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Oral Soft tissues > Exam2 part 1 > Flashcards

Exam2 part 1 Flashcards

1
Q

Describe phase 1 of the periodontal treatment phases

A

Phase 1: Initial (soft tissue) Therapy

  • Scaling and Root Planing (SRP) - removal of accretions on the root
  • Oral Hygiene Instruction (OHI)
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2
Q

When is the re-evaluation done in PD treatment and what is done at this time

A

4-6 weeks after initial therapy is completed

- Re-collect and analyze data

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3
Q

Describe phase 2 of the PD treatment phases

A

Phase 2: Surgical Therapy (hard tissue)

  • Bony defects
  • Grow bone back
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4
Q

What phase occurs during periodontal treatment after re-evaluation or of phase 2 if treatment has been successful

A

Maintenance phase

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5
Q

Calculation of attached ginigva

A
  1. AG=KG - Probing depth OR

2. AG = (GM to MGJ) - Probing depth

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6
Q

Calculation of CAL

A

CAL = PD + CEJ to GM (+ if apical, - if coronal)

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7
Q

Where does periodontal disease start in the mouth

A

Starts at most coronal part of interproximal tissue and migrates apically

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8
Q

What cells are found in gingiva

A 
Squamous epithelium
Keratinocytes
Nonkeratinocytes
- Melanocytes - pigment
- Langerhan's cells - antigen presenting
- Merkel Cells - free nerve endings
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9
Q

Name and define each of the ginigval fibers

A

Circular: Support & contour to free gingiva
Dentogingival: support of the gingiva
Dentoperiosteal: anchors tooth to bone
Alveologingival: attaches gingiva to alveolar bone
Transseptal: Keeps teeth in alignment and protects bone

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10
Q

What type of tissue characterizes the fiber groups

A

Type 1 and 3 collagen

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11
Q

Name and define each of the periodontal fibers

A

Alveolar Crest: Resists lateral movement
Horizontal: Opposes lateral forces
Oblique: absorbs occlusal forces (largest group)
Apical: Resists tipping of the tooth
Interradicular: Resists forces of luxation (pulling out) and tipping

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12
Q

Describe the MGJ (3)

A
  1. MGJ does not change, line is permanent
  2. Line of demarcation between alveolar mucosa and attached gingiva
  3. MGJ is point at which keratinized and non-keratinized epithelium meet
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13
Q

What is the relationship between smoking and GCF flow

A

There is immediate transient but marked increase

  • Increased crevicular fluid at the smoking event
  • Smoking has stunted inflammatory reaction
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14
Q

What is the role of GCF

A

It is a type of host defense mechanism

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15
Q

Is there a difference in GCF between healthy and unhealthy people

A

Healthy: Present in small amount
Diseased: Present in larger quantity in people with gingivitis causing tissue to look wet

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16
Q

Describe the composition of GCF

A

**IgG

Proteins, Ag, Ab (IgG), Enzymes, epithelial cells, leukocytes, electrolytes (K, Ca), Organic comp.

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17
Q

T or F, The GCF flow determines the permeability of the sulcular epithelium

A

True

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18
Q

What is the normal level of GCF

A

Normal = 0.43 to 1.56 uL (no gingivitis)

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19
Q

Levels of GCF increase with what 5 things

A
  1. Circadian rhythm: from 6 AM to 10 PM
  2. Inflammation: removes products
    • Initial pathogenesis stage –> increase
  3. Female sex hormones
  4. Mechanical: chewing gum
  5. Immediate increase w/ smoking event
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20
Q

How do you test for GCF

A

Test with filter paper (threads or micropipette) at gingival sulcus and analyzed with Perioton

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21
Q

Is tetracycline higher or lower in GCF than in serum

A

Higher

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22
Q

Drug induced gingivitis begins where and spreads how?

A

Starts at interdental papilla extends to facial/lingual margins, can cover root surfaces

23
Q

T or F, Drug induced gingivitis is only due to plaque specific association

A

False, may or may not be plaque-associated

24
Q

What drugs are associated with drug induced gingivitis

A
  1. Anti-Convulsants/Anti-seizure (Dilantin)
  2. Ca Channel blockers (Nifedipine, Diltizen, Verpamil)
  3. Immunosuppressants (Cyclosporine, Tacrolimus)
  4. Oral contraceptives
25
Q

Describe the action of drugs like Dilantin

A

Stimulates fibroblast proliferation, inactivation of collagenase

  • Plaque induced
  • Dose response is questionable
26
Q

Describe action of drugs like Nifedipine, Diltizen, & Verpamil

A

Increase in cellular production and breakdown??

