diagnosis stuff Flashcards
(tys question)
list some points about how ppd is not reliable as a diagnostic indicator of perio and why it cannot be used alone
1) PD is not indicative of CAL and so should only be used as an adjunct
- bc CAL is dependent on the location of FGM
2) PD not reproducible
- Greenstein 1997: there are problems with reproducibility as ppd is very variable, dependent on things like tip of probe, angulation, probing force
3) increase in PD does not necessarily indicate perio disease
- may be due to other factors like pseudopockets, gingival hyperplasia, or even endo origin
4) PD doesnt tell us if disease is active or not
- Greenstein 1997: not able to differeentiate between pockets with stable periodontitis lesions and sites undergoing disease progression
- Egelberg 1994: episodic nature of perio destruction further reduces the diagnostic ability of PD
5) errors in probing can occur
(tys question)
what would be some info we use to confirm diagnosis that it is a perio abscess
- signs of attachment loss which is indicative of perio aetiology
- sensibility tests are positive so not pulpal pathology
- previous dental hx of perio therapy
- full mouth perio chartings to see if there are generalised deep ppd
- type of perio pocket: if it is narrow, points more towards a cracked tooth but if it is wide base then indicative of perio pocket
- presence of suppuration would indicate that its an abscess
- bitewedge test to exclude diagnosis of cracked tooth
(tys) risk factors associated with severity of perio disease
systemic factors
- diabetes
- taking meds like nifedipine, phenytoin etc
- osteoporosis
microbial factors
- poor oh
- bacterial strains present (red complex or AA, Pgingi)
tooth factors
- enamel pearl
- palatal grooves
- tooth position in arch
- presence of overhanging restorations
genetic factors
- il1 polymorphism
social/ environmental factors
- smoking
- stress
- alcohol
