Diagnosis and Classification

Question 1

What three things contribute to periodontal diseases?

Answer 1

1-Microbial plaque
2-Geentic/host factors
3-Acquired/environmental factors

Question 2

Assessing the risk factors for disease progression leads to what?

Answer 2

Prognosis

Question 3

What should be included in the history and physical examination?

Answer 3

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)

Question 4

Before measuring the level of attachment loss, what should you do?

Answer 4

Describe the absence or presence of inflammation

Question 5

Radiographs and attachment levels indicate what happened in the _______ whereas signs of inflammation, erythema, etc. are indicative of whats happening ________

Answer 5

Past, Now

Question 6

The periodontal probe is used to measure what?

Answer 6

Probing depths (not pocket depths)

Question 7

The UNC 15 probe has what measurement scale?

Answer 7

marked every mm for 15 mm. dark sections to show 4, 9 and 14 mm

Question 8

A probe with mm markings only at certain levels (1,2,3,5,7,8,9 and 10) is called what?

Answer 8

Williams marking (the school uses Michigan “O” with williams marking

Question 9

Marked bands that are several mm in width with no there markings are what type of probe?

Answer 9

Color-coded probe

Question 10

What is the ideal probing depth of a healthy sulcus?

Answer 10

1 to 3 mm (probe should tough teeth near the CEJ)

Question 11

Attachment level looks at the relationship of the osseous crest height to what?

Answer 11

the CEJ

Question 12

Adult periodontitis is now called what?

Answer 12

Chronic periodontitis

Question 13

early onset periodontitis is now called what?

Answer 13

Aggressive periodontitis

Question 14

Instead of periodontitis being associated with systemic disease it is considered to be what?

Answer 14

A manifestation of systemic disease

Question 15

Necrotixing ulcerative periodontitis is now called what?

Answer 15

Necrotizing periodontal disease

Question 16

What are the two main categories of gingivitis?

Answer 16

1-plaque induced (interaction between plaque and hosts defense system)
2-non-plaque induced (Small percentage of cases, allergic reactions, fungi, autoimmune etc.)

Question 17

When is root planning used?

Answer 17

To manage periodontitis

Question 18

Any bleeding on probe is a good sign of what?

Answer 18

Inflammation

Question 19

Why are longitudinal records important when determining if inflammation and attachment loss are periodontitis or not?

Answer 19

Attachment loss may be due to previous conditions and the current plaque is only causing gingivitis not periodontitis

Question 20

What are 3 medications associated with gingivitis?

Answer 20

1-Phenytoin (Dilantin for epilepsy)
2-Cyclosporin (transplants)
3-Calcium channel blockers

Question 21

How do you determine if gingivitis is generalized or localized?

Answer 21

• less than 30% of sites is localized
• more than 30% of sites is generalized

*percentages are also true for periodontitis

Question 22

Wickams striae are white lines on the oral mucosa associated with what?

Answer 22

Lichen Planus

Question 23

How much clinical attachment is present in Slight periodontitis?

Answer 23

1-2 mm CAL

Question 24

How much clinical attachment is present in Moderate periodontitis?

Answer 24

3-4 mm CAL

Question 25

How much clinical attachment is present in Severe periodontitis?

Answer 25

5 mm of CAL or more

Question 26

What slow progressing, plaque induced form of periodontitis is most common?

Answer 26

Chronic Periodontitis

Question 27

What two things must be present in the same location at the same time for periodontal disease?

Answer 27

1-Loss of periodontal attachment from CEJ

2-Presence of gingival inflammation extending beyond the marginal gingiva into the connective tissue

Question 28

What are three examples of things to help patients be aware of before periodontal therapy?

Answer 28

1-May increase motility of teeth
2-May be more sensitive to hot or cold on exposed roots
3-Receeding gums

Question 29

What term replaced the term “early onset periodontitis”?

Answer 29

Aggressive periodontitis

Question 30

What relatively rare oral disease with rapid/episodic attachment loss, and familial aggregation is seen in clinically healthy individuals (usually younger than 30)?

Answer 30

Generalized aggressive periodontitis

*attachment loss affecting 3 or more permanent teeth other than 1st molars/incisors.

Question 31

Localized aggressive periodontitis is different than generalized because it involves mainly what teeth?

Answer 31

1st molars/incisors

*also more typical in circumpubertal patients

Question 32

What are two major organisms associated with Aggressive periodontitis?

Answer 32

1-A.a.

2-P. Gingivalis

Question 33

What are the two basic forms of Necrotizing Periodontal disease?

Answer 33

1-Necrotizing Ulcerative gingivitis (NUG)

2-Necrotizing Ulcerative Periodontitis (NUP)

Question 34

Rapid onset of pain, necrosis and ulceration of marginal gingiva and a predispostion to decreased systemic resistance are all features of what both ________ and _______

Answer 34

NUG and NUP

Question 35

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

Answer 35

NUP

Question 36

A fistula containing circumscribed collection of neutrophil-laden pus in the soft tissue wall of the periodontal pocket is called what?

Answer 36

Periodontal abscess

*can be caused by incomplete calculus removal, occlusion of pocket by foreign body

Question 37

What are the three categories of periodontal abscesses?

Answer 37

1-Gingical abscess (gingiva only)
2-Periodontal abscess (tissue adjacent to pocket)
3-Pericoronal abscess (crown of partially erupted tooth)