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periodontology 2 > clinical and radiographic examination > Flashcards

clinical and radiographic examination Flashcards

1
Q

what six criteria are needed for a complete periodontal examination?

A
  1. perio probing
  2. clinical attachment loss
  3. BOP
  4. mobility
  5. furcation involvement
  6. plaque index.
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2
Q

what 2 probes are traditionally used for perio probing?

A

UNC and CP

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3
Q

how do you probe interproximally?

A

line the cusp tip and the root apex up with the perio probe.

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4
Q

probing force should be how many newtons?

A

.75N

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5
Q

What is the preferred method for determining periodontal diagnosis?

A

clinical attachment loss

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6
Q

mild, moderate, and severe CAL levels

A

mild- 1-2mm of loss
moderate- 3-4 mm of loss
severe- 5mm+ of loss

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7
Q

when does the probing dept=CAL?

A

when gingival margin is at CEJ

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8
Q

When do you subtract from you probing depth?

A

pseudopockets, when gingival margin is above CEJ

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9
Q

when do you add to your pocket depth fo CAL?

A

recession, when gingival margin is below CEJ

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10
Q

Bleeding upon probing

A

one of eariliest signs of gingival inflammation. This occurs even sooner than color change or other visual signs

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11
Q

whats one of the most common reasons for BOP?

A

chronic inflammation, caplillaries are engoreged and close to the surface.

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12
Q

miller tooth mobility classes

A

1- fist distinguishable sign of movement greater than “normal”

  1. 1mm of combined movement
  2. 1+mm in any direction and /or vertical depression or rotation of the crown in its socket( the moement it becomes compressible its a 3)
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13
Q

what probe is used for furcation detection?

A

neighbors probe

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14
Q

class 1 furcation

A

the concavity above the furcation can be felt but not the furcation itself

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15
Q

class 2 furcation

A

probe partially enters furcation extending ~1/3 the width of tooth

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16
Q

class 3 furcation

A

in mandibular molars the probe passes completely through the furcation.
In maxillary molars the probe passes through until being impeded by the palatal root.

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17
Q

class 4 furcation

A

same as class 3 but entrance to furcation is visible clinally.

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18
Q

whats the average width of a furcation entrance and a scaler?

A

furcation entrance- .5mm.
scaler- .75mm.
its hard to fit the scaler in.

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19
Q

whats the plaque index used for?

A

to determine patients ability to remove plaque and material from teeth

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20
Q

plaque index scores 0-3

A

PI0- no plaque in gingival area
PI1- film of plaque adhering to FGM & adjacent areas. This plaque is only seen be running probe on tooth surface
PI2- soft deposits within gingival sulcus and FGM. This can be seen by the naked eye
PI3- abundance of soft matter within the gingival sulcus, and FGM

21
Q

how is PI calculated?

A

count sites with plaque

divide by sites that dont have plaque

22
Q

what films can be used for a proper periodontal diagnosis?

A 
intra oral radiographs
panorex
CT scans ( implants)
23
Q

Intra oral radiographs are most accurate because….

A

they produce the least amount of magnification ( 6-7%)

periapicals and bitewings

24
Q

whats the pritchard criteria for periapical films?

A

includes cusp tips with little to none of the occlusal surface showing
enamel caps and pulp chambers showing
open interproximals
proximal contacts shouldnt overlap unless teeth are our of line

25
Q

bitewing films

A

for posterior crowns, alveolar bone height in relation to CEJ

26
Q

horizontal bitwings are commonly used for what?

A

detection of interproximal caries

27
Q

vertical bitweings are commonly used for what?

A

evaluate bone for periodontal involvement.

28
Q

Panorex uses

A

to view large anatomical structures

implants, pathology, TMJ

29
Q

what are the positives of panorex

A

allows for full mouth imaging
low radiation
fixed head position for standardization

30
Q

whats the bad of panorex?

A

25-30% magnification

cant obtain precise view of perio structures

31
Q

whats the ugly of panorex?

A

mutschelknauss and vonder ohe did a study and found FMX with right angle to alveolar bone was superior to panorex

32
Q

is CT scan usefull to periodontists?

A

yes, its great for implants and helps with pathology diagnosis

33
Q

what do dentists call a CT scan?

A

dentascan

34
Q

why is examining the interdental septa usefull?

A

because roots can obscure facial and lingual surfaces of alveolar bone

35
Q

the angulation of the interdental septa is useually aligned with what?

A

parallel to a line connecting the adjacent teeths CEJ

36
Q

why is it good to look at lamina dura?

A

( radiopaque border next to PDL)
loss of lamina dura limited to alveolar crest may indicate extension of gingival inflammatory process into underlying alveolar bone.

37
Q

does Manson think the lamina dura even actually exist?

A

no, the line appearance is just made by the shape and position of the tooth root in relation to the x-ray beam.” manson”

38
Q

does Rams think the lamina dura exists?

A

yes,

and he says its associated with PD ( look at slide 47)

39
Q

height of crest
hausman
kallestal
general

A

hausman- .04-1.9mm
kallestal- maxilla .9-1.0 mm, mandible .7-.8mm.
general- 2mm

40
Q

what causes the wide range of height of crest numbers?

A

Regan said the x-ray angulation

This is why theyre strictly just an adjuct to clinical exam.

41
Q

what are some radiologic evidences of periodontal disease?

A

vertical/horizontal bone loss and calculus

42
Q

whats an early sign of periodontal disease?

A

a wedge like appearece mesially or distally to teeth on the aveolar bone

43
Q

whats horizontal bone loss?

A

reduction in interdental septa with the crest horizontal and perpendicular to long axis of adjacent teeth.
Yoon says bone loss 2mm or moreparallel to CEJ of surrounding teeth

44
Q

whats vertical bone loss

A

reduction in interdental septa with crest having an angular disposition
commonly in aggressive disease
classified into number of walls

45
Q

how much bone loss is needed to see vertical bone loss on radiographs?

A

.5-1.0mm

46
Q

why are radiographs not so great in vertical defects detection?

A

thick bony cortical plates and ruut surfaces can block the defect.

47
Q

whats the best way to detect vertical bone loss?

A

surgical exploration.

48
Q

whats a furcation arrow?

A

small triangular radiographic shadow over either the mesial or distal root in the proximal furaction area.
Hardekopf noted 18% mesial sites and 7% distal sites exhibited a furcation arrow

periodontology 2 (8 decks)

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