Exam 3 Flashcards
Pryophosphate
inhibitor of calcification that occurs in parotid saliva of humans in variable amounts. anticalculus component of tartar control dentrifices
Development of caries flow cart
Cariogenic food stuff
(fermentable carbohydrate taken into film)
Dental Biofilm
(rapid action, PH of biofilm drops)
acid formation
(forms immediately)
(frequent exposures of tooth surface to acid)
Demineralization
(caries process initiated)
(white spot incipient lesion)
cavitated carious lesion
canine relation of class 3
the distal surface of the mandibular canine is mesial to the mesial surface of the maxillary canine by at least the width of a premolar.
What are the 2 types of periodontal pockets?
Suprabony or Infrabony
Crystals
at least two-thirds of the inorganic matter matter of calculus is crystalline, principally apatitie. predominating is hydroxyapatite, which is the same crystal present in enamel, denton, cementum, and bone. Calculus also contains varying amounts of brushite, whitlockite, and octocalcium phosphate
Overjet
(measurement)
the horizontal distance between the labioncisal surfaces of mandibular incisors and the linguincisal surfaces of the maxiallry incisors. One way to measure the amount of overjet is to place the tip of a probe on the labial surface of the mandibular incisor, holding it horizontally against the incisal edge of a maxillary tooth, read the distance in millimeters. (usually no greater than 3 mm)
What are the stages of gingivitis and periodontitis divided into?
initial lesion, early lesion, established lesion, and advanced lesion
what are the three steps in calculus formation?
pellicle formation
biofilm formation
mineralization
canine relation of class 2 or distoclusion
the distal surface of the mandibular canine is distal to the medial surface of the max. canine by at least the width of the premolar.
effects of nifedipine
induced gingival enlargement (drug used for treatment of angina and ventricular arrhythmias)
What is a gingival pocket?
Pseduo pocket, not a true pocket and the gums are puffed against the tooth.
This is a pocket formed by gingival enlargement without apical migration of the junctional epithelium
tooth surface attached biofilm
plaque that is associated with calculus formation, root caries and root resportion
matrix
intracellular or intermicrobial substance of a tissue or the tissues from which a structure develops, gains support, and is held together
Where is supragingival calculus located?
on the clinical crown coronal to the margin of the gingiva. on implants, complete and partial dentures.
What is pellicle composed of?
Glycoproteins from saliva and absorbed by hydroxyapatite of the tooth surface
Edge to Edge bite
incisal surfaces of maxillary teeth occlude with incisal surfaces of mandibular teeth instead of overlapping as in normal occlusion
(anterior)
What instrument is used for furcation measurement?
Nabors probe
What is a periodontal pocket?
It is attachment loss.
It is a pocket formed as a result of the disease degeneration that caused the JE to migrate apically along the cementum.
moderate over bite
when incisal edges of maxillary teeth appear within the middle third of the mandibular teeth
mesognathic
having slightly protruded jaws which give the facial outline a relatively flat appearance. (slight profile)
this is normal
Adsorption
attachment of one substance to the surface of another. the action of a substance in attracting and holding other materials or particles to the surface
How much microbial bacteria is found in biofilm?
more than 500 distinct
initial lesion (microscopic lesion)
Occurs within 2-4 days of irritation from bacteria accumulation.
migration and infiltration of WBC into the JE and sulcus result from body response to infectious agents (tissue at base of socket)
increased gingival sulcus fluid (leads to edema)
early break down of collagen of the gingival fibers groups
fluid fills the space in the CT
When does pellicle form?
Pellicle is constantly forming. it forms within minutes after matierals has been removed from the surface
What is the number one sign of gingival inflammation?
Bleeding on probing
collagenase
enzyme that catalyzes the degradation of collagen
Fluoride in Calculus
The concentration of fluoride in calculus varies and is influenced by the amount of fluoride received from fluroride in the drinking water, topical application, dentrifices or any form that is received by contact with the external surface of calculus
trauma from occlusion
injury to the periodontium that results from occlusal forces in excess of the reparative capacity of the attachment apparatus also called occlusal traumatism
etiologic, predisposing, contributing or risk factors may be either….
local or systemic
How are the lines in the layers of calculus?
They are called incremental lines. only seen microscopically
where is the location of subgingival calculus?
(below the gum line)
it is on the clinical crown apical to the margin of the gingiva and extending nearly to the clinical attachment on the root surface on dental implants.
