Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 PERIODONTOLOGY > BDS4 Periodontology PPs > Flashcards

BDS4 Periodontology PPs Flashcards

1
Q

What are the clinical signs of improved health following periodontal treatment?

A
  • reduction in probing depths
  • no BoP
  • decreased mobility
  • plaque <15%
  • bleeding <10%
  • PPD </= 4mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why might oral antibiotics not be effective in treating chronic periodontal disease?

A
  • microbial complexity
  • antibiotic resistance
  • biofilm resistance
  • ABs not mediating the host immune response
  • ABs inactivated by first pass metabolism
  • poor pt adherence to regime
  • poor OH
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you manage a periodontal abscess with systemic involvement?

A
  • administer LA
  • drainage via incision or via pocket
  • give some subgingival PMPR of pocket (try to avoid excessive trauma)
  • if tooth poor prognosis consider XLA
  • advise analgesia
  • give OHI
  • prescribe Chlorhexidine 0.2%, 1 min gargle tih 10ml, 2x per day
  • PenV 250mg 2 tablets 4x a day for 5 days
  • review
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is SIRS?

A

Any 2 or more of:
- temp >38 or <36
- tachycardia >90bpm
- tachypnea >20 breaths per min
- WCC >12,000/mm^3 OR <4000/mm^3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a periodontal abscess?

A

Acute infection of an existing periodontal pocket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the signs and symptoms of a periodontal abscess?

A
  • pain on biting
  • TTP
  • pt complains tooth feels high
  • increased mobility
  • swelling
  • deep pocketing at swelling
  • BoP and potential purulent exudate on probing
  • bad taste/smell from area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can a periodontal abscess be differentiated from a periapical abscess?

A

Sensibility testing in a periodontal abscess = normally POSITIVE

Sensibility testing in a periapical abscess = NEGATIVE

Mobility less likely in a PA abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a periapical abscess managed?

A
  • drainage of abscess [via pocket if present or via incision]
  • consider PMPR if pocketing present
  • RCT of tooth / XLA if poor prognosis
  • CHX 0.2% prescribed
  • only prescribe antibiotics if signs of spreading infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you manage traumatic occlusion in a patient with periodontal disease?

A
  • PMPR
  • bite raising appliance when sleeping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What factors can influence localised mobility of teeth?

A
  • existing periodontal disease
  • traumatic/heavy occlusion
  • morphology/length of roots
  • PA bone loss
  • resorption of roots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When might splinting be advised for a patient with mobile teeth?

A
  • pt has loss of function
  • pt has discomfort
  • OH is good
  • pt doesn’t want teeth XLA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is there a reduction in tooth mobility after periodontal treatment?

A
  • long junctional epithelial attachment [reduction in perio pocketing]
  • increased tissue tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can you do if the PDL of a tooth is still widened after successful periodontal treatment?

A
  • reduce contact of tooth in occlusion
  • consider splinting too?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What bacteria are involved in necrotising gingivitis?

A

fusiform & spirochetes bacteria (anaerobic gram negative bacteria)
- treponema denticola
- prevotella intermedia
- p gingivalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical signs and symptoms of necrotising gingivitis?

A
  • pain
  • bleeding
  • grey sloughing of gingiva
  • punched out/crater appearance
  • pseudomembranous formation over top
  • blunted papillae
  • halitosis/foetus oris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 5 risk factors for development of necrotising gingivitis?

A
  • smoking
  • stress
  • immunocompromised (eg HIV)
  • malnourished
  • young age
  • poor OH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the management of necrotising gingivitis?

A
  • PMPR to remove plaque/deposits under LA for next 2-3 days
  • advise pt SOFT TOOTHBRUSH to clean teeth
  • 0.2% Chlorhexidine MW (minimum twice a day BUT can use it 3 times a day, warn pt they might get a lot of stinging due to sore gums, advise pt should hold it in their mouth for 1 min) OR Hydrogen peroxide 0.3% MW (hold in mouth for 2 mins, dilute if necessary, use minimum twice a day)
  • if systemic involvement/no improvement 400mg Metronidazole TID for 3 days (avoid alcohol)
  • then assess risk factors & pre-existing gingivitis & smoking cessation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define localised and generalised bone loss:

A
  • Localised <30%
  • Generalised >30%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List the 2017 classification of periodontal diseases:

A
  • Health
  • Plaque induced Gingivitis [intact / non-intact periodontium]
  • Non plaque induced Gingival Diseases and Conditions
  • Periodontitis
  • Necrotising Periodontal Diseases
  • Periodontitis as a manifestation of Systemic Disease
  • Systemic Diseases or Conditions Affecting the Periodontal Tissues
  • Periodontal Abscesses
  • Periodontal-endodontic lesions
  • Mucogingival deformities and conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why might someone with gingival health have a reduced periodontium?

A
  • previous periodontal patient that has responded to treatment
  • trauma from toothbrushing etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does a healthy periodontium react to traumatic occlusion?

A

PDL widening that can increase mobility
- this reverses once tooth is taken out of occlusion/occlusion sorted
- no LOA or inflammation

22
Q

How does a healthy but reduced periodontium react to traumatic occlusion?

A

PDL widening HOWEVER mobility is increased more due to already lessened PDL attachment/bone
- again reverses once occlusion fixed

23
Q

What is Chlorhexidine?

A

Bisbiguanide digluconate antiseptic

24
Q

What is the mode of action of Chlorhexidine?

A

Dicationic
- 1 cation adheres to pellicle
- 1 cation disrupts bacterial membrane

Works against gram +ve and -ve bacteria, fungi, viruses and candida!

25
Q

What is the substantivity of Chlorhexidine Diglugonate?

