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Restorative > Basic Perio > Flashcards

Basic Perio Flashcards

0
Q

How do fibrous gingival enlargement differ from oedematous enlargement?

A

Oedematous tissue is soft and when touched may bleed spontaneously
Fibrous tissue is hard

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1
Q

Gingiva that appear enlarged can be caused by what?

A

Oedema or Fibrous tissue

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2
Q

How do you record gingival recession?

A

From the CEJ to the free gingival margin

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3
Q

What factors may influence the depth of the pocket recorded?

A 
Presence of calculus
Angle of probe
Bulbosity of tooth
Thickness of probe 
Pressure applied
Presence of inflammation- a probe can more easily penetrate throu the pocket epithelium in inflamed tissues
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4
Q

What should you use to investigate furcation involvement?

A

A curved explorer

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5
Q

How can furcation lesions be classified?

A

Class 1: initial involvement, less than 1/3 destruction
Class 2: tissue destruction is more than 1/3
Class 3: through and through lesion

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6
Q

What should you record from

Radiographic analysis regarding periodontal disease?

A 
Pattern of bone loss: horizontal or vertical
Furcation involvement
Varies root anatomy
Subgingival calculus
Widened pdl space
Overhangs
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7
Q

What are the issues around microbial sampling in perio?

A
  1. Difficult to find a lab that wi do it

2. Difficult to ensure that the technique used to sample will ensure the anaerobic organisms stay alive

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8
Q

What method can be used instead of microbial sampling?

A

PCR

This detects bacterial DNA therefore the the bacteria can be dead or alive for this to work

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9
Q

Name some types of gingivitis

A 
Chronic gingivitis 
Pregnancy gingivitis
Plasma cell gingivitis
Desquammative gingivitis 
NUG
Primary herpetic gingivo stomatitis
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10
Q

What is chronic gingivitis?

A

Plaque induced inflammatory lesion if the gingiva

10-20 days following plaque establishment within the gingiva

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11
Q

How do you treat chronic gingivitis?

A

OHI
Interdental aids
Scaling supra and Subgingival
Eliminate plaque retentive factors

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12
Q

What causes pregnancy gingivitis?

A

Increase in circulating oestrogen and progesterone and their metabolites may aggravate pre existing gingivitis

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13
Q

How do the hormones in pregnancy and puberty affect the gingival tissues?

A

Increase the permeability of the vessels

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14
Q

When does pregnancy gingivitis become most severe?

A

Within the 2-8 the month

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15
Q

What other gingival feature other than gingivitis may be seen during pregnancy?

A

Gingival epulis

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16
Q

What are the features of pregnancy gingivitis?

A

Generalised, marginal, oedematous Inflam

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17
Q

What is the treatment for pregnancy gingivitis?

A

OHI and scale

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18
Q

What is plasma cell gingivitis?

A

Contact hypersensitivity reaction most commonly to cinnamon and toothpaste

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19
Q

What does the microscopical analysis show for plasma cell gingivitis?

A

Atrophic epithelium

Plasma cell infiltrate into epithelium

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20
Q

What are the features of plasma cell gingivitis?

A

Gingiva are red and fiery in appearance with varying degrees of swelling and lesions may be seen on tongue and palate

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21
Q

What is the difference between horizontal and vertical bone loss?

A

Horizontal bone loss is when the entire width of the interdental bone is lost
Vertical boneless is when the bone adjacent to the root surface is lost

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22
Q

How do you treat grade 1 furcation lesions?

A

OHI
Scale
Furcoplasty

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23
Q

How do you treat grade 2 furcation lesions?

A

OHI
Scale with or without flap
Root resection
GTR

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24
Q

How do you treat grade 3 furcation lesions?

A 
OHI
Scaling
Root resection 
Hemisection
Tunnel prep 
Xla
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25
Q

Why would you use flap surgery in furcation treatment?

A

This is more commonly used for grade 2 and 3 furcation lesions and enables you to obtain a complete view of the furcation once the granulation tissue is removed

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26
Q

What is the aim of a furcoplasty?

A

Produce a healthy gingival papilla n the furcation entrance

27
Q

What 2 procedures does a furcoplasty comprise of?

A

Odontoplasty

Osteoplasty

28
Q

What is an Odontoplasty?

A

The removal of tooth substance to the widen the entrance to the furcation but only a small amount should be removed to avoid post op sensitivity

29
Q

What is an osteoplasty?

A

Re contouring of adjacent bone on the lingual, buccal or palatal alveolar plates that are not providing any tooth support

30
Q

What is a tunnel preparation?

