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Periodontology > Diagnosis, Prognostication, Treating Planning and Outcomes > Flashcards

Diagnosis, Prognostication, Treating Planning and Outcomes Flashcards

1
Q

What is periodontitis

A

An infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss; characterised by pocket formation and/or recession of the gingiva

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2
Q

What are some of the clinical features of periodontitis

A
  • Gingival inflammation
  • Bleeding on probing
  • Gingival recession/enlargement
  • Periodontal pockets
  • Loss of clinical attachment
  • Loss of alveolar bone
  • Tooth mobility, drifting of teeth
  • Tooth loss
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3
Q

What is important to ask in the Social history of a period patient

A
  • Job?
  • Stress?
  • Smoking? (none, started?, how long?/many)
  • Likely attendance/compliance
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4
Q

What is important to ask in the Family history of a period patient

A
  • Periodontitis in family

- Diabetes?

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5
Q

What is important to ask in the medical history of a period patient

A
  • Systemic diseases
  • Medication/treatments
  • Allergies
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6
Q

What is important to ask in the dental history of a period patient

A
  • Oral hygiene practice
  • Compliance
  • Previous therapy
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7
Q

What parameters are checked in order to classify severity of periodontal disease

A
  • Probing pocket depth
  • Probing attachment level
  • Furcation involvement
  • Tooth mobility
  • Plaque
  • Bleeding/suppuration
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8
Q

What are the different classes of furcation involvement

A 
Class 1 (A) - less than 1/3 loss (3mm ish)
Class 2 (B) - more than 1/3 loss (3mm ish) but not through and through
Class 3 (C) - Through and through with probe
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9
Q

What is horizontal bone loss

A

When there is alveolar bone resorption where the height of the bone in relation to the teeth has been uniformly decreased

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10
Q

What is vertical bone loss

A

This is an abnormal decrease in alveolar bone on one proximal surface of a tooth compared to the tooth on the adjacent side

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11
Q

What do we use to classify periodontitis (not just clinical tings)

A
  • Age of onset/presentation
  • Medical history - contributory or not?
  • Family history
  • Presumed etiological factor
  • Clinical presentation (extent and severity)
  • Speed of disease progression
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12
Q

What is the more prevalent form of periodontitis in adults

A

chronic periodontitis

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13
Q

What is the difference between localised and generalised periodontitis

A 
Localised = less than or equal to 30% of sites
Generalised = greater than 30% of sites
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14
Q

What is the probing depth of slight, moderate and severe chronic periodontitis

A 
Slight = 3-5mm
Moderate = 5-7mm
Severe = >7mm
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15
Q

What is the CAL of slight, moderate and severe chronic periodontitis

A 
Slight = 1-2mm
Moderate = 3-4mm
Severe = >5mm
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16
Q

What is the clinical definition of periodontitis (where these things must be present clinically or it doesnt count)

A
  • Interdental CAL (attributed to periodontal causes) is detectable at 2 or more adjacent teeth
  • Buccal or oral CAL of 3 or more mm. with pocketing greater than 3mm detectable at 2 or more teeth
17
Q

What indicates stage 1 severity periodontitis

A 
Interdental CAL (at greatest site) = 1-2mm
Bone loss = coronal third (<15%)
Tooth loss = none
18
Q

What indicates stage 2 severity periodontitis

A 
Interdental CAL (at greatest site) = 3-4mm
Bone loss = coronal third (15-33%)
Tooth loss = none
19
Q

What indicates stage 3 severity periodontitis

A 
Interdental CAL (at greatest site) = 5 or more mm
Bone loss = extending to middle third of root and beyond
Tooth loss = 4 or less teeth
20
Q

What indicates stage 4 (final stage) severity periodontitis

A 
Interdental CAL (at greatest site) = 5 or more mm
Bone loss = extending to middle third of root and beyond
Tooth loss = 5 or more teeth
21
Q

What indicates stage 1 complexity periodontitis

A
  • Max probing depth of 4 or less mm

- Mostly horizontal bone loss

22
Q

What indicates stage 2 complexity periodontitis

A
  • Max probing depth of 5 or less mm

- Mostly horizontal bone loss

23
Q

What indicates stage 3 complexity periodontitis

A

In addition to Stage 2 complexity:

  • Probing depths of 6 or more mm.
  • Vertical bone loss of 3 or more mm.
  • Furcation involvement class 2 or 3
  • Moderate ridge defects
24
Q

What indicates stage 4 complexity periodontitis

A 
In addition to Stage 3 complexity:
Need for complex rehabilitation due to:
- Masticatory dysfunction
- Secondary occlusal trauma
- severe ridge defects
- Bite collapse, drifting, flaring
- less than 20 remaining teeth
25
Q

What is the grading of periodontitis used for

A

To indicate the rate of progression of periodontal disease

26
Q

What grade modifiers can there be

A
  • smoking and diabetes
27
Q

Describe the smoking risk factor that can put a patient in each of the periodontitis grades

A

Grade A = non-smoker
Grade B = less than 10 cigs a day
Grade C = 10 or more cigs a day

28
Q

Describe the diabetes risk factor that can put a patient in each of the periodontitis grades

A

Grade A = normoglycemic/no diagnosis of diabetes
Grade B = HbA1c < 7% in patients with diabetes
Grade C = HbA1c ≥ 7% in patients with diabetes

29
Q

What rate of progression of radiographic bone loss or CAL puts a patient in each of there periodontitis gradings

A

Grade A = no loss over 5 years
Grade B = <2mm over 5 years
Grade C = ≥2mm over 5 years

30
Q

What %bone loss/age score is used for each periodontitis grading

A

Grade A = <0.25
Grade B = 0.25 - 1.0
Grade C = >1.0

31
Q

What is the main distinction between stage 3 and 4 periodontitis

A

It should be based on the complexity of managing the case that is influenced by tooth loss

32
Q

Definition of prognosis

A

The likely cause of a medical condition

33
Q

What are some of the criteria for a patient to have “periodontal stability”

A
  • <10% BOP
  • No sites with PPD>5mm.
  • No degree 2/3 furcations
  • No mobility > 1
  • No sensitivity, caries, aesthetic concerns
34
Q

When Initial PPD is < 3mm. what PPD reduction can be predicted after non-surgical treatment

A

0.5mm

35
Q

When Initial PPD is 3-6mm. what PPD reduction can be predicted after non-surgical treatment

A

1.0-1.5mm

36
Q

When Initial PPD is 7-10mm. what PPD reduction can be predicted after non-surgical treatment

A

2.5-5.0mm

Periodontology (12 decks)

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