In normal Class 1 occlusion what are some general conditions that can occur?
Crowded maxillary or mandibular anterior teeth. Protruded or Retruded maxillary incisors. Anterior cross bite. posterior cross bite. medial drift of molars resulting from premature loss of teeth
aerobe
heterotrophic microorganism that can live and grow in the presence of free oxygen. some are obligate and others are facultative
How is calculus mineralization in people who have neglected oral hygiene?
it can begin as early as 24-48 hours
what happens in days 14-21 in changes in biofilm?
gingivitis is clinically evident
non surgical periodontal therapy (NSPT)
includes dental biofilm removal and biofilm control (by patient) supragingival and subgingival scaling, root planing, and the adjunctive use of chemotherapeutic agents for control of bacterial infection, desensitizing hypersensitive exposed root surfaces, and dental caries prevention as related to the health of the periodontium
severe over bite
when incisal edges of maxillary teeth are within cervical third of mandibular teeth
unattached biofilm
free floating bacteria
contains WBC, motile, gram -
other names for subgingival calculus
submarginal
serumal (source of minerals is in the blood serum. appears black)
what is a systemic factor?
a factor that results from or influenced by physical or mental disease or condition
periodontitis
inflammation in the periodontium affecting gingival tissues, periodontal ligament, cementum and supporting bone
Which type of pellicle is clear, translucent, insoluble, and not visible until disclosed?
Surface pellicle, unstained
Infrabony
Pocket in which base of pocket is below or apical to the crest of the alveolar bone
Have to have radiograph to see
Suprabony
Pocket in which base of pocket is coronal to the crest of the alveolar bone.
Horizontal bone loss
cross bites
posterior- maxillary or mandibular posterior teeth are either facial or lingual to their normal position. this condition may occur bilaterally or unilaterally.
anterior- incisors are lingual to the mandibular incisors
collagen
white fibers of the connective tissue
what does calculus have to do with perio diseases?
it is a local contributing factor
dental calculus
referred to as tartar. calculus is dental biofilm that has been mineralized primarily with calcium and phosphorus and occur on the teeth and prosthetic appliances worn in the mouth
edema
an accumulation of excessive fluid in cells, tissues, or a serous cavity
mineralization
addition of mineral elements, such as calcium and phosphorus to the body or a part thereof with resulting hardening of the tissue
Facial profile of Class 2 or distoclusion
retrognathic, maxilla protrudes, lower lip is full and often rests between the maxillary and mandibular incisors, the mandible appears retruded or weak
effects of cyclosporine
induced gingival enlargement (immunosuppressant drug used for patients with organ transplants to prevent rejection)
perio diseases and dental caries are…
infectious, transmissible diseases caused by pathogenic microorganism found in biofilm
facet
a shiny, flat worn spot on the surface of the tooth frequently on the side of a cusp
Calculogenic
adjective applied to the dental biofilm that is conducive to the formation of calculus
other names for supragingival calculus
supra marginal
extragingival
coronal indicating that the calculus is on the anatomical crown. salivary a term indicating the source of minerals is in the saliva
What happens in days 7-14 with changes in biofilm?
Inflammation can be observed in the gingiva
End to End bite
molars and premolars occlude cusp to cusp as viewed mesiodistally
(posterior)
prognathic
having a prominent, protruded mandible and normal(usually) maxilla (concave profile)
bulldog jaws
types or facial profiles:
mesognathic
retrognathic
prognathic
which type of pellicle is embedded in tooth structure, particularly where tooth is demineralized?
subsurface pellicle
Trace elements of calculus
Various trace elements have been identified. trace elements include Chlorine (Cl), Zinc (Zn), Strontium (Sr), Bromine (Br), Copper (Cu), Manganese (Mn), Tungsten (W), Gold (Au), Aluminum (Al), Silicon (Si), Iron (Fe), and fluorine (F)
inorganic components of calculus
the main components of calcium (Ca), Phosphorus (P), Carbonate (CO3), Sodium (Na), Magnesium (Mg), Potassium (K)
mechanism of mineralization
heavy calculus formers have higher salivary levels of calcium and phosphorus than do light calculus formers. light calculus formers have higher levels of parotid pyrophosphatr. pyrophostate is an inhibitor of calcification and is used in anti calculus dentrifices
Three types of pellicles
surface pellicle, unstained
surface pellicle, stained
subsurface pellicle
Organization of subgingival biofilm
tooth surface attached biofilm
unattached biofilm
epithelial associated biofilm
source of subgingival calculus
the gingival sulcus fluid and the inflammatory exdudate supply the minerals for the subgingival deposits
parafunctional
abnormal or deviated function, as in bruxism
what is the effect of phenytoin?
