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BDS3 Periodontology > Classification of Periodontal Diseases (2) > Flashcards

Classification of Periodontal Diseases (2) Flashcards

1
Q

Can you have periodontal health on a reduced periodontium?

A
  • Yes
  • Can have recession but due to a cause other than periodontitis e.g. crown lengthening surgery or wisdom tooth extraction that leaves a defect on the distal of the 7
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2
Q

If a patient has a reduced periodontium due to periodontitis will they always be a periodontitis patient?

A
  • Yes
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3
Q

What are the new definitions of periodontal health? (3)

A
  • Patients with an intact periodontium
  • Patients with a reduced periodontium due to causes other than periodontitis and
  • Patients with a reduced periodontium due to periodontitis
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4
Q

What is the definition/requirements for gingival health?

A
  • Clinical gingival health in an intact periodontium is characterised by the absence of bleeding on probing, erythema and edema, patient symptoms and attachment and bone loss
  • Physiological bone levels range from 1.0-3.0mm apical to the cemento-enamel junction
  • For an intact periodontium and a reduced and stable periodontium, gingival health is defined as <10% bleeding sites and no pocket depths exceeding 3mm
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5
Q

What 2 types of periodontium can be included as ‘plaque-induced gingivitis’ (localised/generalised)?

A
  • Intact periodontium

- Reduced periodontium

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6
Q

What can cause plaque-induced gingivitis? (3)

A
  • Associated with dental biofilm alone
  • Mediated by systemic or local risk factors
  • Drug influenced gingival enlargement
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7
Q

When is bleeding on probing localised?

A

When there are less than 30% of sites affected

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8
Q

When is bleeding on probing generalised?

A

When there are more than 30% of sites affected

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9
Q

Is gingivitis stable if there is bleeding on probing?

A
  • No
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10
Q

What do the probing pocket depths need to be if periodontitis is stable?

A
  • Need to be 4mm or less
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11
Q

What are modifying factors for plaque-induced gingivitis?

A
  1. Systemic conditions
    a) Sex steroid hormones
    1) Puberty
    2) Menstrual cycle
    3) Pregnancy
    4) Oral contraceptives

b) Hyperglycaemia
c) Leukaemia
d) Smoking
e) Malnutrition

  1. Oral factors enhancing plaque accumulation
    a) Prominent subgingival restoration margins
    b) Hyposalivation
  2. Drug-influenced gingival enlargements
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12
Q

Will hormonal changes itself cause gingivitis?

A
  • No

- The plaque causes the gingivitis and change in hormones may exaggerate the response

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13
Q

What is a pregnancy epulis considered as?

A
  • Considered a mucogingival deformity
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14
Q

Are Pregnancy epulis’s common?

A
  • Yes

- They are made worse by the presence of plaque

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15
Q

Drug influenced gingival enlargement is relatively common. What are 2 types of drug that can cause this?

A
  • Calcium channel blockers

- Immunosuppressants

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16
Q

What are possible causes of non-dental biofilm induced gingival diseases? (8)

A
  • Genetic/developmental disorders
  • Specific infections
  • Inflammatory and immune conditions
  • Reactive processes
  • Neoplasms
  • Endocrine, nutritional & metabolic diseases
  • Traumatic lesions
  • Gingival pigmentation
17
Q

What is an example of an inflammatory/immune condition that can cause non-plaque induced gingival diseases?

A
  • Lichen planus
18
Q

What nutritional deficiency can cause plaque indices gingival diseases?

A
  • Vitamin C deficiency
19
Q

What is usually present in a patient with necrotising gingivitis? (7)

A
  • Necrosis and ulcer in the interdental papilla
  • Gingival bleeding
  • Pain
  • Pseudo membrane formation
  • Halitosis
  • Extra oral - regional lymphadenopathy/ fever
  • In children, pain and halitosis less frequent, whereas fever, lymphadenopathy and sialorrhea were more frequent
20
Q

What is halitosis?

A
  • Offensive smelling breath
21
Q

What is usually present in a patient with necrotising periodontitis? (4)

A
  • In addition to S&S of necrotising gingivitis:
  • Periodontal attachment and bone destruction (this can happen rapidly)
  • Frequent extraoral signs
  • In severely immune-compromised patients, bone sequestrum may occur
22
Q

What is usually present in patients with necrotising stomatitis? (2)

A
  • Bone destruction extended through the alveolar mucosa

- Larger areas of osteitis and bone sequestrum

23
Q

What are characteristics of necrotising gingivitis? (6)

A
  • Quite distinctive
  • Sluffing of the gingival margin
  • White/grey fibrin coating
  • Looks very sore
  • Ulceration
  • Papilla have lost their normal architecture
24
Q

What are characteristics of necrotising periodontitis? (3)

A
  • Get negative architecture
  • Crater like defect
  • Very localised and very dramatic loss of bone and tissue
25
Q

Give examples of rare diseases that affect the course of periodontitis resulting in the early presentation of severe periodontitis? (5)

A
  • Papillon Lefevre syndrome
  • Leukocyte adhesion deficiency
  • Hypophosphatasia
  • Down’s syndrome
  • Ehlers-Danlos
26
Q

There are rare conditions that affect the periodontal supporting tissues independently of dental plaque biofilm-induced inflammation. Give 2 examples of these?

A
  • This is a more heterogenous group of conditions which result in breakdown of periodontal tissues and some of which may mimic the clinical presentation of periodontitis.
  • Squamous cell carcinoma
  • Langerhans cell histiocytosis
27
Q

Are periodontal abscesses common?

A
  • Yes
28
Q

How do periodontal abscesses often present?

A

Present often with pus draining through a pocket or sinus

29
Q

When might we see periodontal abscesses? (3)

A
  • People with periodontitis who don’t get periodontal treatment will get abscesses
  • People who do get periodontal treatment might get some but much less
  • Sometimes see periodontal abscesses in people who don’t have periodontitis - this could be because something is stuck there or could be the dentists fault e.g. leaving a bit of dam or floss to get stuck there
30
Q

What is a periodontal endodontic lesion?

A
  • Essentially a non-vital tooth with abscess
  • Need to find out if there is root damage or not
  • If there is then need to work out what is wrong
  • If no root damage then need to find out if it is a periodontal patient or not
31
Q

What is the most common mucogingival deformity/condition?

A
  • Gingival recession
32
Q

What is type 1 gingival recession?

A

Gingival recession with no loss of inter-proximal attachment. Interproximal CEJ is clinically not detectable at both mesial and distal aspects of the tooth

33
Q

What is type 2 gingival recession?

A

Gingival recession associated with loss of interproximal attachment. The amount of interproximal attachment loss (measured from the interproximal CEJ to the depth of the interproximal sulcus/pocket) is less than or equal to the buccal attachment loss (measured from the buccal CEJ to the apical end of the buccal sulcus/pocket)

34
Q

What is type 3 gingival recession?

A

Gingival recession associated with loss of interproximal attachment. The amount of interproximal attachment loss (measured from the interproximal CEJ to the apical end of the sulcus/pocket) is greater than the buccal attachment loss (measured from the buccal CEJ to the apical end of the buccal sulcus/pocket)

35
Q

Look at lecture for examples

A

:)

BDS3 Periodontology (3 decks)

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