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Clinical Radiology - Perio Conditions Flashcards

1
Q

Disease processes involving the periodontium

A

Perio diseases

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2
Q

Supportive apparatus surrounding a tooth

A

Periodontium

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3
Q

Is the PDL space radiopaque or radiolucent?

A

Radiolucent

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4
Q

T/F: The PDL space is narrower at the cervical level

A

FALSE, the PDL space is wider at the cervical level

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5
Q

What is involved in alveolar bone?

A

Alveolar crest
Lamina dura

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6
Q

What is the expected distance between the alveolar crest and the CEJ?

A

0.5-2mm

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7
Q

Why is the distance between the alveolar crest and CEJ expected to increase throughout our life (even in the absence of disease)?

A

Attrition -> causing our teeth to continuously erupt
Resorption

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8
Q

Characterized by inflammatory host response in perio tissues that may lead to localized or generalized alterations in supporting bone and soft tissues

A

Perio diseases

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9
Q

What plays a primary role in perio diseases?

A

Plaque biofilm

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10
Q

Perio diseases involve an inflammatory response and release of what?

A

Inflammatory mediators

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11
Q

In perio diseases, the inflammatory response causes what 4 things to occur?

A

Loss of and apical migration of JE
Pocket formation
Bacterial colonization
Osteoclastic bone resorption

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12
Q

What is the MOST important thing for diagnosis of perio diseases?

A

Clinical exam

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13
Q

What is measured/observed in the clinical exam to diagnose perio diseases?

A

Gingival index
Probing - bleeding, recession, CAL
Mobility

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14
Q

What is complementary to the diagnosis of perio diseases?

A

X-Rays

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15
Q

What do X-Rays show us in regards to perio diseases?

A

Extent of destruction of alveolar process
Local irritating factors
Record of course of disease

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16
Q

What are the best X-Rays for perio assessment of posterior teeth?

A

Bitewings

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17
Q

What X-Ray should you take if the extent of bone loss cannot be depicted on a regular bitewing?

A

Vertical bitewing

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18
Q

What X-Ray should you take if there is a posterior tooth with advanced bone loss?

A

PA

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19
Q

What are the best X-Rays for perio assessment of anterior teeth?

A

PAs

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20
Q

What X-Ray shows the overall status of alveolar crest, but is not the best image due to superimpositions, distortions, and lower resolution?

A

Pano

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21
Q

What are the 3 limitations of panos?

A

Superimpositions
Distortions
Lower resolution

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22
Q

When taking bitewings, correct __________ __________ matters!

A

horizontal angulation

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23
Q

When taking PAs, correct __________ and __________ __________ matters!

A

horizontal and vertical angulation

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24
Q

Localized erosion of interproximal alveolar crest

A

Early bone changes

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25
What will you see on X-Rays if there are early bone changes?
Cortical surface of alveolar crest looks diffuse Loss of sharp interproximal angle -> looks round
26
What type of bone loss? Approximately parallel to imaginary line between CEJs
Horizontal bone loss
27
What type of bone loss? Oblique to imaginary line between CEJs
Vertical bone loss
28
What type of bone loss? Angular or triangular-shaped defects
Vertical bone loss
29
What type of bone loss? Usually associated with local exacerbating factors
Vertical bone loss
30
What are the types of vertical bone loss?
1 walled bone defect (means 1 wall remains) 2 walled bone defect (means 2 walls remain) 3 walled bone defect (means 3 walls remain)
31
What is the easiest type of vertical bone loss to treat?
3 walled bone defect (since 3 walls still remain! only 1 wall wast lost)
32
What type of bone loss? All 4 walls are lost
Horizontal bone loss
33
What type of bone loss? Resorption of cortical plate adjacent to teeth
Buccal or lingual cortical plate loss
34
What type of bone loss? May occur alone or in association with another type of bone loss
Buccal or lingual cortical plate loss
35
T/F: You can predict if the buccal vs the lingual cortical plate is lost based on X-Rays
FALSE - you don't know which one was lost until you probe!
36
What are some other radiographic signs associated with perio disease?
Changes to density and trabecular pattern of bone Mix of radiolucent and radiopaque patterns Local contributing factors
37
Why will you see a mix of radiolucent and radiopaque patterns in perio disease?
Sclerotic bone rxn -> thicker trabeculae
38
What are 3 local contributing factors that you will see in perio disease?
Calculus Defective restorations Open interproximal spaces
39
Presence of calculus on X-Rays may be ___________
underestimated
40
A certain degree of calcification is required before _________ is seen on X-Rays
calculus
41
What are 2 examples of defective restorations?
Overhangs Misfits/voids
42
If a pt has open interproximal contacts, what may facilitate the progression of perio disease?
Food impaction
43
Perio disease often progresses in _________
bursts
44
Perio disease may have _________ periods of active inflammation and destruction, followed by times of quiescence with no appreciable changes
cyclic
45
What are the 3 possible manifestations of perio?
Mild Moderate Severe
46
What can contribute to the progression of perio disease?
OH Age Stress Smoking Systemic diseases Hormonal changes
47
What are 3 examples of hormonal changes that can contribute to the progression of perio disease?
Puberty Pregnancy Menopause
48
Mild perio involves the _______ third of the root
cervical
49
Moderate perio involves the _______ third of the root
middle
50
Severe perio involves the _______ third of the root
apical
51
Widening of PDL space at apex of interradicular bony crest of furcation
Furcation involvement
52
Perio lesions that extends to apex, causing secondary endo disease
Endo-perio lesion
53
Periapical inflammatory disease from endodontic origin extending coronally to aveolar crest
Endo-perio lesion
54
Irreversible anatomical changes of residual ridges following dental extraction; NOT related to perio
Alveolar ridge atrophy
55
Increased distance between CEJ and alveolar crest is not necessarily the result of perio. Name one reason for this.
Supraeruption
56
Can radiographic signs of stabilization of perio disease be seen?
Yes, occasionally -> interproximal cortex of alveolar crest is reformed
57
Name a malignant neoplasm found in the mouth
Squamous cell carcinoma
58
When this disease involves the alveolar process, it may mimic the radiographic appearance of perio
Malignant neoplasm
59
How is a malignant neoplasm differentiated from perio disease?
Clinical appearance Failure to respond to tx
60
Malignant neoplasm or perio? Irregular widening of the PDL space along its entire length, and destruction of the lamina dura
Malignant neoplasm
61
How do you evaluate a peri-implant condition?
X-rays
62
What will you see on an X-ray for a patient with a peri-implant condition?
Changes in bone levels around implants
63
Absence of bone loss beyond bone level changes resulting from initial bone remodeling; bone loss does not exceed 2mm
Peri-implant health
64
What is the typical pattern of initial marginal bone loss around an implant?
Saucerization
65
What are the 2 peri-implant conditions?
Peri-implantitis Bone loss beyond initial remodeling

D2 Fall (46 decks)

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