Exam #2 Review Flashcards
Loe and Silness Gingival Index
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
Loe and Silness Plaque Index
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
How to do a PSR
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
PSR Codes
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
O’Leary Index
Put a disclosing agent in the mouth, rinse, and count the red surfaces
Teeth have 4 surfaces, MLDF
NIDR Calculus Inex
0 = no calc 1 = supragingival calculus, but none subgingivial 2 = Supragingival and subgingival calculus OR just subgingival calculus
Reliability
If you run a test on the same patient multiple times, how likely you are to get the same result
Sensitivity
When disease is present, how likely you are to detect it
If its high, you won’t get false negatives
Specificity
When disease is not present, how likely you are to say its absent
If its high, you won’t get false positives
Predictive Value Positive
The probability of disease in a subject with a positive test result
Predictive Value Negative
The probability of no disease in a subject with a negative result
Herpetic Lesion syptoms
Painful gingivitis with redness
Ulcerations with serofibrinous exudate
Edema accompanied by stomatitis
Herpetic lesions Characterisitics
Incubation period is one week
Formation of vesicles, which rupture, coalesce, and leave fibrin-coated ulcers
Healing within 10-14 days
Recurrent HSV
Common presentation = herpes labialis
On vermillion border and/or adjacent to it
Intra-oral ulcers in attached gingiva and hard palate
Recurrent HSV treatmet
Limit bacterial superinfection (careful plaque control)
Can use antivials in immunocompromised patients
Herpes Zoster
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
Thrush
Candida albicans
Acquired during birth
Pseudomembranous/erosive lesions
Thrush Predisposing conditions
Antibiotics Immunosuppresion Malnutrition HIV Diabetes
Thrush oral locations
Can be just about anywhere
Thrush clinical manifestations
Pseudomembranous candidosis = white plaque
Erythematous candidosis = looks like gingivitis
Thrush diagnosis and treatment
via clinical signs and symptoms
Microscopic exam of smear - can be misleading
Correct predisposing factors and give antifungals
Lichen planus
Oral involvement alone is uncommon Dangerous because it has premalignant potential Characteristic skin lesions Varied clinical appearances Any area of the oral mucosa
Lichen planus Histopathology
Subepithelial band-like accumulation of lymphocytes
Characteristics of a type IV hypersensitivity
Fibrin in the basement membrane
Accumulation/Deposits of IgM, C3, C4, C5
Pemphigoid
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
Pemphigus
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
Acanthylosis
Canthus layer
Another name for Stratum spinosum (because it has bridges or ‘canthae’)
Breakdown of the spinous bridges
Necrotizing ulcerative gingivitis
Adolscents or young adults, smokers, adn individuals under stress
Pain, ulceration, and necrosis of the interdentinal papillae
Bleeding
Predisposing factors for NUG
Systemic disease like ulcerative colitis, blood dyscrasias, and nutritional deficiencies
Abnormalities of WBC functions
AIDS
NUG Treatment
OHI
Mechanical debridement
Systemic antibiotic treatment
Surgical correction of gingival destruction
Fibroma/Fibrous hyperplasia
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
Pyogenic granuloma
Ulcerated
Near gingival margin
Reddish or bluish, sometimes lobulated, sessile, or pedunculated
Bleeding is common
Highly vascular with chornic inflammatory cells
Peripheral giant cell granuloma
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
Periapical cemental dysplasia
Fibrous, osseous cemental lesions
Tooth is usually vital
Usually no symptoms
Periapical bone is replaced by fibroblastic tissue through a cementoblastic phase
Papilloma
Four or five different types of papiloma are present
Exophytic, pedunculated, or sessile lesions
Reddis or whitish gray in color
HPV common
Osteosarcoma
7% of osteosarcomas occur in the jaw
Clinical and radiographic exams are required
Widening of the PDL is common
