exam 2- chapter 15, 16 and some of 14 Flashcards
1
Q
what are the symptoms of pericoronitis?
A
swelling of the operculum and/or other associated gingiva, redness, and extreme pain.
The tissue may be so swollen that it interferes with mastication.
Trismus (muscle spasm) may also occur.
The patient may have a fever.
Purulent exudate occurs in approximately one half of the patients with pericoronitis.
2
Q
what are other types of implants that are used and may have been placed in an older time?
A
subperiosteal and transosteal
3
Q
this is a custom made cast framework that is placed beneath the periosteum over the alveolar bone
A
subperiosteal implant
4
Q
when is immediate implant placed?
A
at time of extraction
5
Q
how is a gingival abscess treated?
A
must be drained and irrigated..
warm salt water rinses are recommended for post-op therapy
after treatment scaling and root planning is performed
6
Q
An increased rate of bone growth and an increased amount of surface contact with bone:
A
Allows for better transfer of forces to bone.
Facilitates earlier loading, which is the placement of restorations on the implants.
Permits better success in areas with poor bone quality.
7
Q
what instruments can be used safely around implants?
A
plastic, nylon, titanium, graphite and gold plated curettes and air abrasive
8
Q
dental implants with the highest success rate are made of
A
titanium
9
Q
pockets that extend epically beyond the crest of the bone are
A
infrabony pockets
10
Q
reversible inflammatory reaction in the soft tissues surrounding an implant.
A
Peri-implant mucositis
11
Q
what are the types of endossesous implants?
A
blade and root form type
12
Q
in this type of abscess, pulpal infection to a tooth can spread to the pulp from an adjacent infected tooth through the lateral canals
A
periapical abscess
13
Q
inflammatory reactions that affect soft and hard tissues around the implant, leading to the loss of supporting bone.
A
Peri-implantitis
14
Q
what bacteria are associated with NUG?
A
large proportion of spirochetes and gram-negative organisms.
15
Q
where are gingival abscesses found?
A
found on the margin of the gingiva and not associated with any abnormality of deeper tissues
16
Q
this type of implant is placed within the bone
A
endosseous implants
17
Q
how are gingival fibers in health - teeth vs implants?
A
teeth- inserted into supracrestal root cementum
implants- fibers arranged parallel to implant
18
Q
what are the causes of early implant failure?
A
failure to achieve osseointegration, inherent host tissue factors, bacterial contamination of wounds, poor surgical technique, and instability of the implant
19
Q
when are follow ups suggested for implants?
A
6, 12, and 36 months and then every 2-3 years after..
20
Q
what is the term for an abscess that is found on the marginal gingiva and is not involved in the deeper periodontium
A
gingival abscess
21
Q
patients with implants may require special instructions and devices for plaque biofilm control because the shapes of the fixtures, abutments and prosthesis can be very complex
A
both the statement and the reason are correct and related
22
Q
Immediately providing a fixed provisional implant-supported crown after implant placement is termed
A
immediate loading
23
Q
what is criteria for implant success?
A
- no peri implant radiolucency
- absence of mobility
- bone loss not greater than one third of implant
- provide functional service for 5 years in 85 percent of cases in the anterior maxilla and 90 percent in anterior mandible. after 10 years, 80 percent success in the maxilla and 85 percent in mandible
- absence of persistent or irreversible signs or symptoms such as pain, infection, neuropathies, parasthesia, and violation of the mandibular canal
- bone loss <0.2 mm annually after first year of service
- implant design allows restoration satisfactory to patient and dentist
- absence of continuous marginal bone loss
- absence of persistent soft tissue complications
- probing depth <4 to 5 mm; bone loss <4 mm
- no mechanical failure
24
Q
what is an indication of loss of integration and implant failure?
A
presence of mobility
25
the gap between the implant and socket wall
jumping distance
26
recall intervals for patients with implants can be the same as for patients without implants. implants tend to accumulate biofilm and calculu quickly, but these are easy for patients to remove
both are false
27
what should you consider when determining if an abscess is periodontal or periapical?
85% of the tooth pain is pulpal.. and 15% is periodontal
most periapically will test nonvital
periapical pain is sharp, severe, intermittent and difficult to localize
periodontal is usually constant, localized, and less severe
28
when is a late implant placed?
6 months or longer after extraction
29
periodontal pathogens associated with failing implants are similar to those found in periodontal disease around natural teeth. any signs and symptoms of periodontal inflammation should be addressed with thorough cleaning bad plaque biofilm control
both statements are true
30
what does probing around implants provide?
assessment of bleeding and pus
31
these are associated with pre-existing periodontal disease..may occur around any tooth in the mouth when the perio pockets becomes occluded, often as a result of foreign object
acute periodontal abscess
32
what symptoms are included with acute periodontal abscess?
swelling, deep red to blue discoloration of the tissue, sensitivity to pressure, mobility, tooth feels "high"
33
this type is either a screw or cylindrically shaped with different lengths, diameters and design characteristics.....provide osseous anchorage through the formation of a lattice between the implant surface and bone.
root form
34
placement of a restoration at the time of the implant surgery
immediate loading
35
pockets that are coronal to horizontal bone loss
suprabony pockets
36
the density of the cortical bone is....