A

12 hours [how long it stays in oral cavity]

26
Q

Give 2 common doses of chlorhexidine:

A
  1. 0.2% 10ml 2x daily for 1 minute
  2. 0.12 15ml 2x daily for 1 minute
27
Q

Give 4 side effects of using Chlorhexidine Mouthwash:

A
  • tooth staining if excessive use
  • taste disturbance
  • anaphylaxis
  • burning/stinging sensation
28
Q

Give 8 uses of chlorhexidine:

A
  • endodontic irrigant
  • irrigation under peri-coronitis operculum
  • post-surgery disinfection
  • pre-surgery disinfection
  • irrigation of dry socket
  • necrotising periodontitis/gingivitis
  • periodontal abscess
  • ulceration
29
Q

What 7 things are recorded on a periodontal full mouth pocket chart?

A
  • teeth missing
  • gingival margin
  • pocket depth
  • loss of attachment
  • BoP
  • mobility
  • furcation involvement
30
Q

What are some disadvantages of a 6PPC?

A
  • assumes all pts have same root length so may appear worse than they actually are
  • probing depths are subjective to operator
31
Q

What are some local factors that cause gingival recession?

A
  • periodontal disease
  • habits [nail/pen biting]
  • traumatic OB
  • traumatic toothbrushing
  • crowding
  • orthodontics
  • frenal attachments
  • abrasive toothpaste
32
Q

How can you measure/classify gingival recession

A
  • Miller’s Classification
  • photos
  • study models
  • pocket charting
33
Q

How is localised gingival recession managed?

A
  • dentine desensitising agents placed on root
  • monitor for worsening/improvement
  • gingival veneer
  • free gingival graft [from palate]
  • minimise other risk factors [eg improve OH, treat traumatic occlusion]
  • atraumatic toothbrushing advice
34
Q

How can bony defects be classified?

A

Horizontal bone loss

Vertical bone loss
- 1 wall
- 2 wall
- 3 wall (heal better)

35
Q

A patient is deemed to be suitable for regenerative periodontal surgery. What are the indications of this?

A
  • 2 & 3 walled defects
  • grade 2 furcation in mandibular teeth
  • grade 2 buccal furcation in maxillary molars

*pt OH and motivation is good

36
Q

If regenerative periodontal surgery of a molar tooth fails, how else can this tooth be managed?

A
  • XLA
  • hemisection
  • tunneling procedure
  • monitor & leave
37
Q

Why is diabetes a risk factor for development of periodontal disease?

A
  • altered host response to infection [impaired immune response]
  • chronic hyperglycaemia can cause dysfunction of immune cells [neutrophils and macrophages] & impair their ability to fight off bacterial pathogens
  • diabetes affects the blood vessels and causes microvascular changes
  • impaired wound healing [polymorphonuclear leukocyte function]
  • chronic hyperglycaemia leads to glycation of proteins [ECM components of perio tissues] and leads to formation of AGEs which exacerbate perio disease and tissue destruction
38
Q

Explain the mechanism of development of a vertical bone defect vs horizontal:

A
  • plaque deposition and radius determines this
  • if there is larger deposits of bone adjacent to site of bone loss [eg >2mm interproximal bone] then the defect pattern is vertical
39
Q

Give 2 ways to test for diabetes:

A
  • Fasting Plasma Glucose
  • Random Plasma Glucose
40
Q

Give the normal values and diabetic values for a random plasma glucose test:

A

Normal = <11.1mmol/L

Diabetic = >11.1mmol/L

41
Q

Give the normal values and diabetic values for a fasting plasma glucose test:

A

Normal = <7mmol/L

Diabetic = >7mmol/L

42
Q

How does smoking affect the periodontal tissues?

A
  • restricted blood flow [reduction in delivery of oxygen + nutrients]
  • impaired chemotaxis [ability of immune cells to detect & migrate towards chemical signals released by pathogens/injured tissues]
  • impaired phagocytosis
  • upregulation of proinflammatory cytokines, chemokines and MMPs
43
Q

What is interleukin-1?

A

A pro-inflammatory cytokine
- stimulates release of enzymes
- stimulates RANKL to bind to RANK and induces osteoclast formation & recruitment

44
Q

Give some reasons as to why non-surgical management of periodontal disease may be unsuccessful?

A
  • inadequate PMPR
  • furcation/angular defects that are difficult to access
  • patient poor OH
  • patient immunocompromised
  • patient is a smoker
  • motile anaerobes penetrate deep into periodontal tissues
45
Q

A patient attends with inflammation of the gingiva extending beyond the mucogingival junction. Give a clinical description:

A

Desquamative gingivitis

46
Q

Name 3 oral conditions associated with desquamative gingivitis:

A
  • lichen planus
  • pemphigoid
  • pemphigus
47
Q

What are 2 local factors that may exacerbate desquamative gingivitis:

A
  • sodium lauryl sulphate (SLS)
  • plaque
48
Q

Give 2 topical treatments for desquamative gingivitis:

A
  • betamethasone tablets 1mg dissolved in 10ml of water
  • beclomethasone inhaler 1mg puff 2/4x daily
  • tacrolimus in gingival retainer
49
Q

What is TIPPS?

A

OHI:
- talk
- instruct
- practise
- plan
- support

50
Q

How is mobility graded?

A

Grade 1 = <1mm horizontal movement
Grade 2 = 1-2mm horizontal movement
Grade 3 = >2mm horizontal movement and/or depression/rotation

51
Q

What is PSD?

A

Patient Specific Direction
- Written instruction for a specific pt allowing a healthcare professional to administer medication like LA

52
Q

When prescribing local anaesthetic, what four details should be included in PSD?

A
  • Method and site of administration
  • Specific type of LA & Dosage
  • Concentration of LA
  • Maximum number of cartridges

BDS4 PERIODONTOLOGY (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions