Exam #2 Review

Question 1

Loe and Silness Gingival Index

Answer 1

0 = Normal
1 = Mild inflammation, slight color change and edema, no bleeding
2 = Moderate inflammation, redness, edema, bleeds on probing
3 = Severe inflammation, marked redness and edema, ulceration, spontaneous bleeding

Question 2

Loe and Silness Plaque Index

Answer 2

0 = No plaque
1 = A film of plaque adhereing to the FGM and adjacent area of the tooth.  This plaque may only be seen by using the probe to scrape it
2 = Moderate accumulation of soft deposits within the gingival pocket, or the tooth and the gingival margin which can be seen with the naked eye
3 = Abundance of soft matter within the gingival pockets and or on the tooth and gingival margin

Question 3

How to do a PSR

Answer 3

Go by sextants and check depths with CIPTN

If you have a score of 3 in a quad, stop and do a full perio exam

Question 4

PSR Codes

Answer 4

0 = Colored area visible, no calc or defective margins, no BoP
1 = Colored area visible, no calc or defective margins, BoP present
2 = Colored area visible, calc or defective margins present, BoP can be present
3 = Colored area partially visible, calc and CoP may or may not be visible
4 = Colored area not visible

Question 5

O’Leary Index

Answer 5

Put a disclosing agent in the mouth, rinse, and count the red surfaces
Teeth have 4 surfaces, MLDF

Question 6

NIDR Calculus Inex

Answer 6

0 = no calc
1 = supragingival calculus, but none subgingivial
2 = Supragingival and subgingival calculus OR just subgingival calculus

Question 7

Reliability

Answer 7

If you run a test on the same patient multiple times, how likely you are to get the same result

Question 8

Sensitivity

Answer 8

When disease is present, how likely you are to detect it

If its high, you won’t get false negatives

Question 9

Specificity

Answer 9

When disease is not present, how likely you are to say its absent
If its high, you won’t get false positives

Question 10

Predictive Value Positive

Answer 10

The probability of disease in a subject with a positive test result

Question 11

Predictive Value Negative

Answer 11

The probability of no disease in a subject with a negative result

Question 12

Herpetic Lesion syptoms

Answer 12

Painful gingivitis with redness
Ulcerations with serofibrinous exudate
Edema accompanied by stomatitis

Question 13

Herpetic lesions Characterisitics

Answer 13

Incubation period is one week
Formation of vesicles, which rupture, coalesce, and leave fibrin-coated ulcers
Healing within 10-14 days

Question 14

Recurrent HSV

Answer 14

Common presentation = herpes labialis
On vermillion border and/or adjacent to it
Intra-oral ulcers in attached gingiva and hard palate

Question 15

Recurrent HSV treatmet

Answer 15

Limit bacterial superinfection (careful plaque control)

Can use antivials in immunocompromised patients

Question 16

Herpes Zoster

Answer 16

Varicella zoster virus causes chicken pox
Small ulcers on the tongue, palate, and gingiva
Latent in the dorsal root ganglion
Unilateral lesions
2nd and 3rd branch of the trigeminal ganglion

Question 17

Thrush

Answer 17

Candida albicans
Acquired during birth
Pseudomembranous/erosive lesions

Question 18

Thrush Predisposing conditions

Answer 18

Antibiotics
Immunosuppresion
Malnutrition
HIV
Diabetes

Question 19

Thrush oral locations

Answer 19

Can be just about anywhere

Question 20

Thrush clinical manifestations

Answer 20

Pseudomembranous candidosis = white plaque

Erythematous candidosis = looks like gingivitis

Question 21

Thrush diagnosis and treatment

Answer 21

via clinical signs and symptoms
Microscopic exam of smear - can be misleading
Correct predisposing factors and give antifungals

Question 22

Lichen planus

Answer 22

Oral involvement alone is uncommon
Dangerous because it has premalignant potential
Characteristic skin lesions
Varied clinical appearances
Any area of the oral mucosa

Question 23

Lichen planus Histopathology

Answer 23

Subepithelial band-like accumulation of lymphocytes
Characteristics of a type IV hypersensitivity
Fibrin in the basement membrane
Accumulation/Deposits of IgM, C3, C4, C5

Question 24

Pemphigoid

Answer 24

Autoantibody reactions against hemidesmosomes and lamina lucida components
Detachment of the epithelium from the CT
Compliment-mediated cell destructive process may be involved in the pathogenesis
Deposits of C3, IgG, and other Ig’s

Question 25

Pemphigus

Answer 25

Formation of intraepithelial bullae in skin and mucous membrane
Strong genetic background (especially Jewish and Mediterainian)
Painful desquamative lesions, erosions, or ulcerations
Chronic course with recurrent bulla formation
Ciruclating autoantibodies against interepithelial adhesion molecules

Question 26

Acanthylosis

Answer 26

Canthus layer
Another name for Stratum spinosum (because it has bridges or ‘canthae’)
Breakdown of the spinous bridges

Question 27

Necrotizing ulcerative gingivitis

Answer 27

Adolscents or young adults, smokers, adn individuals under stress
Pain, ulceration, and necrosis of the interdentinal papillae
Bleeding

Question 28

Predisposing factors for NUG

Answer 28

Systemic disease like ulcerative colitis, blood dyscrasias, and nutritional deficiencies
Abnormalities of WBC functions
AIDS

Question 29

NUG Treatment

Answer 29

OHI
Mechanical debridement
Systemic antibiotic treatment
Surgical correction of gingival destruction

Question 30

Fibroma/Fibrous hyperplasia

Answer 30

A focal fibrous hyperplasia caused by irritation
Sessile, well-circumscribed smooth surface nodules
Cell poor, hyperplastic collagenous tissue
May show hyperkeratinization
Differential diagnosis - giant cell fibroma

Question 31

Pyogenic granuloma

Answer 31

Ulcerated
Near gingival margin
Reddish or bluish, sometimes lobulated, sessile, or pedunculated
Bleeding is common
Highly vascular with chornic inflammatory cells

Question 32

Peripheral giant cell granuloma

Answer 32

Anywhere in the gingival mucosa
Focal collection of multi-nucleated, osteoclast-like giant cells with a richly cellular and vascular stoma separated by collagenous septa
Probably originated from PDL

Question 33

Periapical cemental dysplasia

Answer 33

Fibrous, osseous cemental lesions
Tooth is usually vital
Usually no symptoms
Periapical bone is replaced by fibroblastic tissue through a cementoblastic phase

Question 34

Papilloma

Answer 34

Four or five different types of papiloma are present
Exophytic, pedunculated, or sessile lesions
Reddis or whitish gray in color
HPV common

Question 35

Osteosarcoma

Answer 35

7% of osteosarcomas occur in the jaw
Clinical and radiographic exams are required
Widening of the PDL is common