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Periodontics > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Define the process of patient care

A
  • Assessment
  • Diagnosis
  • Planning
  • Implementation
  • Evaluation

ADPIE

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2
Q

What are the objectives of a periodontal assessment?

A
  • Provides a comprehensive picture of patients periodontal health status
  • Determine health status
  • Look for signs of inflammation and damage to periodontium
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3
Q

What are the fact gathering process?

A
  • Baseline data for long term monitoring of periodontal disease activity
  • Evaluate the success of periodontal treatment
  • Accompanied by documentation of all clinical findings
  • Needs to be performed on all patients
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4
Q

Reasons for periodontal documentation?

A
  • Reference tool
  • Record
  • Educational resources
  • Medical and legal document
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5
Q

What are the assessments in the clinical examination?

A
  • Interview
  • Extraoral/Intraoral
  • Oral Hygiene
  • Periodontal
  • Dentition
  • Radiographic
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6
Q

Describe the component of interview assessment

A

Medical History:
* Ensures safety of patient
* Aids clinician
* Verified with interview ans signature

Dental History:
* Chief complaint
* Acquire details necessary for diagnosis
* Past and present dental treatment
* Current oral hygiene practices
* Behavorial habits
* Attitude towards dentistry

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7
Q

Describe the component of Extra/Intra Oral assessment

A

Extroral
* Presence of pathology: Look, Feel, Listen, Smell

Intraoral
* Presence of Pathology: Oral mucosa, gingiva characterisitcs

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8
Q

Describe the component of Oral Hygiene assessment

A
  • Plaque biofilm
  • Calculus
  • Tooth Surface topography
  • Stain
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9
Q

Describe the component of Periodontal assessment

A
  • Probe depth
  • Clinical attachment level (CAL)
  • Bleeding and suppuration
  • Furcation detection and measurement
  • Mucogingival considerations
  • Tooth mobility and migration
  • Fremitus
  • Implications of implants
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10
Q

Describe the component of Dentition assessment

A
  • Caries
  • Restorations
  • Overhanging margins
  • Proximal contact relationships
  • Tooth abnormalities
  • Parafunctional habits
  • Tooth wear
  • Sensitivity or hypersensitivity
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11
Q

Describe the component of Radiographic assessment

A
  • Interdental septa
  • Bone destruction
  • Furcation areas
  • Dental implants
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12
Q

What are intrinsic stains

A

Fluorosis: too much fluoride over a period of time
Tetracycline: Medication
Minocycline: Medication

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13
Q

What are extrinsic stains and their associated causes?

A

Brown: Poor hygiene, Tannins and tobacco, Chlorhexidine, Stannous Fluoride
Green: Poor Hygiene, Enamel cuticle, Fluorescent bacteria and fungi
Black: Chromogenic bacteria, Ferric sulfide
Orange: Poor Hygiene, Chromogenic bacteria

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14
Q

What are the limitations of probing?

A
  • Junctional Epithelium(JE) penetration/ puncture
  • Probing Force
  • Placement and Angulation variations
  • Accuracy of depth
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15
Q

What are the etiology of recession?

A
  • Multifactorial
  • Anatomic variations
  • Occlusal trauma
  • Smoking or chewing tobacco
  • Inflammatory periodontal disease
  • Trauma induced by tooth brushing
  • Ortho
  • Crown margins
  • RPD clasps
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16
Q

Describe normal and abnormal clinical presentation of the periodontium

A
17
Q

Describe the normal and abnormal clinical presentation of the dentition.

A
18
Q

How do you calculate Clinical attachment level (CAL)?

A

Overgrowth: Subtract overgrowth amount coronal to CEJ from probing depth

Recession: add the probe depth and recession measurement

19
Q

How do you calculate attached ginigva?

A

1) record width of keratinized gingiva
2) Amount of keratinized gingiva minus probing depth
** You calculate on the outside*

20
Q

How do you chart recession/FGM and Probing depth

A
21
Q

How do you chart mobility

A

Mobility: Grade 0-3
0- Physiologic Mobility only (Not charted)
1- Slight pathology 1mm BL (Not charted)
2- Moderate pathology 1-2mm BL
3-Severe pathology greater than 2mm BL or MD vertical displacement

22
Q

What type of instrument is specifically designed for measuring furcation involvement?

A

Nabers probe, curved with blunt tip and calibrated

23
Q

List and describe the indices used to report furcation involvement

A
  • Mandibular molars= bifurcated= Facial and Lingual involvements
  • Maxillary Molars= Trifurcated= Facial Mesial and distal
  • Maxillary 1st Premolars= Bifurcated= Mesial and distal
24
Q

List and describe the indices used to report tooth mobility and dental caries.

