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Periodontics I > Classification Scheme for Periodontal & Peri-Implant Diseases > Flashcards

Classification Scheme for Periodontal & Peri-Implant Diseases Flashcards

1
Q

The periodontitis Armitage 1999 states that the severity of disease is based upon:

A

clinical attachment level (gold standard)

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2
Q

The periodontitis Armitage 1999 states that the severity of disease is based upon clinical attachment level (gold standard)

Slight:
Moderate:
Severe:

A

Slight: 1-2 mm
Moderate: 3-4mm
Severe: >= 5mm

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3
Q

The periodontitis Armitage 1999 states that the severity of disease is based upon clinical attachment level (gold standard)

________: 1-2mm
________: 3-4mm
________: greater than or equal to 5mm

A

Slight: 1-2mm
Moderate: 3-4mm
Severe: greater than or equal to 5mm

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4
Q

What is the PRIMARY cause of tooth loss in the US population over the age of 30?

A

Periodontitis

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5
Q

With the 1999 classification of periodontal diseases and conditions, why was there concern with the categories chronic periodontitis and aggressive periodontitis?

A

there was not enough evidence that they were two different entities

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6
Q

In simple terms what’s it mean if you have periodontitis?

A

attachment loss

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7
Q

What can cause pseudo pockets?

A

gingival hyperplasia due to medications, genetic diseases etc.

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8
Q

Attachment loss can be measured via:

A

radiographic bone loss & probing depths

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9
Q

If there is no attachment loss there is no _____ because its not ____

A

staging & grading; periodontitis

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10
Q

Few practitioners use _____ routinely

A

clinical attachment level (CAL)

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11
Q

AAP formed a task force in 2015 to identify alternative criteria including:

A
  1. radiographic bone loss (RBL)
  2. probing depth (PD)
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12
Q

T/F: A 6mm probing depth with 20% bone loss is significantly different that 6 mm with 75% bone loss

A

True

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13
Q

Probing depth is not considered:

A

diagnostic

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14
Q

Probing depth is not considered diagnostic because: (2)

A
  1. Inflammation has effect on penetration of probe into tissue
  2. Inflammation (swelling) may move gingival margin coronally (pseudo pocket)
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15
Q

When inflammation moves the gingival margin coronally:

A

pseudopocket

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16
Q

In regard to the 2015 task force guidelines, the 2017 workshop recommended: (2)

A
  1. use interproximal attachment loss (2 or more non-adjacent teeth)
  2. use probing depth as a “complexity” factor (difficulty of treatment)
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17
Q

How do you use attachment loss?

A

Use two sites that are not next to each other

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18
Q

The 2017 classification of periodontal and peri-implant diseases and conditions new classification is based on strongest:

A

current evidence

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19
Q

The 2017 classification of periodontal and peri-implant diseases and conditions developed a ______ system that is:

A

adaptive system; 3 dimensional

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20
Q

The 2017 classification of periodontal and peri-implant diseases and conditions adaptive system (3 dimensional) takes into account: (3)

A
  1. severity/extent (number of teeth affected rather than sites)
  2. prognosis (affects no teeth, up to 4 teeth, 5 or more teeth)
  3. progression (grading)
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21
Q

answer to something: Plaque in a susceptible host

basically was discussing about if he gave each of us a spoonful of plaque (ew) why we would all not have the same response

A
22
Q

Periodontal disease is an _____ disease

A

inflammatory

23
Q

Approximately _____ % of adults over the age of 30 years old have periodontitis and this is the primary cause of tooth loss in adults

A

47%

24
Q

What is the primary cause of tooth loss in adults?

A

periodontitis

25
Q

What categories of people show a greater percentage of periodontitis?

A
  • Men
  • Mexican Americans
  • Adults below the 100% federal poverty level
  • current smokers
  • self reported diabetics
26
Q

Three steps to staging and grading a patient

Step 1:

A

Initial case overview to assess disease

27
Q

Three steps to staging and grading a patient

Step 1: Initial case overview to assess disease

Screening involves:

A
  1. full mouth probing depths
  2. full mouth radiographs
  3. missing teeth
28
Q

Mild to moderate periodontitis will typically be either:

A

stage I or stage II

29
Q

Clinical attachment loss of 1-2mm is stage:

A

Stage I

30
Q

Clinically attachment loss of 3-4mm is stage:

A

Stage II

31
Q

Three steps to staging and grading a patient

Step 2:

A

Establish stage

32
Q

When establishing a stage (step 2) for mild to moderate periodontitis (typically stage I or stage II), what else are you determining during this step?

