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D2 Fall > Clinical Radiology - Perio Conditions > Flashcards

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
Q

What will you see on X-Rays if there are early bone changes?

A

Cortical surface of alveolar crest looks diffuse
Loss of sharp interproximal angle -> looks round

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26
Q

What type of bone loss?

Approximately parallel to imaginary line between CEJs

A

Horizontal bone loss

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27
Q

What type of bone loss?

Oblique to imaginary line between CEJs

A

Vertical bone loss

28
Q

What type of bone loss?

Angular or triangular-shaped defects

A

Vertical bone loss

29
Q

What type of bone loss?

Usually associated with local exacerbating factors

A

Vertical bone loss

30
Q

What are the types of vertical bone loss?

A

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
Q

What is the easiest type of vertical bone loss to treat?

A

3 walled bone defect (since 3 walls still remain! only 1 wall wast lost)

32
Q

What type of bone loss?

All 4 walls are lost

A

Horizontal bone loss

33
Q

What type of bone loss?

Resorption of cortical plate adjacent to teeth

A

Buccal or lingual cortical plate loss

34
Q

What type of bone loss?

May occur alone or in association with another type of bone loss

A

Buccal or lingual cortical plate loss

35
Q

T/F: You can predict if the buccal vs the lingual cortical plate is lost based on X-Rays

A

FALSE - you don’t know which one was lost until you probe!

36
Q

What are some other radiographic signs associated with perio disease?

A

Changes to density and trabecular pattern of bone
Mix of radiolucent and radiopaque patterns
Local contributing factors

37
Q

Why will you see a mix of radiolucent and radiopaque patterns in perio disease?

A

Sclerotic bone rxn -> thicker trabeculae

38
Q

What are 3 local contributing factors that you will see in perio disease?

A

Calculus
Defective restorations
Open interproximal spaces

39
Q

Presence of calculus on X-Rays may be ___________

A

underestimated

40
Q

A certain degree of calcification is required before _________ is seen on X-Rays

A

calculus

41
Q

What are 2 examples of defective restorations?

A

Overhangs
Misfits/voids

42
Q

If a pt has open interproximal contacts, what may facilitate the progression of perio disease?

A

Food impaction

43
Q

Perio disease often progresses in _________

A

bursts

44
Q

Perio disease may have _________ periods of active inflammation and destruction, followed by times of quiescence with no appreciable changes

A

cyclic

45
Q

What are the 3 possible manifestations of perio?

A

Mild
Moderate
Severe

46
Q

What can contribute to the progression of perio disease?

A

OH
Age
Stress
Smoking
Systemic diseases
Hormonal changes

47
Q

What are 3 examples of hormonal changes that can contribute to the progression of perio disease?

A

Puberty
Pregnancy
Menopause

48
Q

Mild perio involves the _______ third of the root

A

cervical

49
Q

Moderate perio involves the _______ third of the root

A

middle

50
Q

Severe perio involves the _______ third of the root

A

apical

51
Q

Widening of PDL space at apex of interradicular bony crest of furcation

A

Furcation involvement

52
Q

Perio lesions that extends to apex, causing secondary endo disease

A

Endo-perio lesion

53
Q

Periapical inflammatory disease from endodontic origin extending coronally to aveolar crest

A

Endo-perio lesion

54
Q

Irreversible anatomical changes of residual ridges following dental extraction; NOT related to perio

A

Alveolar ridge atrophy

55
Q

Increased distance between CEJ and alveolar crest is not necessarily the result of perio. Name one reason for this.

A

Supraeruption

56
Q

Can radiographic signs of stabilization of perio disease be seen?

A

Yes, occasionally -> interproximal cortex of alveolar crest is reformed

57
Q

Name a malignant neoplasm found in the mouth

A

Squamous cell carcinoma

58
Q

When this disease involves the alveolar process, it may mimic the radiographic appearance of perio

A

Malignant neoplasm

59
Q

How is a malignant neoplasm differentiated from perio disease?

A

Clinical appearance
Failure to respond to tx

60
Q

Malignant neoplasm or perio?

Irregular widening of the PDL space along its
entire length, and destruction of the lamina
dura

A

Malignant neoplasm

61
Q

How do you evaluate a peri-implant condition?

A

X-rays

62
Q

What will you see on an X-ray for a patient with a peri-implant condition?

A

Changes in bone levels around implants

63
Q

Absence of bone loss beyond bone level changes resulting from initial bone remodeling; bone loss does not exceed 2mm

A

Peri-implant health

64
Q

What is the typical pattern of initial marginal bone loss around an implant?

A

Saucerization

65
Q

What are the 2 peri-implant conditions?

A

Peri-implantitis
Bone loss beyond initial remodeling

D2 Fall (37 decks)

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