Diagnosis and Classification Flashcards
What three things contribute to periodontal diseases?
1-Microbial plaque
2-Geentic/host factors
3-Acquired/environmental factors
Assessing the risk factors for disease progression leads to what?
Prognosis
What should be included in the history and physical examination?
1-chief complaint 2-risk history 3-medical and dental history 4-Extraoral/intraoral exam 5-clinical exam 6-Radiographic exam (as needed) 7-supplemental diagnostic tests (as needed)
Before measuring the level of attachment loss, what should you do?
Describe the absence or presence of inflammation
Radiographs and attachment levels indicate what happened in the _______ whereas signs of inflammation, erythema, etc. are indicative of whats happening ________
Past, Now
The periodontal probe is used to measure what?
Probing depths (not pocket depths)
The UNC 15 probe has what measurement scale?
marked every mm for 15 mm. dark sections to show 4, 9 and 14 mm
A probe with mm markings only at certain levels (1,2,3,5,7,8,9 and 10) is called what?
Williams marking (the school uses Michigan “O” with williams marking
Marked bands that are several mm in width with no there markings are what type of probe?
Color-coded probe
What is the ideal probing depth of a healthy sulcus?
1 to 3 mm (probe should tough teeth near the CEJ)
Attachment level looks at the relationship of the osseous crest height to what?
the CEJ
Adult periodontitis is now called what?
Chronic periodontitis
early onset periodontitis is now called what?
Aggressive periodontitis
Instead of periodontitis being associated with systemic disease it is considered to be what?
A manifestation of systemic disease
Necrotixing ulcerative periodontitis is now called what?
Necrotizing periodontal disease
What are the two main categories of gingivitis?
1-plaque induced (interaction between plaque and hosts defense system)
2-non-plaque induced (Small percentage of cases, allergic reactions, fungi, autoimmune etc.)
When is root planning used?
To manage periodontitis
Any bleeding on probe is a good sign of what?
Inflammation
Why are longitudinal records important when determining if inflammation and attachment loss are periodontitis or not?
Attachment loss may be due to previous conditions and the current plaque is only causing gingivitis not periodontitis
What are 3 medications associated with gingivitis?
1-Phenytoin (Dilantin for epilepsy)
2-Cyclosporin (transplants)
3-Calcium channel blockers
How do you determine if gingivitis is generalized or localized?
- less than 30% of sites is localized
- more than 30% of sites is generalized
*percentages are also true for periodontitis
Wickams striae are white lines on the oral mucosa associated with what?
Lichen Planus
How much clinical attachment is present in Slight periodontitis?
1-2 mm CAL
How much clinical attachment is present in Moderate periodontitis?
3-4 mm CAL
How much clinical attachment is present in Severe periodontitis?
5 mm of CAL or more
What slow progressing, plaque induced form of periodontitis is most common?
Chronic Periodontitis
What two things must be present in the same location at the same time for periodontal disease?
1-Loss of periodontal attachment from CEJ
2-Presence of gingival inflammation extending beyond the marginal gingiva into the connective tissue
What are three examples of things to help patients be aware of before periodontal therapy?
1-May increase motility of teeth
2-May be more sensitive to hot or cold on exposed roots
3-Receeding gums
What term replaced the term “early onset periodontitis”?
Aggressive periodontitis
What relatively rare oral disease with rapid/episodic attachment loss, and familial aggregation is seen in clinically healthy individuals (usually younger than 30)?
Generalized aggressive periodontitis
*attachment loss affecting 3 or more permanent teeth other than 1st molars/incisors.
Localized aggressive periodontitis is different than generalized because it involves mainly what teeth?
1st molars/incisors
*also more typical in circumpubertal patients
What are two major organisms associated with Aggressive periodontitis?
1-A.a.
2-P. Gingivalis
What are the two basic forms of Necrotizing Periodontal disease?
1-Necrotizing Ulcerative gingivitis (NUG)
2-Necrotizing Ulcerative Periodontitis (NUP)
Rapid onset of pain, necrosis and ulceration of marginal gingiva and a predispostion to decreased systemic resistance are all features of what both ________ and _______
NUG and NUP
Though punched out papilla are typical of both NUG and NUP, ____________ often involves significant loss of CT and alveolar bone and is more often associated with immunosuppressed individuals
NUP
A fistula containing circumscribed collection of neutrophil-laden pus in the soft tissue wall of the periodontal pocket is called what?
Periodontal abscess
*can be caused by incomplete calculus removal, occlusion of pocket by foreign body
What are the three categories of periodontal abscesses?
1-Gingical abscess (gingiva only)
2-Periodontal abscess (tissue adjacent to pocket)
3-Pericoronal abscess (crown of partially erupted tooth)
