Diagnosis

Question 1

What are the three things that contribute to periodontal disease?

Answer 1

Microbial plaque, Genetics/host factors, and Acquired/environmental factors

Question 2

What characteristic of pathogenic bugs cause periodontal disease?

Answer 2

virulence factors

Question 3

Modifying _________ _______ (characteristic) of pathogenic flora should result in improved clinical condition?

Answer 3

virulence factors

Question 4

What two things are in part responsible for pathogenesis?

Answer 4

Virulence, and the concentration of microorganisms capable of producing disease

Question 5

What are the two basic steps to diagnosis?

Answer 5

1. Describing presence or absence of inflammation 2. Measuring attachment loss

Question 6

What has happened in the patient’s dental history is indicated by what two things?

Answer 6

radiographs, attachment levels

Question 7

What is happening now in the patient’s mouth is indicated by what?

Answer 7

Signs of inflammation

Question 8

Diagnose: A patient with no inflammation and no signs of attachment loss from prior periodontitis.

Answer 8

Periodontal health

Question 9

Diagnose: A patient with no inflammation but has attachment loss due to prior periodontitis.

Answer 9

Periodontal health with history of periodontitis

Question 10

Diagnose: A patient with inflammation, but no signs of attachment loss.

Answer 10

gingivitis

Question 11

Diagnose: A patient with inflammation and ongoing attachment loss.

Answer 11

Periodontal disease

Question 12

Diagnose: A patient with inflammation and attachment loss that is not ongoing.

Answer 12

Gingivitis with Hx of periodontal disease

Question 13

What is a periodontal probe’s main purpose?

Answer 13

Used to evaluate the health of the periodontal tissues, and extent of periodontal damage.

Question 14

A UNC 15 probe has what kind of markings?

Answer 14

A marking for each millimeter (1-15) but three dark bands at 4, 9, and 14 mm

Question 15

What does a probe with William’s markings look like?

Answer 15

A marking at each mm, except at 4 and 6mm

Question 16

A color coded probe has what kind of markings?

Answer 16

Dark colored bands that are 3mm wide (used for faster evaluation)

Question 17

What is an ideal probing depth?

Answer 17

1 - 3mm

Question 18

In an ideal sulcus, where should the end of the probe touch?

Answer 18

It should touch the enamel near the CEJ

Question 19

Can a periodontal pocket be determined by probing depth alone?

Answer 19

No

Question 20

When measuring clinical attachment level, what is the baseline to measure from?

Answer 20

The CEJ because the gingival margin isn’t constant

Question 21

What findings are important to diagnose periodontal disease?

Answer 21

Probing depth, recession, BOP, furcation involvement, mobility, rotation, spacing, restorations, caries, and anatomy

Question 22

Adult periodontitis is now called?

Answer 22

Chronic periodontitis

Question 23

Early onset periodontitis (aka juvenile periodontitis, prepubertal perio, or rapidly progressive perio) is now called?

Answer 23

Aggressive periodontitis

Question 24

Periodontitis associated with systemic disease is now considered?

Answer 24

Periodontal as a MANIFESTATION of systemic disease

Question 25

Necrotizing ulcerative periodontitis is now called?

Answer 25

Necrotizing periodontal disease

Question 26

What kinds of things can cause Non-plaque induced gingival lesions?

Answer 26

bacteria, viruses, fungi, genetics, systemic conditions, trauma, or foreign bodies

Question 27

What three things can modify plaque induced gingival disease?

Answer 27

Systemic factors, medications, and malnutrition

Question 28

What are three common medications to cause gingivitis?

Answer 28

Phenytoin (dilantin), Cyclosporin, and Calcium channel blockers

Question 29

What proportion of the mouth must experience inflammation or destruction to be considered generalized gingivitis?

Answer 29

greater than or equal to 30%, otherwise it’s considered localized

Question 30

Lichen planus is an example of what?

Answer 30

An auto-immune caused gingivitis

Question 31

What findings would you use to diagnose chronic periodontitis?

Answer 31

BOP, abscess, bone loss, attachment loss, furcation involvement, probing depth, plaque, calculus, smoking, mobility, and systemic conditions

Question 32

Slight periodontitis shows how much CAL?

Answer 32

1 - 2mm CAL

Question 33

Moderate periodontitis shows how much CAL?

Answer 33

3 - 4mm CAL

Question 34

Severe periodontitis shows how much CAL?

Answer 34

5+mm CAL

Question 35

To diagnose periodontitis, what two things MUST be present at the same time in the same location?

Answer 35

Loss of attachment from the CEJ, and presence of gingival inflammation extending beyond marginal gingiva

Question 36

Generalized Aggressive periodontitis is typically seen in what age range?

Answer 36

Under 30 years old

Question 37

Attachment loss affecting 3+ permanent teeth (other than permanent 1st molars or incisors) is classified as what?

Answer 37

Generalized aggressive periodontitis

Question 38

Attachment loss of 2+ teeth, including one 1st molar and 2 or less other tooth types, is considered what kind of periodontitis?

Answer 38

Localized aggressive periodontitis

Question 39

Name 3 common features of necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis.

Answer 39

rapid onset of pain, ulceration and necrosis of marginal gingiva (usually papilla), and predisposition to decreased systemic resistance to bacterial infections

Question 40

Punched out papilla are indicative of what?

Answer 40

necrotizing ulcerative gingivitis

Question 41

Occlusion of a pocket by either a foreign body or calculus can cause what?

Answer 41

Periodontal abscess

Question 42

What is a fistula?

Answer 42

A little “tube” that very slowly drains an abscess (doesn’t have to be adjacent to abscess to connect)