3-4 times that of cancellous bone
37
what is the mobility of teeth vs implants?
teeth- physiologic as a function of PDL
implant- no pdl. Rigid fixation similar to that of functional ankylosis
38
where are subperiosteal implants used?
maxilla or mandible
39
this is an inflammation of microbial origin that is associated with accumulations of suppuration or purulence in periodontal tissues
periodontal abscess
40
what is the influence the rate of bone apposition and growth and the amount of bone-to-implant contact.
implant surface
41
this implant is no longer used today due to high number of failure
blade type
42
which modality is always acceptable for cleaning implant abutments?
rubber cap polishing
43
what is used to see changes in bone density?
tomography and digital subtraction radiographic techniques
44
how are periodontal abscesses characterized by?
swelling
pain
discomfort
45
these type of abscesses occur in disease free areas and may be related to a forceful inclusion of some foreign object to the area..
gingival abscesses
46
how is the gingival sulcus depth with teeth vs implants?
shallow with teeth
implants- depth dependent on implant type and prosthetic component length
47
what does the absence of the PDL around implants create?
rigid bone implant interface
48
what are causes of late implant failure?
mechanical overload, fatigue failure of components and peri implant infection
49
where does the peri implant soft tissue form?
around the section of the implant system that extends from the bone into the oral cavity.
50
this type of implant passes thru the mandible in an apico-coronal direction and protrudes through the gingival tissues into the mouth for prosthesis anchorage
transosteal implant
51
how is the proprioception with teeth vs implants?
teeth- receptors within PDL
implants- no receptors within interface
52
how does a periapical abscess appear on xray?
round radiolucency at the apex of the tooth
53
the measurement from the crest of the gingival margin to the base of the pocket
probing depth
54
which of the following oral conditions are contagious?
herpetic gingivistomatits
55
where can acute herpetic gingivostomatitis occur?
on any of the oral mucous membranes
56
these are characterized by an overgrowth of pathogenic organisms that result in suppuration.. usually painless, and drain into the oral cavity through a pocket or sinus tract
chronic periodontal abscess
57
what is the term for an abscess that is the result of a pulpal infection from caries or trauma?
periapical abscess
58
this is the growth of action of bone tissue as it assimilates surgically implanted devices or prosthesis to be used as either replacement parts or anchors
osseointegration
59
an opportunistic infection of the gingiva that is associated with stress, lifestyle, and some chronic illnesses and conditions. non communicable, primarily observed in young adults who are under severe stress and individuals who are immunocompromised.
NUG
60
this type of abscess is the result of infection through caries, traumatic fracture of the tooth, or trauma from a dental procedure
periapical abscess
61
what is the criteria for implant success?
bone loss not exceeding 0.2 mm
62
how is a periapical abscess treated?
root canal or extraction
untreated abscesses can lead to abscesses of the brain or swelling of the fascial planes
ludwigs angina (life threatening complication of infection)
63
what is the shape of the bone dependent upon?
history of trauma or infection, the length of time since tooth loss occurred and loading by removable prosthesis
64
what is the major benefit and indication for periodontal surgery?
to gain access to root surfaces for scaling and root planing
65
what are the three types of abscesses?
periodontal, gingival, periapical
66
an acute periodontal abscess presents as red, raised and shiny. suppurations is always found in patients with acute periodontal abscesses
the first statement is true and second is false
67
what are some specific clinical characteristics associated with NUG?
Involved papillary gingiva becomes necrotic and appears cratered or “punched out.”
Surface of the gingiva has a pseudomembranous coating made up of necrotic bacteria and tissue.
Gingiva is reddened and painful.
Lesions may be localized or generalized.
Patients have a strong and offensive breath odor, described as fetid (fetor oris).
68
what is the implant biologic width made up of?
2 mm long junctional epithelium and a 1 mm zone of connective tissue
69
an abscess associated with a partially or fully erupted tooth that is covered completely or partially by a flap of tissue called an operculum.
pericoronitis
70
inflammatory reactions in the tissues surrounding an implant.
Peri-implant disease
71
the presence of pain can assist the clinician in distinguishing a periodontal from a periapical abscess because periapical pain is difficult to localize
the statement is not correct but the reason is
72
what are the majority of implants?
endosseous implants
73
where is the location of crestal bone in teeth vs implants?
teeth- 1 to 2 mm from cementoenamel junction
implants- dependent on implant design. ranges 0.5-2.5 mm from implant shoulder or to first thread
74
which type of implant provides direct osseous anchorage through formation of a lattice between surface and bone?
endosseous
75
when NUG reoccurs, what is an appropriate name?
NUP
76
who is acute herpetic gingivostomatitis more common in?
now more commonly found in young adults, possibly representing primary infection with genital herpes virus, herpes simplex virus II (HSVII).