induced gingival enlargement (drug uses for seizures)
Class 2, Division 2
Anterior teeth flare out
the mandible is retruded and all maxillary incisors are protruded.
ex- deep over bite, excessive over jet, abnormal muscle function (lips), short mandible or short upper lip
biofilm
dynamic, complex, multi species communities of microorganisms that colonize the oral cavity. unique characteristics allow biofilms to adapt to a variety of every changing environments. characteristics include- tenacious adherence to surfaces, protective EPS, 3D structures with complex nutrient and communication pathways.
Acellular
not made up of or containing cells
What is occlusion?
the relationship of the teeth in the mandibular arch to those in the maxillary arch as they are brought together.
What are the functions of attached gingiva?
Give support to the marginal gingival
withstand stresses of mastication and tooth brushing
provide attachment for moveable alveolar mucosa
what is the cause of
perio disease?
bacteria
Which type of pellicle can have extrinsic stain and be brown, grayish and other colors?
surface pellicle, stained
Tooth position of malocclusion
Crowded or overlapped
rotated
deep anterior over bite
tongue thrust
the infantile pattern of suckle swallow movement in which the tongue is placed between the incisor teeth or alveolar ridges- may result in an anterior open bite, deformation of the jaws and abnormal function
material alba
white or cream colored cheesy mass that can collect over dental
biofilm on unclean neglected teeth. it is composed of food debris, mucin, bacteria sloughed epithelial cells
normal over bite
when incisal edges of maxillary teeth are within the incisal third of the mandibular teeth
Facial profile of Class 3
Prognathic, lower lip and mandible are prominent
biofilm maturation
microorganisms settle in the pellicle layer. colonies are formed. in early calculus the colonies consist of primarily of cocci and rod shaped organisms. by the fifth day, the biofilm is mostly made up of filamentous organisms. the colonies grow together to form a cohesive biofilm layer.
Class 2 or distoclusion
Mandibular teeth posterior to normal position in their relation to maxillary teeth
risk factor for periodontal disease
effect of certain drugs
phenytoin
cyclosporine
nifedipine
this is loosely adherent mass of bacteria that occurs on top of biofilm where removal is neglected. this is a product of informal accumulation of living and dead bacteria, desquamated epithelial cells, disintegrating leukocytes, salivary proteins and possible a few particles of food debris
matieral alba
what is used in toothpaste to prevent calculus?
pryophosphates, zinc, triclosan
What is a local factor?
Factor in the immediate environment of the oral cavity or specifically in the environment of the teeth or periodontium
Where is the most supragingival calculus?
most frequent sites. on the lingual surfaces of mandibular anterior teeth and the facial surfaces of maxillary first and second molars. opposite the openings of the ducts of the salivary glands
xerostomia
dryness of the mouth from lack of normal secretions
Open bite
Lack of occlusal or incisal contact between certain maxillary and mandibular teeth because either or both have failed to reach the line of occlusion. the teeth cannot be brought together and a space remains as a result of the marching of the line of occlusion
pellicle formation
the pellicle, or cuticle, is composed of mucoproteins from the saliva and is an acellular material. the pellicle begins to form within minutes after all deposits have been removed from the tooth surface
malrelations of groups of teeth
crossbites edge to edge bite end to end bite open bite over jet underjet overbite
In the formation of biofilm, what organisms are exiting in the first few hours?
Gram + cocci and rods
require oxygen
indus
nucleus, focus, point of origin
What is the rule of thumb for normal occlusion class 1?
The Mesiobuccal cusp of maxillary 1st molar occludes with the buccal groove of the mandibular 1st permanent molar
What is a pocket?
Diseased sulcus
a pocket has an inner wall(the tooth surface), and an outer wall (the sulcular epithelium) of the free gingiva
composition of calculus
mature calculus contains between 70% and 90% inorganic components. the rest is organic components and water
toxin
a poison, protein produced by certain animals, higher plants and pathogenic bacteria
iatrogenic
resulting from treatment by a professional person
class 2, division 2
the mandible is retruded and one or more maxillary incisors are retruded.
ex- max lateral incisors protrude while both central incisors retrude, crowded maxillary ant. teeth or deep over bite.
anterior teeth go in
what is used to detect calculus?
