epidemiology of periodontal diseases Flashcards
How does a case control study go about?
take histories of a group of interest and compare them with non- interested group and draw conclusions.
how do cohort studies go about?
follow a group of interest and non interest over time and compare outcomes
how do randomized controlled trials go about?
take patients and randomly put the in groups. Give one group a treatement while the others not. Then follow up and compare results.
studies level of increasing evidence
expert opinion, case reports, case control studies, cohort studies, randomized controlled trials, systematic reviews/meta analysis ( most evidence)
prevalance of diseases
numer of people with disease/ total population
whats sensitivity?
the proportion of patients with disease who test positive
whats specificity?
proportion of patients without disease who test negative
positive predictive value
proportio of patients with positive tests who have disease.
negative predictive value is…
the proportion of patients with negative tests who do not have disease
whats the GI index?
gives a score from 0-4 ranking the health of the gingiva. Measures mesial distal, buccal and lingual surfaces
GI 0
normal gingiva
GI 1
mild inflammation: slight color change or slight edema, no BOP
GI2
moderate inflammation , redness , BOP
GI3
severe inflammation, spontaneous bleeding
Whats the plaque index?
give a score ranking the amount of plaque
PI0
no plaque
PI1
film of plaque adhering to the FGM and adjacent areas of the tooth.
PI2
moderate accumulation of soft deposits within the gingival sucus, on FGM which can be seen by nake eye
PI3
abundance of soft matter within gingival sulcus on FGM
Periodontal index
measures the overall periodontal health of M,D,F,L surfaces.
Periodontal index score 0
no gingival inflammation nor loss of function caused by destruction of supporting bone
Periodontal index score 1
mild gingivitis, inflammation in the free gingiva but it doesnt encircle the tooth
Periodontal index score 2
gingivitis, inflammation all the way around the tooth
Periodontal index score 6
gingivitis with pocket formation,
Periodontal index score 8
advanced destruction with loss of masticatory function.
Periodontal disease index
developed by Ramfjord and only assesses 6 teeth which are 3,9,12,19,25,28,
Definition of gingivitis
plaque-induced gingivitis is defines as inflammation of the gingiva in the absence of clinical attachment loss
chronic gingivitis
slow onset and longer duration
is gingivitis reversible?
yes
gingivitis is based on sites and location. So it can be….
localized or generalized, marginal, papillary, or diffuse
what is one of the earliest signs of inflammation ?
BOP, its a predictor of future attachment loss as well.
how does gingiva appear during inflammation?
smooth and shiny with no stippling
what co-exists in chronic gingivitis?
both destructive( edematous), and reparative( fibrotic) changes.
what to expect to see in the initial lesion ( stage 1) of gingivitis
occurs within 2-4 days of plaque accumulation, capillary vasodilation and increasaed blood flow, inflammatory cells, perivascular loss of collagen
what to expect to see in the initial lesion ( stage 2)
4-7 days after plaque accumulation, erythema, BOP, increased vascular proliferation, lymphocytes, increased collagen destruction, development of RETE pegs,
what to expect to see in the established lesion ( stage 3)
2-3 weeks after plaque accumulation, erythema, edema, cyanosis( blue), BOP, engorged blood vessels, alot of plasma cells, increased collagen destruction, JE shows rete peg evelopment.
2 types of established lesions appear to exist.
- some remain stable and do not progress for months or years
- others seem to become more active and to convert to progressively destructive lesions
the advances lesion ( stage 4)
aka periodontitis, lesion extends to alveolar bone
plaque retentive factors include….
overcontoured crowns, open margins, narrow embrasures, open contact, ill-fitting partial dentures, caries, tooth malposition
