Chapter 20 Perio Assessment and Charting Flashcards
What are the 4 units to a healthy periodontium?
Gingiva
PDL
Alveolar process
Cementum
What is gingiva?
The masticatory oral mucosa that surrounds the cervical portion of the teeth
What are the 4 anatomic areas of the gingiva?
Free or unattached gingiva
gingival sulcus
attached gingiva
interdental gingiva/papilla
What is the free gingiva?
Gingival tissue closest to the crown, does not directly attach to alveolar bone
What is located 0.5 to 2mm coronal to the CEJ and fits tightly around each tooth?
Free gingiva
What is the gingival sulcus?
The space between the free gingiva and the tooth
A healthy gingival sulcus usually measures what from the GM to the base of the sulcus?
0.5 to 3mm
What is attached gingiva?
Free gingiva connects with the alveolar gingiva at the gingival groove, the attached gingiva is continuous with the free gingiva
What shallow groove is clinically visible in less than one-half of the population?
Gingival groove
Attached gingiva covers what?
The crestal portion of the alveolar bone on the facial and lingual surfaces and roof of the mouth
Where is the gingival papilla located?
The interdental space between two adjacent teeth
Alveolar mucosa
Movable tissue loosely attached to underlying alveolar bone. Compromised of nonkeratinized epithelium
Junctional Epithelium JE
A cufflike band of squamous epithelium that completely encircles and is attached to the tooth. Base of the sulcus is formed by JE
Gingival crevicular fluid GCF
A serumlike fluid secreted from underlying connective tissue into the sulcular space, little or no fluid is found in a healthy gingival sulcus. But can flow 1 day after no oral biofilm control
Cementum
mineralized bonelike substance that covers the roots of teeth and serves as attachment point for PDL fibers
Periodontal ligament PDL
Fibrous connective tissue that surrounds and attaches the tooth roots to the alveolar bone
Alveolar bone
Compromised of compact or cortical bone and of spongy bone marked by trabecular spaces, compact bone is outside wall, spongy bone is interior
Alveolar crest
Alveolar bone located between the teeth
Periodontal endoscope
Illuminated fiberoptic instrument that provides high magnification views of the gingival sulcus or perio pocket
Dental biofilm-induced gingivitis
Is inflammation of the gingival tissue and a reversible bacterial infection confined to the gingival tissue
What occurs in gingivitis?
Free gingiva shows signs of inflammation, but no apical migration of the JE has occurred beyond the CEJ, no evident bone loss
What are the three clinical features of necrotizing periodontal diseases?
papillary necrosis
bleeding
pain
Gingival recession
Apical migration of the margin of the gingiva causing root exposure
Traumatic Occlusal Force
Any occlusal force that damages the teeth or periodontal attachment tissues
Occlusal trauma
Injury to the periodontium
Supracrestal attached tissues
Formerly biologic width, are the JE and connective tissues that attach the gingiva to the alveolar bone above the crest of the bone
Periodontal abscess
Localized periodontal infections that result in inflammation and can ultimately lead to the formation of purulent exudate
Purulent exudate
Containing pus
What are osseointegrated dental implants monitored for?
peri-implant health, peri-implant mucositis, peri-implantitis, or peri-implant soft and hard tissue deficiencies
Peri-implant health
The absence of redness (erythema), swelling (edema), bleeding, and suppuration of tissues surrounding the implant.
Peri-implant mucositis
Inflamed gingival tissue surrounding a dental implant and is characterized by redness, bleeding, swelling, and/or suppuration, slightly deeper PD is possible due to tissue enlargement from inflammation rather than bone loss
Peri-implantitis
A dental biofilm-induced disease that can also be caused by placement or surgical trauma. Characterized by same inflammatory signs as peri-implant mucositis, and also has progressing alveolar bone loss
Peri-implant soft and hard tissue deficiencies
Reduced dimensions of the alveolar bone or ridge that occur during the healing process after tooth loss
Psuedopocket
Artificially deepened sulcus caused by the marginal gingiva moving coronally not apically from inflammation
Probing depth
Distance from gingival margin to the base of sulcus/pocket
Periodontal pocket
Pathologically deepened sulcus
Suprabony periodontal pocket
occurs when JE has migrated below CEJ but remains above crest of alveolar bone, commonly associated with horizontal bone loss
Intrabony periodontal pocket
occurs when JE migrates below the crest of the alveolar bone, commonly associated with vertical bone loss
Clinical Attachment Loss CAL
The position of the attached periodontal tissues at the base of the pocket, determined by comparing GM distance from CEJ with distance from base or pocket
Furcation involvement
Loss of interradicular bone and PDL attachment of multirooted teeth
Tooth mobility
Degree to which a tooth can move horizontally or apically, 3 grades
Fremitus
Vibration or movement of teeth when in contacting positions from the patient’s own occlusal forces
PSRs
Periodontal Screening and Recording, codes 0-4
