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DH100 PreClinic > Ch. 20 Periodontal Examination > Flashcards

Ch. 20 Periodontal Examination Flashcards

1
Q

Periodontal examination is a component of what?

A

Care plan. Necessary for the treatment plan of the pt

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2
Q

Basic exam instruments

A

Mouth mirror
Periodontal probe
Furcation probe
Sub gingival explorer (ODU EXD 11/12)

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3
Q

Mouth mirror Purposes and uses

A
  1. Indirect vision
    Distal surfaces of posterior teeth, lingual surfaces of anterior
  2. Indirect illumination
    Relict light to any area in oral cavity
  3. Trans illumination
    Direct light through teeth
  4. Retraction
    Protect or prevent interference by cheeks tongue lips
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4
Q

Do not use shank to retract!

A
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5
Q

Is subgingival calculus darker than supragingival calculus?

A

Yes

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6
Q

Precautions for air water syringe

A

Give pt a warning with the air

Avoid sharp blast of air on cervical areas of teeth or open carious lesions

Sensitive to pts

Dry by blotting with gauze or cotton roll

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7
Q

Explorer

A

Slender, wire like metal tip that is circular in cross section and tapers to a fine sharp point

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8
Q

Explorer-general purposes and uses

A

Detect irregularities by tactile sense
-calculus, defects in restorations, etc

Define extent of instrumentation needed
-How much calculus, what instrument to use

Evaluate completeness of treatment

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9
Q

Sublingual explorers
Specifics explorer #
What it can be used for

A

ODU 11/12

facilitated by angled shank with a short tip

Adapted to all surfaces of tooth but useful for proximal surface exam

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10
Q

Supragingival Explorer

A

Examines pits and fissures bc it’s not as sharp

Shepherd hook explorer
Surfaces and margins of restorations and sealants

Pigtail or cow horn
Proximal surfaces for calculus, margins of restorations, dental caries

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11
Q

Types of stimuli

A

Tactile
-Vibrations from instrument

Auditory
-sound may be created when in contact with irregular tooth structure
-cementum and calculus have distinctive click
Metallic restorations “Squeak” or “ring”

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12
Q

Purposes and Uses of a Probe

A
  1. Measure probing depth
  2. Location of gingival margin in relation to CEJ (CAL)
  3. Location of mucogingival junction
  4. Other gingival determinations (bleeding)
  5. Guide treatment- Assessment data (basis of tx plan)
  6. Evaluate Treatment outcomes
  7. Evaluation at continuing care and perio maintenance appointments
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13
Q

Marquis Probe

A

Color coded in 3mm increments

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14
Q

UNC 12

A

Color coded in 5, 10, 12
Used in clinic

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15
Q

Sulcus

A

Healthy (normal space between tooth and gingiva)

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16
Q

Pocket

A

Diseased, unhealthy gingival sulcus

Measured from base to Gingival Margin

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17
Q

Where do gingival and periodontal infections begin most frequently?

A

COL area

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18
Q

Factors Affecting probe accuracy

A
  1. Stage and extent of perio disease
    -severe inflammation, may overestimate attachment loss
  2. Perio probe
  3. Placement problems
    -anatomic: tooth contours, furcation, crowding
    -Inferences: calculus, restorations
    -access and visible: blood, biofilm, opening by pt
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19
Q

COL

A

Depression under contact area between facial and lingual papilla

Conforms to proximal contact area

where infection begins-usually deepest area on probe

20
Q

Stages of extent of perio disease?
Normal
Gingivitis
Advanced

A

Normal-
Base of pocket goes to base of junctional epithelium

Gingivitis-
Probe goes into junctional epithelium

Advanced-
Probe passes fully through junctional epithelium

21
Q

Preliminary assessment prior to perio exam

A
  1. Medical history
  2. Dental and psychosocial history
  3. Vital signs
  4. Eo/Io exam
  5. Risk assessment
  6. X-rays
  7. Dental exam (missing teeth, Carie’s, restorations, occlusion)
  8. Hard and Soft deposits noted
    -Supra and subgingival calculus
22
Q

Mouth deposits

A

Hard- calculus (can’t remove with toothbrush only metal instruments)
Supra, subgingival

Soft-biofilm, plaque

23
Q

Where is supragingival calculus usually located?