A

Tooth mobility:
-Loss of support
-Rotation
-Elongation/extrusion
Dental Caries
G.V Black Cavity Classification:
Class 1- Pits and Fissures
Class 2- Proximal Spaces on Posterior teeth
Class 3- Proximal Spaces on Anterior teeth (no angle)
Class 4- Proximal Spaces on Anterior teeth with angle
Class 5- Cervical Third
Class 6- Edge and cusp

25
Q

List and describe the indices used to report tooth wear

A

Attrition- parafunction, reduced salivary
Erosion- chemical, gastric, diet
Abrasion- excessive abrasion by foreign object
Abfraction- occlusal stress

26
Q

Identify radiographic changes seen in periodontal diseases

A

Interdental Septa- break down of the lamina dura, loss of radiopacity, breaks in the crestal plate
Bone loss- Horizontal or vertical , Furcations

27
Q

State the characteristics of ginigval epithelium

A
  • Protection of underlying structures
  • Selective interchange with oral environment (absorption of drugs)
  • Avascular (relies on lamina propria for blood supply and nutrients
  • has serveral layers
28
Q

What are the 4 layers of ginigival epithelium?

A

Stratum Corneum (cornified)
Stratum Granulosum (Granular)
Stratum Spinosum (Spinous/prickle)
Stratum Germinativum/basale (Basal)

29
Q

What are the different characteristics of the 4 layers of ginigval epithelium ?

A

Stratum Corneum (cornified) (TOP)
- Keratinized, para and non
- barrier membrane
Stratum Granulosum (Granular)
-Keratin Formation
-Flatten cells
-Shrinking nuclei
Stratum Spinosum (Spinous/prickle)
- 8-12 layers thick
- Langerhans cells
Stratum Germinativum/basale (Basal)
- Mitotic
- Keratinocytes (Touch cell)
- Melanocytes (Touch Cell)
- Merkel Cells (Touch Cell)

30
Q

Differentitate among the three types of gingival epithelium:
Oral
Sulcular
Junctional

A

Oral (OE):
- Covers=crest of gingiva, outer surface of the free ginigva and attached gingiva.
- Keratinized or parakeratinized stratified squamous epithelium (masticatory mucosa)
- Keratinized Tissue: hard palate and dorsum of tongue

Sulcuar (SE):
- lines the gingival sulcus, thin and non keratinized
- DOES NOT have rete pegs
- Maybe parakeratinized near oral cavity opening
- goes from the coronal area of JE to crest of MG
- It forms the gingival wall of sulcus
- DOESNOT have granulosum or corneum
- Acts as a semipermeable membrane

Junctional (JE):
- nonkeratinized
- Two cell layers: basale and spinosum
- Thickness from coronal to apically
- Length ranges from .71 to 1.35mm
- Attaches to tooth by epithelial attachment (basement lamina and hemidesmosomes from enamel or cementum

31
Q

Explain the renewal of gingival epithelium and its keratinization process

A

GE renews constantly - Thickness maintained by the balance between cell formation and shedding of old surfcae cells

During the keratinization process
- process by epithelial cells differentiating or mature
- Different types of differentiating reflects functional demand and stimulus placed on tissue
- Entire thickness is replaced

32
Q

Define Fenestrations

A

A window of bone loss on the facial of the mandible

Bone defect

33
Q

Define Dehiscences

A

V shaped defects apical to the cementoenamel junctions extending through marginal bone

Bone defect

34
Q

What is the difference between fenestrations and dehiscences?

A

Fenestration is not commonly associated with ginigval recession, unlike dehiscence.

Both can affect either a natural tooth or dental implant

35
Q

How do you chart Furcation grade

A

by grade I-IV (FITS)

I- early involvement=bone is intact (Feel It)
II- Moderate= bone is destroyed but probe cannot pass through it (In it)
III-Severe= Probe can pass through the roots (Through it)
IV- Severe severe= Visible due to recession (See It)

36
Q

How do you chart bleeding on probe?

A

during probing- presence or absence on chart
Detailed description to include amount and rate
Ex: Gen light BOP, loc mod molars

Light= delayed
Mod= @ the time of probing
Severe=@ time and excessive

37
Q

Where is the fremitus tested?

A

Only maxillary anterior teeth

38
Q

Cell turn over time

A
  • Palate, tongue and cheek is 5-6 days
  • Ginigiva is 10-12 days
  • JE is 4-7 days

Periodontics (9 decks)

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