Dentistry - periodontal disease Flashcards

1
Q

What structures are included in the periodontium?

A

The supporting structures -
Gingiva
Periodontal ligament
Alveolar bone
Cementum

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2
Q

What is periodontal disease?

A

Inflammation and infection of the periodontium by plaque bacteria and host response

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3
Q

What is the difference between gingivitis and periodontitis?

A

Gingivitis - initial reversible stage
Periodontitis - later irreversible stage

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4
Q

What is the difference between plaque and calculus?

A

Calculus is mineralised plaque - gives plaque a rough retentive surface above and below the gumline
Calculus - just irritant, not pathogenic like plaque is

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5
Q

How quickly can plaque form?

A

Within 24 hours if undisturbed

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5
Q

What is plaque?

A

A biofilm - organic matrix of glycoproteins, bacterial, lipids, cellular debris
Stops host defences/antibiotics

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6
Q

What is gingivitis?

A

Inflammation confined to the gingiva (gums)
Reddening and oedema of the tissue progressing to ulceration, bleeding and gum detachment from the tooth

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7
Q

How is gingivitis treated?

A

Plaque control - dental cleaning at home or professionally

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8
Q

What are the different stages of the gingivitis index?

A

0 - normal
1 - mild reddening/inflammation, no bleeding
2 - Reddening, oedema, bleeding on probing
3 - Marked inflammation, ulceration, spontaneous bleeding

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9
Q

What is periodontitis?

A

Later irreversible stage of inflammation extending to deeper supporting structures of tooth

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10
Q

What are the pathological changes that occur due to periodontitis?

A

Gingival recession/loss of attachment
Root exposure
Furcation
Pocket formation
Alveolar bone loss
Tooth loss

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11
Q

What is the calculus index?

A

0 - no calculus
1 - 0-25% coverage of tooth
2 - 25-75%
3 - 75-100%

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12
Q

Why is the calculus not very useful?

A

The degree of calculus doesnt correspond to the degree of periodontitis

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13
Q

What is the name for the distance measured between the cemento-enamel junction and the gingival margin?

A

Gingival recession

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14
Q

What is the name for the distance measured between the top of the gingival margin to the bottom of the pocket?

A

Periodontal pocket depth

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15
Q

How do you work out attachment loss?

A

The sum of the gingival recession and the periodontal pocket depth
Take away the normal gingival sulcus depth

16
Q

What is the normal gingival sulcus depth in a dog?

A

0-3mm

17
Q

What is the normal gingival sulcus depth in a cat?

A

0-0.5mm

18
Q

What is the furcation involvement?

A

The amount you can get the probe between the tooth roots

19
Q

What are the grades of furcation involvement?

A

Grade 1 - probe gets less than halfway under the crown
Grade 2 - probe gets more than halfway under the crown
Grade 3 - probe can pass under crown

20
Q

How do you manage periodontal disease?

A

Scale and polish
Gingivectomy
Open periodontal surgery
Subgingival curettage and root planing
Extraction
Home care

21
Q

What is root planing?

A

Removal of calculus and plaque from tooth surface in gingival sulcus

22
Q

What is subgingival curettage?

A

Removal of granulation tissue and gum lining from gingival sulcus

23
Q

Why do you polish after scaling teeth?

A

Removes microscopic scratches that plaque can stick to
Also removes plaque better

24
Q

What is open periodontal surgery used for?

A

Treatment of deeper pockets - more than 4-5 mm

25
Q

What is open periodontal surgery?

A

Making a flap of gum, scale and polish subgingival surface, then lavage and sew flap back

26
Q

What is a gingivectomy? When is it done?

A

Removal of excess gingiva around teeth - eliminate pseudopockets

27
Q

How much gingiva must be left after gingivectomy?

A

At least 2mm

28
Q

When should you extract teeth?

A

Attachment loss more than 25% of root length
Grade 3 furcation bone loss
Mobility - wobbly
Fractured tooth
Retained deciduous tooth
If client cant commit to home care

29
Q

What local consequences to surrounding tissues can periodontitis cause?

A

Oro-nasal fistula
Endodontal disease
Pathologic fracture
Ocular issues
Oral cancer
Osteomyelitis

30
Q

What is endodontal disease?

A

Pulp and dentine affected

31
Q

What systemic consequences can periodontal disease cause?

A

Patients inflammatory mediators causing more damage
CV disease
Hepatic disease
Renal insults
Diabetes
Neoplasia