Diagnosis Flashcards
refractory periodontitis ADA classification?
continued attachment loss (of yearly >2.5mm) despite proper perio treatment. Type V
In gingivitis, signs of inflammation will be confined to?
gingiva
inflammation that goes beyond gingival margin called?
diffuse inflammation
What could be a local contributing factor for gingivitis associated with dental plaque only?
braces, restoration, root fracture, etc.
Two subsets of gingivitis associated with dental plaque only?
Without other local contributing factors
With local contributing factors
Patients who are on maintenance, no ongoing attachment loss, but still have existing attachment loss are considered as?
Periodontitis
Localized vs Generalized Periodontitis
Localized = less than 30% of SITES Generalized = more than 30%
Slight, Moderate, Severe chronic periodontitis criteria?
slight: 1-2mm clinical attachment loss
moderate: 3-4
Severe: 5+
Abcess classification?
Gingival abcess
Periodontal abcess
Pericoronal abcess
Categories for mucogingival deformities and conditions around teeth
gingival/soft tissue recession [ facial or lingual ]
Lack of keratinized gingiva
how to ID keratinized gingiva?
keratinized is whiter
How to clinically ID lack of keratinized gingiva?
roll technique - will create fold at mucogingival jcn
How to diagnose lack of attached gingiva?
see where mucogingival jcn is, if probe goes beyond that, then positive
Vertical and horizontal ridge deficiency classification?
Which more predictable for ridge augmentation?
Seibert 1: BL (horizontal) loss but apico-coronal (vertical) OK
Seibert 2: BL normal but apico-coronal loss
Seibert 3: both
One (horizontal) is easiest to treat because you still have a “wall” in the area, easy for cells to migrate.
Most common complex for causing perio d?
red complex - p gingivalis, t denticula, t forcythia
Chonic periodontitis may have certain periods of…
rapid progression
How to decide on chronic perio diagnosis level?
Highest levels of CAL, and greater or less than 30%
Can you have multiple diagnoses?
Yes, you can have local severe and generalized moderate/slight. But give worst diagnosis possible.
If pt has even ONE site with 5+ mm, what is dx?
still severe
Which is more sensitive, radiographic bone loss or CAL?
CAL.
BOP on which grades of perio disease?
all
Problem with using sites for local/generalized?
can have one site per tooth, still “localized”
Aggressive vs Chronic
aggressive - usually younger pt (onset) clinically healthy, rapid attachment loss and bone destruction, outcome more difficult to control, altered serum Ab, more family/genetic factor
chronic - tends to have poor hygiene
Localized aggressive periodontitis affects which teeth most?
first molars and incisors
If there is a “cut” between calculus of teeth, what does this mean?
pt is flossing but not correctly
Generalized vs local form of aggressive periodontitis difference?
local will not present with as much calculus - general less able to have good hygiene
Local - at least 2 teeth (one molar)
-but no more than 2 teeth other than first molars and incisors (central and lateral). [maximum 14]
Generalized - any more than this
If pt is having ortho, and develop perio disease, do what?
stop, very rapid destruction of tissue.
Why maxillary first molar tend to have more perio disease than mandibular?
Much less compact bone in maxilla - less resistance
More concavity on root of max first molar - harder
How to distinguish endodontic and periodontic abcess
If test tooth and non-vital, abcess from endo origin
If vital, perio
What is combined perio-endo lesion?
non-vital but furcation/bone loss
Does root fracture cause bone loss?
if waited long time bc local factor
Miller classes for recession?
1: recession but not MGJ, no bone loss
2: recession beyond MGJ
3: recession beyond MGJ AND bone loss/recession
4: same as 3 but severe, negative architecture
easy way to check if bone is intact interproximally?
if papilla is intact, most likely bone is too
Which miller classes will have full recovery?
1 and 2
Primary vs secondary occlusal trauma
Primary - natural tooth, normal attachment, excess force
Secondary - restored tooth, attachment loss, can have normal OR excessive force
