comprehensive exam and TP

Question 1

patient eval and examination

Answer 1

1) medical and dental history
2) thorough clinical and radio exam
3) IOE and EOE
4) document findings

Question 2

medical history

Answer 2

1) predisposing conditions
2) treatment, management, outcomes
3) any oral implications
4) any medications

Question 3

examples

Answer 3

1) diabetes
2) hypertension
3) pregnancy
4) smoking
5) substance abuse
6) medication

Question 4

dental history

Answer 4

1) chief complaint
2) past dental and periodontal therapy

Question 5

exams

Answer 5

1) thorough EOE and IOE

Question 6

what else

Answer 6

1) caries, mobility
2) missing teeth and why?
- impaction, orthodontic reasons, periodontal disease
3) signs of parafunctional habits
4) root irregularities

Question 7

examination of periodontium

Answer 7

1) review initial exam before 2nd visit
2) present case to attending perio instructor
- take recorded data and use it to come up with a logical diagnosis and TP

Question 8

gingiva

Answer 8

1) pink, blue, pigmented
2) size
3) contour
4) consistency
5) texture

Question 9

tissue response

Answer 9

1) edematous
2) fibrotic

Question 10

pockets

Answer 10

1) mm
2) CAL and BOP
3) usually painless
4) detected with periodontal probe, not radiographs alone

Question 11

techique

Answer 11

1) walk that probe around

Question 12

PD vs level of attachment

Answer 12

1) base of pocket and GM
2) base of pocket to CEJ

Question 13

attachment loss

Answer 13

1) 1-2 mm mild
2) 2-4 moderate
3) >= 5mm severe

Question 14

probing around implants

Answer 14

1) plastic probe

Question 15

attached gingiva

Answer 15

1) keratinized gingiva - sulcus depth

Question 16

MG problem

Answer 16

1) lack of keratinized tissue
2) gingival recession
3) abnormal frenum insertions
4) no attached gingiva

Question 17

periodontl abscess

Answer 17

1) acute
- avoid, along alteral aspect of root surface
- gingiva is red and edematous
2) chronic
- usuall sinus tract
- opens into gingival mucosa along the length of the root

Question 18

classification

Answer 18

1) class I
- incipient bone loss
2) class II??

Question 19

radiographs

Answer 19

1) diagnostic, current

Question 20

other diagnostic aids

Answer 20

1) microbial sampling
2) diagnostic casts
3) radiographic image
4) medical labs

Question 21

categories of diagnosis

Answer 21

1) health, gingivitis, periodontitis

Question 22

diagnosis

Answer 22

1) generalized or localized-
- if 30% or less is localized
2) severity
- mild, moderate, severe
- based on CAL
3) stage and grade

Question 23

mild

Answer 23

1) >3 <5 mm PD
2) BOP yes
3) up to 15% radiographic bone loss

*just check the slides!!

Question 24

stage and grade

Answer 24

1) staging is based on severity complexity, extent
2) grading is past progression and risk

everyone with a history of PD should be staged and graded

Question 25

primary etiology

Answer 25

1) bacterial or microbial plaue 2) susceptible host

Question 26

secondary etiology

Answer 26

1) caries, calculus, over contours margins, open contacts 2) modifying, alter the response - occlusal trauma, diabetes

Question 27

prognosis

Answer 27

1) educated guess and estimate of response to treatment 2) depends on damage that has occurred and dentist's periodontists ability to remove etiologic factors

Question 28

prognosis considerations

Answer 28

1) excellent, good, fair, guarded, poor, hopeless 2) look at CAL, PD, patient compliance, med history, etc.

Question 29

systemic/environmental factors

Answer 29

1) smoking 2) systemic disease 3) genetic factors

Question 30

local factors

Answer 30

1) subgingival calculus 2) location of teeth 3) prosthetic factors

Question 31

baseline form

Answer 31

1) occlusal considerations!! 2) for new patients or >2 years 3) inflammatory diagnosis - health, gingivitis, periodontitis - generalized or localized - mild, moderate, or severe 4) stage and grade only periodontitis hx patients 5) etiology - plaque, followed by calculus, restoration, diabetes, smoking, etc. 6) re-evaluation 4-6 weeks later (even for prophy and SRP)

Question 32

proposed TP

Answer 32

1) present it to patient 2) patient education 3) alternatives 4) potential complications 5 )expected results

Question 33

inital therapy

Answer 33

1) pt education and OHI 2) periodontal therapy 3) adult prophy, sc/RP or debridement 4) re-evaluation - all new pacific patients!!!!! 5) even if tx was a prophy are scheduled for re-evaluation

Question 34

steps in reevaluation

Answer 34

1) update med and dental history 2) periodontal findings 3) tissue response - inflammation, bleeding, plaque control, PD, mobility, caries control, mucogingival defects

Question 35

repeat portions of initial therapy

Answer 35

1) OHI 2) sc/rp 3) reinstrument, surgery

Question 36

periodontal surgery

Answer 36

1) make a more cleansible environment

Question 37

when to refer

Answer 37

1) significant attachment and bone loss 2) mucogingival defects 3) aesthetic concerns 4) unstable periodontal condition 5 )rapid progression of periodontitis 6) anything beyond your scope