Clinical Attachment Loss

Question 1

What is clinical attachment loss

Answer 1

The measurement of the distance from the CEJ to the base of the pocket.
It is the sum of the recession and pocket depth

Question 2

How would you measure probing depth

Answer 2

Insert probe in sulcus/ pocket
Parallel to long axis of the tooth
Do not apply force
Move Apically
Circumferentially around each surface of the tooth

Question 3

Risk indicators

Answer 3

Age, gender, occupation, systemic diseases, smoking, baseline mean attachment loss, baseline mean recession , baseline mean BOP, baseline mean probing depth, number of missing teeth, tooth variable, site variable, subgingival temperature

Question 4

Determinants of successful periodontal maintenance

Answer 4

1. Collaboration between hygienist, patient and periodontist
2. Partnership between patient and oral health team
3. Patient accepts responsibility of oral health
4. Patient’s overal condition

Question 5

Objectives of periodontal maintenance

Answer 5

Preserve clinical attachment levels
Maintain alveolar bone height
Control inflammation
Evaluation and reinforcement of personal oral hygiene
Maintenance of optimal oral health

Question 6

What symptoms signify recurrence?

Answer 6

Increased inflammation
Recession
Increased mobility
Increased pocket depth, no radiographic change
Increased pocket depth, with increased radiographic bone loss

Question 7

A failing case may be recognized by:

Answer 7

1. Recurring inflammation revealed by gingival changes and bleeding of the sulcus on probing
2. Increased depth of sulci, leading to recurrence of pocket formation
3. Gradual increase in bone loss determined by radiographs
4. Gradual increase in tooth mobility as determined by clinical examination

Question 8

Advanced periodontal diagnostic techniques

Answer 8

Advances in clinical diagnosis
Advances in radiographic assessment
Advances in microbiologic analysis
Advances in characterization of the host response

Question 9

Limitations of current conventional diagnostic techniques

Answer 9

Does not provide the cause of the disease
Does not give info on the patients susceptibility to the disease
Cannot identify the sites with ongoing disease or sites in remission
Cannot tell if the response to therapy is positive or negative

Question 10

Advances in microbiologic analysis

Answer 10

Immunohistodiagnostic analysis
Enzymatic methods
Molecular biology techniques
- nucleic acid probes
- PCR
- checkerboard DNA-DNA hybridization