A
  • confirm clinical attachment loss (CAL)
  • rule out non-periodontitis causes of CAL (e.g. cervical restorations or caries, root fractures, CAL due to traumatic causes)
  • Determine maximum CAL or radiographic bone loss
  • Confirm RBL patterns
33
Q

For moderate to severe periodontitis these guys are typically:

A

Stage III or IV

34
Q

When establishing a stage (step 2) for moderate to severe periodontitis (typically stage III or stage IV), what else are you determining during this step?

A
  • determine maximum CAL or RBL
  • confirm RBL patterns
  • assess tooth loss due to periodontitis
  • evaluate case complexity factors (e.g. severe CAL frequency, surgical challenges)
35
Q

Three steps to staging and grading a patient

Step 3:

A

Establish grade

36
Q

What should be done in step 3- establishing the grade of the patient?

A
  • calculate RBL (% of root length x 100) divided by age
  • assess risk factors (such as smoking or diabetes)
  • measure response to scaling and root planing and plaque control
  • assess expected rate of bone loss
  • conduct detailed risk assessment
  • account for medical and systemic inflammatory considerations
37
Q

According to the AAP 2017 classification, in regards to staging and grading:

Every patient categorized based on the _______ periodontal site and specific factors that may impact long term management

A

WORST

38
Q

According the the AAP 2017 classification, staging is divided into:

A
  1. severity
  2. complexity
  3. extend and distribution
39
Q

Classify the following stages-

Stage 1:
Stage 2:
Stage 3:
Stage 4:

A

Stage 1: Initial
Stage 2: Moderate
Stage 3: Severe with potential for additional tooth loss
Stage 4: Severe with potential for loss of dentition

40
Q

Staging 1-4 is based upon:

A

severity of disease and complexity of case management

41
Q

What should be taken into consideration when staging?

A
  1. Clinical attachment loss (CAL) - USING WORST SITE
  2. Amount and % of bone loss
  3. Probing depth
  4. Presence/extend of ridge defects and furcation involvement
  5. Tooth mobility
  6. Tooth loss (due to periodontitis if known)
42
Q

Criteria for Defining Periodontitis:

A
  • Interdental clinical attachment loss at 2 or more NON-ADJACENT teeth

OR

  • Buccal or oral clinical attachment loss of > or = 3mm with
    a) pocketing of greater than 3 mm
    b) on 2 or more teeth
43
Q

According to the New staging guidelines using interproximal CAL; a CAL of 1-2 mm would classify someone as:

A

Stage I

44
Q

According to the New staging guidelines using interproximal CAL; a CAL of 3-4 mm would classify someone as:

A

Stage II

45
Q

According to the New staging guidelines using interproximal CAL; a CAL of greater than equal to 5mm would classify someone as:

A

Stage III or IV

46
Q

CAUTION: Ensure the problem cannot be attributed to non-periodontal causes such as:

A
  1. Gingival recession- due to trauma (toothbrush trauma/toothpaste abrasion)
  2. Dental caries- extending to or below the gingival margin
  3. Defect on distal of 2nd molars caused by malposition or extraction of a 3rd molar
  4. Endodontic lesion-draining through marginal periodontium (deep probing depth)
  5. Vertical root fracture (usually isolated deep probing depth)
47
Q

Complexity:
1. Takes into account ____
2. Evaluates ____
3. Evaluates ____

A
  1. overall probing depths
  2. radiographic bone loss, horizontal and vertical
  3. furcation involvements, number of missing teeth, function
48
Q

When considering staging and grading for periodontitis, factors to consider include all EXCEPT:

  • smoking
  • diabetes
  • attachment level
  • bleeding on probing
A
  • bleeding on probing because this is just a sign of inflammation
49
Q

Prognosis based upon staging and tooth loss

Stage I or II =

A

No tooth loss likely

50
Q
A

Periodontics I (18 decks)

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