A

This is used where there are deep grade 2 and 3 furcation defects which means the inter radicular osteoplasty should be more radical to create a tunnel through the furcation

31
Q

What is the difference between root amputation and hemisection?

A

Hemisection is when crown and root are cut in half and amputation is Jen only the root goes

32
Q

When should you place the root filling in a tooth that is going to be hemisected or amputated?

A

Before!!!!

33
Q

What happens in gingival recession?

A

The width of the attached gingiva is reduced

34
Q

What are two features of recession?

A

Still mans cleft

Mc calls festoon

35
Q

What are the predisposing features I’m bone that may lead to recession?

A

Dehiscence and fenestrations

36
Q

What is the difference between a dehiscence and a fenestration?

A

A fenestration is a window in bone and dehiscence is a cleft

37
Q

How do you treat recession?

A

Good OH
Eliminate aetological factoris
Gingival veneer
Ginigival surgery

38
Q

How can occlusal forces cause periodontal trauma?

A

According to Glickmans hypothesis: excessive ocusal forces in the presence of gingivitis acts as a co destructive factor. This means descruction is forced directly through the pdl

39
Q

T/F

Calculus is the aetiological agent periodontal disease?

A

F

Plaque is

40
Q

T/F

Plaque becomes mineralised by ions in GCF to form calculus?

A

F

Ions from saliva

41
Q

T/F

Mature calculus contains HAP ions?

A

T and tricalcium phosphate

42
Q

T/F

Calculus contains no bacteria

A

F

It contains non viable bacteria that have become mineralised

43
Q

T/F

PG does not invade gingival tissues?

A

F

It is able to invade and replicate within gingival epithelial cells

44
Q

T/F

PG is not encapsulated?

A

F

It is encapsulated which helps it resist being phagocytosed

45
Q

T/F

Aa is effectively removed during RSD?

A

False

Because Aa is able t invade gingival tissues

46
Q

T/F

Vertical bone defects are easier to treat than horizontal defects?

A

F

47
Q

Which walled defect is the easiest to treat with GTR?

A

Three walled, it easier to isolate from the epithelium with the GTR membrane

48
Q

When would use a simple flap in perio surgery?

A

Access root surface
Regenerative techniques
Osseous surgery

49
Q

When would you use a modified widman flap in perio surgery?

A

Access rot surface

Crown lengthening

50
Q

When would you use an apically repositioned flap in perio?

A

To allow for pocket reduction and crown lengthening

51
Q

When would you perform a gingivectomy?

A

For pocket revision and crown lengthening

52
Q

When would you perform a gingivoplasty?

A

Re contour gingival tissues

53
Q

When would you use a free gingival graft and split graft?

A

Gingival recession

54
Q

In what patients would perio surgery be carried out amongst?

A

Those with excellent plaque control

55
Q

When would you use a coronally repositioned flap?

A

To get rid of recession

56
Q

When would you place a peridontal pack following surgery?

A

When you are concerned that close adaptation between the flap and the bone has not occurred

57
Q

What sutures should be used in the anterior region when suturing flaps?

A

Vertical mattress sutures and simple interrupted sutures may pull the labial papilla apically which causes an embrasure to appear as a dark triangle

58
Q

What must peridontal dressings not contain?

A

Eugenol

This is irritant to the underlying bone

59
Q

In which patient group are furcation involvement more commonly seen amongst? Reference

A

Smokers

Ziada et al 2007

60
Q

What are the indications for root resection?

A
  1. Severe localised bone loss affecting one root only
  2. Grade 2/3 furcation disease with sufficient bone support for the root to be retained
  3. Deep caries extending in to the root for resection
  4. Endodontic complications eg perforation
  5. Root fracture of pulp floor perforation
61
Q

What are the contraindications for root resection?

A 
Unrestorable tooth
Fused root pattern
Excessive tooth mobility
Insufficient bone support
Other form of restoration may be more suitable 
Extensive caries 
Endo treatment unfeasible
62
Q

Why is it better to carry out the root treatment before the perio surgery?

A

This will have an impact on the rest of the treatment. If the tooth does not stabilise following the RCT then it is not advantageous to embark on the surgery

63
Q

What are the causes of local periodontal problems?

A 
Mouthbreathing
Developmental abnormalities 
Crowding
Perio-endo
Root fracture/perforation
64
Q

How does mouth breathing cause problems?

A

Incompetent lips can lead to mouthbreathing and this can cause the mouth to dry out during sleep causing plaque to accumulate this then causes gingivitis followed by fibrotic lesions

65
Q

How do Developemental abnormalities cause local perio problems?

A

Extra pits and grooves and cusps act as plaque retentive factors

Restorative (45 decks)

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