Chronic Periodontitis

Question 1

True or False: Chronic periodontitis should always be obvious upon inspecting the mouth due to inflammation and bleeding.

Answer 1

False, it’s not always obvious just by looking!

Question 2

What are five clinical features of Chronic Periodontitis?

Answer 2

1. Changes in gingival morphology
2. BoP
3. Increased probing depths
4. Attachment Loss
5. Gingival Recession apical to the CEJ

Question 3

True or False: Probe depths are similar to attachment loss.

Answer 3

False: they are not interchangeable!

Question 4

Alveolar bone loss associated with chronic periodontitis is either ______ or ______.

Answer 4

Vertical or horizontal

Question 5

_____ involvement is variable due to root morphology differences.

Answer 5

Furcation

Question 6

True or False: Decreased tooth mobility, ankylosed teeth, and tooth loss are all associated with chronic periodontitis.

Answer 6

False: INCREASED tooth mobility, drifting teeth, and tooth loss are associated

Question 7

Tissue destruction in chronic periodontitis corresponds with oral hygiene, _____ levels, and ______ factors

Answer 7

plaque levels

oral or systemic

Question 8

True or False: Subgingival calculus is invariably present at disease sites.

Answer 8

True

Question 9

True or False: Individual species vary among individuals and specific subgingival species are not implicated in disease.

Answer 9

False. There is individual variation but specific species ARE implicated

Question 10

Rate of progression is ____ to moderate and rapid bursts of destruction _____ occur.

Answer 10

Slow progression

rapid bursts CAN occur

Question 11

In chronic periodontitis, what determines pathogenesis and progression?

Answer 11

host factors

Question 12

Which sites on the periodontium are more likely to sustain further breakdown?

Answer 12

untreated diseased sites

Question 13

True or False: The best predictor for future attachment or bone loss is past attachment or bone loss.

Answer 13

True

Question 14

Once there are clinical signs of attachment loss, how long until bone loss occurs?

Answer 14

six months

Question 15

Why is early diagnosis of chronic periodontitis so difficult?

Answer 15

because it is mostly painless

Question 16

What kind of pain symptoms are generally associated with chronic periodontitis?

Answer 16

• Localized dull pain

- Gingival tenderness, ‘itching’ gums

Question 17

The “extent” of chronic periodontitis is classified as either _____ or _______.

Answer 17

localized

generalized

Question 18

How is localized differentiated from generalized chronic periodontitis?

Answer 18

localized is LESS THAN OR EQUAL to 30% of sites

generalized is GREATER than 30% of sites

Question 19

How is “severity” of chronic periodontitis determined?

Answer 19

By the amount of attachment loss:
1-2 mm = slight
3-4 mm = moderate
5 or more mm = severe

Question 20

Is “generalized slight with localized moderate chronic periodontitis” a possible diagnosis?

Answer 20

yes

Question 21

Is “generalized gingivitis with localized severe chronic periodontitis” a possible diagnosis?

Answer 21

No, once attachment loss occurs….gingivitis goes out the window

Question 22

True or False: Smoking has a greater impact on formation of periodontal pockets in the young.

Answer 22

True
ages 21-40: non-smokers = 10 –> smokers = 30
ages 41-60: non-smokers = 30–> smokers = 40

Question 23

Risk determinants are ______ factors.

Answer 23

non-modifiable

Question 24

Risk ______ have been identified in cross-sectional studies but have not been confirmed longitudinally.

Answer 24

indicators

“IN the name of the cross” –>indicators = cross sectional

Question 25

HIV/AIDS, osteoporosis, and infrequent dental visits are all risk ______.

Answer 25

indicators

Question 26

Risk ______ are associated with elevated risk but may not be part of the CAUSE.

Answer 26

markers/predictors | ex: furcation involvement, previous perio, calculus

Question 27

True or False: All gingivitis will eventually lead to periodontitis.

Answer 27

False

Question 28

True or False: Gingivitis can be stable for years.

Answer 28

True

Question 29

Bacterial _____ induces gingivitis, but _______ determines if chronic periodontitis will develop.

Answer 29

plaque | host response

Question 30

True or False: Absence of gingivitis is not a good indicator of future periodontal health.

Answer 30

False, its a good indicator of future health

Question 31

_____% of the US population has periodontitis ~65 million people.

Answer 31

>47 %

Question 32

How is chronic periodontitis associated with gender?

Answer 32

it is HIGHER in men

Question 33

_____% of adults above 65 years old have moderate or severe periodontitis.

Answer 33

64%

Question 34

True or False: Severe periodontal disease is the 2nd most prevalent disease in the world.

Answer 34

False. It is the SIXTH most prevalent in the world

Question 35

What are the three models of periodontitis progression?

Answer 35

1. Continuous Model 2. Random Burst Model 3. Asynchronous Multiple Burst Model

Question 36

Which model of progression shows a "slow and constant rate?"

Answer 36

Continuous Model

Question 37

Which model of progression is not specific in its time or site of destruction?

Answer 37

Random Burst Model

Question 38

Which model of progression is more highly associated with Aggressive Perio?

Answer 38

Asynchronous Multiple Burst Model (destruction during specific time frames of life)

Question 39

Clinical Attachment Loss = _____ + ______

Answer 39

probing depth + gingival recession

Question 40

How is BoP expressed?

Answer 40

as % of total sites AVAILABLE

Question 41

What is fremitis?

Answer 41

mobility of tooth upon occlusion

Question 42

What are the four deconfiguration patterns of bony defects?

Answer 42

1 wall, 2 wall, 3 wall, or circumferential | (pattern is critical to treatment)

Question 43

True or False: Treatment of chronic periodontitis is effective and limits tooth loss to 0.6mm teeth/year.

Answer 43

False

Question 44

True or False: Untreated patients lost approximately 0.6 teeth/year.

Answer 44

True

Question 45

Non-compliant patients had _____ the rate of tooth loss per year.

Answer 45

double (0.2 instead of 0.1 in the compliant group)

Question 46

Why do periodontal sites with initially shallow pockets tend to lose CAL?

Answer 46

possible trauma... DO NOT DIG! especially if its of "critical probe depth..2.9mm"

Question 47

Which sites are most susceptible to trauma from digging out pockets?

Answer 47

buccal sites with thin tissue type

Question 48

______ = probe depths less than 2.9mm = root planing at this depth will cause attachment loss

Answer 48

Critical Probe Depth

Question 49

True or False: Although periodontal disease is not reversible, you can increase the appearance, decrease inflammation, and decrease redness.

Answer 49

True

Question 50

You should not maintain (ScRP treatment) _____ mm pockets; surgical therapy is recommended in this circumstance.

Answer 50

6