
75
What may exostosis be related to?
