diagnosis

Question 1

Justify Stage 3 grade c perio diagnosis

Answer 1

-generalized (affects >30% teeth, around 9)
-interdental CAL on 2 non adjacent teeth
-buccal CAL >3 with pocket of >3
-pockets >6
-interdental bone loss > 33%
-furcation 2
-<4 teeth lost to perio
-HbA1c >7%

Question 2

define furcation lesion

Answer 2

the pathologic resorption of bone in the anatomic area of a multi-rooted tooth where the roots diverge

Question 3

Is the Nabers probe a valid tooth for detecting furcation invasion?

Answer 3

Eickholz and Kim 1998
Nabers probe is valid

Question 4

Miller classification for mobility:

Answer 4

1: less than 1
2: greater than 1
3: greater than 1 and vertical

Question 5

define endo-periodontal lesion?

Answer 5

• pathologic communication between the pulpal and periodontal tissues

Question 6

sign of endo perio lesion

Answer 6

-signs: deep PD extending to the root apex, cold test -, radiographic bone loss in the apical or furcation region, STP+, TTP+, purulent exudate/suppuration, tooth mobility, sinus tract/fistula.

Question 7

what are endo-perio lesions associated with

Answer 7

root perforation, fracture/cracking, or external root resorption

Question 8

What are the stages of periodontal disease (Page and Shroeder 1976) “initial lesion”

Answer 8

day 2-4: gingival tissues react to plaque with vasculitis and loss of perivascular collagen

Question 9

What are the stages of periodontal disease (Page and Shroeder 1976) “early lesion”

Answer 9

day 4-10: dense infiltrate of lymphocytes and mononuclear cells, altered fibroblasts, continued loss of CT

Question 10

What are the stages of periodontal disease (Page and Shroeder 1976) “established lesion”

Answer 10

day 14-21: predominance of plasma cells, no significant bone loss; stable for many years and may be converted into “destructive lesion”

Question 11

What are the stages of periodontal disease (Page and Shroeder 1976) “advanced lesion”

Answer 11

plasma cells predominate, loss of alveolar bone and PDL, disruption of tissue architecture with fibrosis

Question 12

signs and symptoms of a chronic apical abscess

Answer 12

gradual onset, little or no discomfort and an intermittent discharge of pus through an associated sinus tract. Radiographically, there are typically signs of osseous destruction such as a radiolucency. ; TTP+; a purulent exudate; and an increase in probing depth.