11/12 or pig tail explorer
Tobacco
the use of tobacco, any form, is a major risk for periodontal involvement.
don’t bleed on probing because nictotine contacts blood vessels
Molar relation of Class 2 distoclusion
The buccal groove of the mandibular first perm. molar is distal to the MB cusp of max 1st molar by at least the width of a premolar.
maxilla will protrude
leukocyte
white blood corpuscle capable of amoeboid movement. functions to protect the body against infection and disease
Underjet
maxillary teeth are lingual to mandibular teeth. measurable horizontal distance between the labioincisal surfaces of the maxillary incisors and the linguoincisal surfaces of the mandibular incisors.
food impaction
the forceful wedging of food into the periodontium by occlusal forces
cariogenic
adjective to indicate a conduciveness to the initation of dental caries such as a cariogenic biofilm or a cariogenic food
malocclusion
any deviation from the physiologically acceptable relationship of the maxillary arch and or teeth to the mandibular arch or teeth
source of supragingival calculus
saliva
formation time of calculus
average time is 12 days. within a range from 10 days for rapid calculus formers to 20 days for slow.
Local contributing factors to disease development
Biofilm is the primary etiologic factor in development of gingival and periodontal diseases
Overbite
Everybody has this. 3 types- normal moderate severe
Iatrogenic
something caused by a dental professional
rough or grooved surface after scaling
inadequately contoured restoration
subdivision
one side is class 1, other side is class 2
Molar relation class 3
The buccal groove of the mandibular first perm. molar is medial to the MB cusp of the max. first perm molar by at least the width of the PM
gingivitis
inflammation of the gingival tissues
pathologic migration
the movement of a tooth out of its natural position as a result of periodontal infection. contrasts with mesial migration, which is the physiologic process maintained by tooth proximal contacts in the normal dental arches
Radiographic examination
not useful for calculus detection because of highly mineralized tooth structure superimposed over calculus deposits. thick highly mineralized calculus may he detected on proximal tooth surfaces. looks like spurs between teeth
food impaction
forceful wedging of food into the periodontium by occlusal forces
retrognathic
having a prominent maxilla and a mandible posterior to its normal relationship. (convex profile)
What are the 4 factors involved in development of gingival and periodontal diseases?
Etiologic factor (actual cause, always biofilm)
Predisposing factor (renders a person succeptible to disease or condition)
contributing factor (lends assistance to disease, always calculus)
risk factor (exposure to increase probability that disease will occur)
anaerobe
heterotrophic microorganism that lives and frowns in the complete or almost complete absence of oxygen. some are obligate and others are facultative
What substances are found in a pocket?
microorganisms and their products
gingival sulcus fluid
desquamted epitelial cells
leuokcytes, the numbers increase as inflammation increases
exdudates (pus)
What is the distribution of subgingival calculus?
may be generalized or localized on single teeth or a group teeth. heaviest deposits are related to areas most difficult for the patient for the patient to access during personal oral biofilm removal procedures
centric relation
the most unstrained, retruded psyologic relation of the mandible to the maxilla from which lateral movements can be made
bacterial changes go from…
gram + to gram -
aerobic to anaerobic
epithelial associated biofilm
loosely attached to pocket epithelium, maybe considered a focal point for advancement of perio infection from this later microorganisms invade underlying connective tissue
what is a major objective in nonsurgical periodontal therapy?
to prepare teeth, through calculus removal, to have biologically acceptable smooth surfaces (leave surface rough enough for PDL fibers to re attach)
Normal (ideal) occlusion
the ideal mechanical relationship between the teeth of the maxillary arch and the teeth of the mandibular arch is as follows: all teeth in the maxillary arch are in the maximum contact with all teeth in the mandibular arch in definite patten. maxillary teeth slightly overlap mandibular teeth on the facial surfaces
refractory
not readily responsive to treatment
trauma from occlusion does not…
does not cause gingivitis, periodontitis, or pocket formation. in the presence of inflammatory disease, the existing periodontal destruction may be aggravated or promoted by traumatic occlusion.
Class 3 (mesiocclusion)
the mandibular teeth are anterior to normal position in relation to maxillary teeth. the mandible is further out
Apatite
crystalline mineral component of bones and teeth that contains calcium and phosphate