A

Maxillary molars, buccal
Mandibular anterior incisors, lingual

24
Q

Perio probe procedure

A

1-2mm
Up and down motion
Slow and controlled
Probe parallel with long axis of tooth
6 readings per tooth (3facial, 3lingual)
“Walking stroke”

25
Q

CAL
Refers to attached tissue at base of
Measure from

A

Clinical attachment level (how many mm to get gums back to good health)

Refers to position of perio attached tissues at base of sulcus or pocket

Measured from fixed point (CEJ)

26
Q

CAL recession

A

CEJ visible, add
PD+GM=cal

27
Q

CAL inflammation

A

CEJ covered, subtract
PD-GM=cal

28
Q

MGI

A

Muccogingival involvement
Not everyone has

Measure to detect adequacy of width of attached gingiva
-measure External surface measure From MGJ to GM
-Measure PD

Subtract PD from total width

29
Q

Determination of mobility

A

2 single ended metal instruments with wide blunt ends, held in modified pen grasp
Apply specific firm finger rests
Also test vertical mobility (into socket) w/ one of mirror handles on occlusal/Incisal edge
Tooth to tooth systematically

30
Q

Record degree of movement (1-3)

A

N. Normal, physiologic

Class 1. Slight mobility, greater than normal

Class 2. Mod mobility greater than 1mm displaced

Class 3. Severe mobility, moves vertically and is depressible in the tooth socket

31
Q

Fremitus
Determined on which teeth?

A

Palpable vibration or movement
Vibratory patterns of teeth

Only determined on maxillary teeth

32
Q

Fremitus measurement
1,2,3?

A

Finger on cervical third as pt bites down continually

N normal
+: one degree, only slight vibration
++: two degree, tooth is clearly palpable but movement is barley visible
+++: movement is clearly observed visually

33
Q

When measuring MGJ, horizontally hold probe and _____ mucosa toward gingival margin.
Maxillary ____&_____
Mandibular______&_____

A

Wrinkle
Facial and buccal
Buccal and lingual

34
Q

Blanching or wrinkling at gingival margin indicates __ attached gingiva

A

No

35
Q

Bifurcation
Which teeth?
What surfaces can be tested for furcation involvement?

A

Mandibular molars
-facial and lingual

Maxillary first premolars
- medial and distal aspects under contact area

36
Q

Trifurcation

A

Teeth with 3 roots

Maxillary molars-palatal and 2 buccal roots

Access at Straight lingual, mesiobuccal and distobuccal roots

37
Q

Furcation involvement classes 1-4

Classified by amount of ___ destroyed in the area

A

Bone destroyed

1-early, feel furcation, bone in tact

2-Enter in furcation but can’t go all the way through to other side
-bone destroyed
-gum still covering
-probe barely enters

3-enter in furcation and goes through to other side
*gum still covering

4-enters all the way through and you can see

38
Q

Normal bone level on radiograph

A

Crest of inderdental bone appears 1-1.5 mm from CEJ
Horizontal from CEJ of one tooth to another

39
Q

Horizontal bone loss
What is the factor?

A

When the crest of the bone is parallel with a line between the CEJs of 2 adjacent teeth

Usually when inflammation is sole factor

40
Q

Generalized vs localized bone loss

A

> 30% = generalized

<30% = localized

41
Q

Vertical (angular) bone loss
Commonly ____?
What contributes to destruction? (2)

A

Reduction in height of Crestal bone that is irregular

Bone level is not parallel with a line joining adjacent cejs

*Angular is more commonly localized
-inflammation and trauma combined in destruction and irregular shape of bone

42
Q

Crestal lamina dura
Normal radiograph
Evidence of disease

A

Compact bone that lies parallel to periodontal ligament

Normal-white, radiopaque

Disease-radiolucent, black, fuzzy

43
Q

Furcation involvement on X-ray
Normal and diseased-color, size?

A

Normal-white opaque, bone fills the area between the roots

Disease-Appear as small radiolucent area or as a slight thickening of the periodontal ligament space

44
Q

Periodontal ligament

A

Connective tissue

Appears as fine black radiolucent line next to the root surface

Widens with disease- around entire side of root to apex or around root

*Outer side is lamina dura=bone that lines tooth socket and appears radiopaque

45
Q

Subgingival explorer facilitated by

A

Angulated shank w/short tip

46
Q

Shepherd hook used for

A

Supragingival smooth surfaces
&
Examines pits and fissures

47
Q

Pigtail or cow horn

A

Supragingival

Proximal surfaces for calculus, dental caries and margins of restorations

DH100 PreClinic (31 decks)

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