Chronic Periodontitis Flashcards
a bacterial infection affects what parts of the periodontium
- gingiva
- cementum
- PDL
- alveolar bone
what is the host-bacterial interaction theory
bacteria + host response = disease
what bacteria are in the red complex?
PG, TF, and TD
what type of perio is most common?
chronic
how fast does chronic progress?
progresses at a slow to moderate rate with short periods of rapid disease progression
in chronic perio, tissue destruction is consistent with what?
presence of local etiologic factors
what does refactory mean?
disease always progresses no matter what we do
what kind of deposits are present in chronic perio
bacterial plaque and subgingival calculus deposits
what was chronic perio previously known as?
adult periodontitis
what are some warning signs of chronic perio?
red swollen gingiva, bleeding during brushing, bad taste in mouth, persistent bad breath, sensitive or loose teeth, and pus around teeth
is pain a symptom? what does this lead to?
no which leads to patients not seeking treatment early in the disease or not following through with treatment after the disease is diagnosed
T/F: clinical appearance is a reliable indicator of the disease
False it is not
what types of changes might we see in chronic perio?
may exhibit pronounced changes in appearance or may exhibit minimal changes in appearance
what kind of adjunct would you use for a patient who has had gingival recession?
proxa brush, end tuft, pipe cleaner, acrylic yarn, and sulcus brush
what causes teeth flaring in the anteriors?
- tongue thrusting
2. bone loss
T/F: bleeding does not mean bone loss
True
what does pus represent?
dead white blood cells and can occur in any infection
define etiology
bacteria alone are not sufficient for progression to chronic periodontitis
what is the onset and severity of perio determined by?
interaction between the host immune response and bacteria
what is extent?
amount of destruction characterized by number of sites that have experienced destruction
what is severity?
seriousness of the disease determined by rate of disease progression over time and response of tissues to treatment
what are characteristics of slight to moderate tissue destruction?
- loss of 1/3 of perio structures
- probe depths 4-6 mm
- CAL up to 4 mm
- Class 1 or 2 furcation
what are characteristics of advanced tissue destruction
- loss of more than 1/3 of perio structures
- probe depths 7 mm or more
- CAL of 5 mm or more
- Class 3 furcation
what is progression?
change or advancement of periodontal destruction
characteristics of localized chronic perio progression
less than 30% of sites in mouth have attachment and bone loss ( or 2 sextants)
characteristics of generalized chronic perio progression
more than 30% of sites in mouth have attachment and bone loss (more than 2 sextants)
the rate of disease progression in chronic periodontitis appears to be _____
slow to moderate
what are treatment considerations for initial therapy
- consult with physican if systemic risk factors are present
- evaluation of plaque control skills
- smoking cessation
- whole mouth debridement
- individualized oral hygiene instructions
what are treatment considerations for re-evaluation?
- re-examine inital therapy’s outcome after allowing time for tissue repair
what are treatment goals? also known as?
also known as long-term goals
- arrest disease progression
- eliminate risk factors
- prevent re-occurrence
- control plaque level
what are desired outcomes?
- decrease SBI
- decrease PCR
- decrease probe depths
- maintain patient comfort
- prevent further attachment loss
what does long term outcome depend on?
depends on patient compliance with self-care and recall appointments at appropriate intervals
do all site respond equally to therapy?
no
what is recurrent perio?
-NEW signs of destructive perio that reappear after therapy
why does recurrent perio occur?
- disease was not adequately treated
2. patient did not practice adequate self-care
what is refractory disease?
determined over time that there is continuing attachment loss at one or more sites
when can refractory disease be applied?
it can be applied to all types of periodontal diseases that do not respond to treatment