77
when is a delayed implant placed?
6-10 weeks after extraction
78
how are acute and chronic periodontal abscesses treated?
scaling and gingival curettage after local antimicrobial therapy is administered
79
the term loading refers to which aspect of implant therapy
placement of abutments and restorations on implants for function
80
what is good for polishing around implants?
tin oxide with rubber cups
81
an acute periodontal abscess can occur as the result of all of the following except one..
antibiotic usage
dental procedures
subgingival scaling
retained popcorn hull or berry seed
antibiotic useage
82
how does an acute periodontal abscess appear?
shiny, red, raised, rounded mass on the gingiva or mucosa
83
the periodontal abscess is characterized by all of the following symptoms except one...
pain
swelling
bleeding
tenderness
bleeding
84
where does the connective tissue bone exist?
between the junctional epithelium on the implant abutment and the bone
85
what should be included in a dental or medical history?
what is the chief complaint? (what is bothering you?)
location? (where do you feel that pain?)
onset? (when did it begin?)
other symptoms? (is something else bothering you?)
systemic factors? (fever, chills, exhausted (malaise))
trauma? (fallen, injury to tooth?)
aggravating factors? (things make pain worse)
alleviating factors? (makes it feel better, heat or ice?)
previous treatment? (ever had any work done on the tooth?)
86
what are treatment options of per-implantitis?
combination of local or systemic antimicrobial therapy, the removal of plaque biofilm and calculus, implant surface decontamination, and the regeneration of defects.
87
how is the connective tissue attachment with teeth vs implants?
teeth- sharpeys collagen fibers inserted into alveolar bone and cementum
implants- bone implant interface has no fiber insertions. filled with chondroitin sulfate glycosaminoglycans
88
the microbiota found in the acute periodontal abscess are predominantly
grab negative and anaerobic
89
once acute herpetic gingivostomatitis occurs for a second time, what can trigger them?
sunlight, trauma and fever or stress
90
according to the ADA council on the dental materials, instruments and implants, accepted implants have demonstrated success in clinical trials of at least 50 patients for a minimum
5 years
91
what is the most commonly affected tooth of pericoronitis?
The most commonly affected tooth is the mandibular third molar.
92
when doing a submerged protocol, what will the patient use to rinse with?
chlorhexidine 0.2% mouthwash twice daily, and the use of systemic antibiotics should be considered to minimize the chances of infection.
93
When an abscess spreads from the pulp to the periodontium or from the periodontal pocket to the pulp...
combination periapical and periodontal abscess
94
oral manifestation of primary infection with the herpes virus, usually herpes simplex virus I (HSVI).
Acute herpetic gingivostomatitis
95
implant integration depends on the...
```
Biomaterials and biocompatibility
Implant design (length, diameter, shape, surface)
Bone factors
Surgical factors
Loading considerations
```
96
how long should probing be avoided after the placement of an implant?
for the first three months
97
using a two stage surgical approach, how long is healing time when placing an implant?
3-6 months
98
true or false/ any implant material is considered a foreign body
true
99
this is a highly reactive yet biocompatible metal
titanium
100
what prevents corrosion of titanium materials?
the oxide layer
101
what is the usual length of an implant
8-14 mm
102
what is the healing time after implant surgery?
mandible is 3 months
| maxilla is 6 months
103
how is the JE attached to the root surface
by hemidesmosomes and a basal lamina
104
can orthodontics be applied once an implant has been osseointegrated?
no
105
what does peri implant soft tissues adhere to?
titanium collar of the implant by hemidesmosomal and basal lamina
106
when can restorative procedures be used?
3-4 weeks of soft tissue healing
107
the dental hygienist is responsible for assessing implants with the same techniques used for natural teeth:
mobility, probing depths, bleeding, plaque and calculus
108
what is used to view accurate levels of bone width and quantities of an implant?
cross sectional and tomographic images can be obtained with the use of computed tomography, special tomographic devices and digital subtraction radiography techniques
109
who is pericoronitis seen in?
young adults 17-26 YO
110
who is NUG common in?
young adults and immunocompromised people... NOT communicable
111
What are the treatment methods of NUG?
1st appt limited amount of debridement... ultrasonic and topical is used to remove sloughing tissue loose debris and plaque and calculus supragingival
2 appt is 1-2 days later where subgingival scaling may occur
3 appt- 3-5 days after first visit
112
what percentage of patients with HSV1 symptomatic
10-20
113
who is acute herpetic gingivostomatkks common in
adults 20-30
114
how long does acute herpetic gingivostomatitis run its course
7-10 days
115
periodontal surgery that includes modification of the bone level or shape
osseous surgery
116
indications for excisional perio surgery?
familial gingival hyperplasia and localized crown lengthening for restorative dentistry
117
this type of graft uses tissue from the palate or edentulous areas
free gingival graft
118
grafting of this has become the procedure of choice when root coverage is the objective of mucogingival surgery
subgingival connective tissue graft
