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247 Periodontics > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

What is the purpose of a periodontal classification system?

A

-Communicates clinical findings accurately to other HCPs
-Helps in formulating a diagnosis and treatment plan
-Helps in predicting treatment outcomes (prognosis)
-Helps in submitting info to insurance

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2
Q

What are the 4 case types?

A

Case 1: Gingivitis
Case 2: Early periodontitis
Case 3: Moderate periodontitis
Case 4: Advanced Periodontitis

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3
Q

Why were “chronic” and “Aggressive” removed from the 1999 classification?

A

There is little evidence that they have distinct pathophysiology.

The same things cause them, they just happen at different rates

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4
Q

Why were staging and grading added to the classification system?

A

For individualizing diagnoses and treatment planning and to address progression (grading)

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5
Q

What are the main categories for classification of periodontal disease and conditions as of 2017?

A
  1. Gingival disease- plaque and non-plaque induced
  2. Periodontitis as a manifestation of systemic disease (relationship btw systemic health and disease)
  3. Necrotizing periodontitis (connected with aggressive)
  4. Abscesses of the periodontium (perio or endo origin)
  5. Periodontitis associated with endodontic lesions
  6. Peri-implant diseases and conditions
  7. Staging and grading
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6
Q

What is peri-implant mucositis?

A

Inflammation of the soft tissue around implants

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7
Q

What is peri-implantitis?

A

Bone loss around an implant

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8
Q

Types of dental biofilm-induced gingivitis

A

-Associated with dental biofilm only
-Mediated by systemic or local risk factors
-Drug-influenced gingival enlargement

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9
Q

Types of nondental biofilm-induced gingivitis

A

-Genetic/developmental disorders
-Specific infections
-Inflammatory and immune conditions
-Reactive processes
-Neoplasms
-Endocrine, nutritional and metabolic diseases
-Traumatic lesions
-Gingival pigmentation

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10
Q

3 Types of necrotizing periodontal diseases

A

Necrotizing gingivitis
Necrotizing periodontitis
Necrotizing stomatitis

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11
Q

What are the periodontitis stages based on?

A

Severity (CAL, radiographic bone loss)
and
Complexity of management (PD, furcations, bone loss pattern, # of remaining teeth, mobility, masticatory dysfunction)

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12
Q

How are types of periodontitis identified?

A

By stages, grades and extent and sitribution

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13
Q

How is extent (how many?) and distribution (where?) of periodontits identified?

A

Localized (<30% of teeth), generalized (>30% of teeth), molar-incisor distribution

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14
Q

What does case phenotype mean?

A

Can affect how a patient responds to treatment

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15
Q

What does grading of periodontitis tell us?

A

Evidence of risk progression: direct evidence of radiographs in bone loss/age
Anticipated treatment response: case phenotype, smoking, hyperglycemia

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16
Q

5 Condition categories affecting the periodontium

A

1- Systemic diseases or conditions
2- Other periodontal conditions
3- Mucogingival deformities and conditions around teeth
4- Traumatic occlusal forces
5- Prostheses and tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontits

17
Q

Other periodontal conditions

A

Periodontal abscess
Endodontic-periodontal lesions

18
Q

Mucogingival deformities and conditions around teeth

A

1- Gingival phenotype- physical characteristics
2- Ginigval/soft tissue recession
3- Lack of gingiva
4- Decreased vestibular depth- lost teeth or AB loss can create very shallow vestibule
5- Aberrant frenum/muscle position
6- Gingival excess
7- Abnormal color- Amalgam tattoo or near endo-treated teeth
8- Condition of exposed root surface- is it notched out? does it have decay?

19
Q

Traumatic occlusal forces

A

1- Primary occlusal trauma- clenching, grinding, occlusal forces
2- Secondary occlusal trauma- Normal chewing forces causing trauma to teeth
3- Orthodontic forces- Controlled traumatic occlusal force

20
Q

Prostheses and tooth-related factors

A

1- Localized tooth-related factors- crown margins, overhangs etc.
2- Localized dental prostheses-related factors- sores

21
Q

Peri-implant diseases and conditions

A

1- Peri-implant health
2- Peri-implant mucositis
3- Peri-implantitis
4- Peri-implant soft and hard tissue deficiencies

22
Q

Describe stage I perio

A

1-2mm CAL
Bone loss in coronal 3rd
No tooth loss due to periodontitis
PD less than 4mm
Mostly horizontal BL

23
Q

Describe stage II perio

A

3-4mm CAL
Bone loss in coronal 3rd (15-30%)
No tooth loss due to periodontitis
PD 5mm or less
Mostly horizontal BL

24
Q

Describe stage III perio

A

5mm or more CAL
Bone loss extends to middle 3rd of root or beyond
4 or less teeth lost due to perio
PD 6mm or more
Vertical BL 3mm or more

25
Q

Describe stage IV perio

A

5mm or more CAL
BL extends to middle 3rd of root and beyond
5 or more teeth lost due to perio
PD 6mm or more
Vertical BL 3mm or greater

26
Q

Describe grade A perio

A

No additional bone or attachment loss over last 5 years
Low levels of tissue destruction
Non-smoker
No diabetes

27
Q

Describe grade B perio

A

Evidence of less than 2mm additional bone/attachment loss over 5 years
Tissue destruction in line with expectations
Smokes less than 10 cigs a day
HbA1c less than 7% in diabetic pts

28
Q

Describe grade C perio

A

2mm or more bone/attachment loss over 5 years
Tissue destruction exceeds expectation
Smokes 10+ cigs a day
HbA1c greater than 7% in diabetic pts

29
Q

Descriptions of perio stages

A

Stage I: Initial
Stage II: Moderate
Stage III: Severe w/ potential for tooth loss
Stage IV: Advanced with extensive tooth loss and potential for loss of dentition

30
Q

Description of perio grades

A

Grade A: Slow rate of anticipated progression
Grade B: Moderate rate
Grade C: Rapid rate

31
Q

Description of “localized” perio

A

30% or less of teeth are involved

32
Q

Description of “generalized” perio

A

More than 30% of teeth are involved

33
Q

Description of “molar/incisor pattern” in perio

A

Only molars and incisors exhibit perio breakdown

247 Periodontics (19 decks)

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