- Verapamil + cyclosporine given to kidney transplant patients in combination

27
Q

T or f, Immunosuppresants that are involved in drug-induced gingivitis are dose related

A

true

28
Q

Describe the 3 main categories involved in plaque induced disease

A
  1. Systemic factors (Endocrine, Blood dyscrasias)
  2. Drugs
  3. Malnutrition (Vit. deficiency, Scurvy)
29
Q

What 5 main categories involved in Non-plaque induced disease

A
  1. Microorganism (Bacteria, Virus, Fungal)
  2. Systemic disease (benign mucous membrane pemphigoid)
  3. Trauma (toothbrush abrasion)
  4. Foreign body reactions (popcorn kernal, ortho)
  5. Genetic (hereditary gingival fibromatosis)
30
Q

Chronic gingivitis classification:

  • localized or generalized
  • Severity
A

Localized: 30% of sites involved
- Diffuse: GM + AG + Papilla

Severity of CAL = soft tissues, bone loss, probing
Slight: 1 or 2 mm CAL
Moderate: 3 to 4 mm CAL
Severe: 5+ mm CAL

31
Q

When we speak about a percentage of sites being either localized or generalized, what sites are used to count percentage

A

Each tooth has 6 sites, so, total # of teeth x 6.

Sites= Mesial buccal, Straight buccal, Distal buccal, Distal palate, Straight palate, Mesial palate

32
Q

T or F, Aggressive gingivitis is most prevalent in adults but can occur in children or adults

A

False, Chronic gingivitis

33
Q

Describe clinical presentation of Chronic Gingivitis

A

Plaque & calculus present
Redness
BOP (bleeding on probing)

34
Q

T or F, Chronic gingivitis mainly occurs in younger patients who are otherwise healthy

A

False, Acute/Agressive gingivitis

35
Q

Describe difference betwen localized and generalized in Acute/Aggressive gingivitis:

A

Localized: Molars/Incisors
Generalized: Molars/Incisors/and other teeth

36
Q

What bacteria plays a significant role in Acute/Aggressive gingivitis

A

A. actinomycetemcomitans

37
Q

In which race is Acute/Aggressive gingivitis more prevalent

A

African Americans

38
Q

Define gingival abscess

A

A localized purulent infection that involves the marginal gingiva and interdental papilla

39
Q

Describe the 3 main points of the clinical features of gingival abscesses

A
  1. Localized swelling - marginal or interdental
  2. Red, smooth, shiny surface
  3. May present purulent exudate (not firm)
40
Q

Describe the etiology of gingival abscesses

A
  1. Bacteria carried into gingival tissue
  2. Foreign body
    - Popcorn hull
    - Toothbrush bristle
    - Fingernail
    - Dental materials
41
Q

Treatment of gingival abscess

A
  • If fluctuant, establish drainage
  • Debridement (removing gross debris)
  • Rinse (saline or CHX)
  • Follow-up
42
Q

T or F, Gingival abscesses are not cysts, not encapsulated but tend to cause bone loss and pocket formation

A

False, All true except that they do not cause bone loss or pocket formation

43
Q

Clinical features of periodontal abscesses (6)

A
  1. Localized purulent inflammation in periodontal tissues
  2. Dull, constant pain, recent origin
  3. Edematous, erythematous, smooth, shiny surface
  4. Discharge of pus with probe or pressure
  5. Mobility
  6. Rapid pocket formation
44
Q

Describe the etiology of periodontal abscess

A
  1. Extension from infected pocket
  2. Incomplete removal of calculus
  3. Root fracture
  4. Multiple abscesses
    - Think systemic disorder (diabetes, immunosuppression)
45
Q

Describe microscopically periodontal abscess

A

Localized accumulation of viable and non-viable PMNs within the pocket wall

46
Q

Describe microbiologically periodontal abscess

A

Gram negative MO, fusiforms and spirochetes

47
Q

Pericoronal (periodontal abscess)

A

Over a partially erupted tooth (over the crown)

48
Q

What type of gingivits is pregnancy gingivitis classified as

A

Plaque induced gingivitis

- Including (prevotella intermedia) - uses steroids as growth factor

49
Q

How is pregnancy gingivitis distributed throughout the mouth

A

Marginal and generalized

50
Q

Prevention of pregnancy associated gingivitis

A

Plaque control

51
Q

T or F, pregnancy associated gingivitis causes a decrease in GCF

A

False, an increase

52
Q

How long will pregnancy associated gingivitis last

A

Goes away after pregnancy

53
Q

Name 4 risk factor for PD

A

Microbial –> specific organism, total microbial burden, biofilm pathogenicity
Systemic –> diabetes (DM), genetics, sex, race, HIV
Behavioral –> tobacco use, patient compliance
Local –> restorations, tooth anatomy, malocclusion

Oral Soft tissues (5 decks)

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