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Final Flashcards

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1
Q

Where does tetracycline concentrate

A

Gingival cervical fluid

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2
Q

What does tetracycline inhibit the action of?

A

Collagenase

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3
Q

How is tetracycline effective?

A

In subantimicrobial doses. 20mg without development of antibiotic resistance

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4
Q

What are the benefits of topically delivered chemical agents (chlorhexidine and tetracycline)

A

Small gains in attach level
Use with srp
Benefits patients/sites not responsive to surgery.

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5
Q

What are some problems with therapeutic mouth rinses?

A

Essential oils may burn mouth and dry out the membranes. Chlrhxdine stains teeth and can discolor tongue, may alter taste and increase calc formation.

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6
Q

What are goals of perio maint?

A

Minimize recurrence and regression of perio
Reduce incidence of tooth loss
Increase the probability of detecting and treating other oral conditions

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7
Q

How long does it take for pathogens to return to pre-instrumentation levels?

A

Approx 9-11 weeks

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8
Q

What are clinical recognitions of recurrence?

A

Progressive attach loss
Pockets deeper over time
BOP
Exudate
X-ray showing bone loss
Increased mobility

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9
Q

What is the impact zone in irrigation?

A

Initial fluid contact area near the gingival margin

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10
Q

What is the flushing zone?

A

Depth of penetration sub-g

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11
Q

True or false, WITH BRUSHING, Water irrigation is more effective than just brushing and flossing

A

True

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12
Q

True or false, water flossed can reduce pathogens in pockets up to 6mm

A

True

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13
Q

True or false, water glosser shows a reduction in inflammatory mediators IL-1b and PGE2

A

True

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14
Q

What percentage of the pocket does the water flosser penetrate?

A

50%

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15
Q

What is the mechanism of action?

A

Trace ging margin at a 90degree angle and start on low power. Work to medium as tissue improves

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16
Q

How deep does the RUBBER TIP penetrate?

A

90% to pockets less than or = to 6mm
64% to pockets over 7mm
Direct at 45 degree angle

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17
Q

Why is conservation of cementum necessary?

A

Optimum perio health and perio regeneration

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18
Q

What are some tissue responses after SRP?

A

Tissue Shrinkage, recession
Readapt root surface by long JE
little change. Residual pocket depth

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19
Q

When should an perio eval take place?

A

4-6 weeks

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20
Q

What is the inflammatory response?

A

Protective mechanism that keeps the infection from doing serious harm to the periodontium through mediators IL-4 and IL-10

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21
Q

Pro-inflammatory mediators

A

Lead to damage of the perio
IL-6 and IL-1
Mmps-collagenase

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22
Q

What is collagenase?

A

Collagen breakdown part of the fundamental pathology in periodontitis

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23
Q

Purpose of doxycycline

A

Inhibits the effects of collagenase, and inhibits part of the destruction that can occur in perio

It also has a low incidence of adverse effects

Can reduce probe depths and result in attachment gains. Can also prevent disease progression.

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24
Q

Chemically modified tetracycline

A

Suppresses bone resorption
Inhibits MMPs
No development of resistant or GI toxicity
UNDER INVESTIGATION

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25
NSAIDS
Reduce inflammation by action of prostaglandins Can inhibit osteoclast activity Acceleration of bone loss when stopped Not approved to treat perio
26
Bisohosphonates
They alter osteoclast activity. Inhibits resorption Side effects include jaw osteonecrosis and reduction in osteoclast survival and function. Not approved to treat perio.
27
Statins
Appear to offer protection against systemic inflammation
28
How many perio cases are attributed to current smoking
42.9%
29
What’s the increased risk of perio in cigarette smokers?
2-3x
30
True or false Smokeless tobacco is associated with severe buccal recession
True
31
In patients that smoke, what is their biofilm colonized by?
P. Gingivalis
32
Why isn’t perio always clinically obvious in smokers?
Nicotine has vasoconstrictor qualities which impair blood flow. This will cause low signs of inflammation. Igg production is decreased, and so are neutrophils.
33
True or false, bone loss in smokers is dose dependent
True. Usually 10 cigs
34
What is biologic width?
Portion of the periodontium coronal to the alveolar crest. Basically the combined areA of the JE AND CT
35
True or false, alveolar bone resorption can result from increased pressure from teeth
True
36
What are clinical and radiographic signs of occlusal trauma?
Tooth mobility Sensitivity to pressure Migration of teeth Widened funnel shaped pdl Angular alveolar bone resorption
37
What is primary occlusal trauma?
Wide pdl Mobility Tooth/jaw pain REVERSIBLE WHEN TRAUMA IS REMOVED Excessive occlusal forces on intact periodontium
38
Secondary occlusal trauma
Normal or excessive forces on periodontitis Inflammation plus OT-rapid bone loss Addition damage due to lateral forces
39
AGE
Advanced glycation end products
40
RAGE
Receptor for advanced glycation end products
41
Glycation
Blood glucose irreversibly binds to proteins and lipids forming AGE which are harmful by products Increased AGE causes neuropathy, retinal disease, and kidney failure in diabetics. Allegedly degrade collagen elastin
42
Where is RAGE found
On cell membrane surface of endothelial, neurons, monocytes/macrophages and periodontium
43
True/false, AGE+RAGE is a major factor for exaggerated periodontal and systemic inflammation, insulin resistance, and impaired tissue repair in diabetic patients with perio
True
44
True/false acute stress is immunoenhancing
True
45
Linear gingival erythema
Associated with HIV, form of candidiases, non biofilm induced, not responsive to conventional therapy.
46
Virulence factor
Mechanisms that enable biofilm bacteria to colonize and damage periodontal tissues
47
LPS-lipopolysaccharide
Gram - bacteria responsible for initiating inflammation
48
T/f prostaglandins initiate most of the alveolar bone destruction in periodontitis
True
49
Innate
First line against pathogens No memory
50
Adaptive
Develops throughout life Requires time to react Memory. Reacts quick on second exposure to same pathogen
51
PMNs and macrophages
Release cytokines which sends ADDITIONAL phagocytic cells Release lysosomes
52
B lymphocytes
Produce immunoglobulin
53
Immunoglobulins
Neutralize bacteria Activate complement system
54
PMNs extended
First line of defense Short lived Chemotaxis Pd bacteria get ate by pms
55
Leukocytes
Numerous in chronic inflammation
56
How long does it take for free floating microbes to attach to a surface?
Minutes
57
How long does it take microbes to form strongly attached micro colonies
2-4 hrs
58
How long does it take the production of extra cellular protective matrix to increase resistance
6-12 hours
59
How long does it take for mature colonies to be resistant to antibiotics
2-4 days.
60
T/f in health, all epithelial lined surfaces are colonized by biofilm
True
61
What are the early colonizer bacteria’s?
Streptococcus, s.mitis, s.oralis
62
Titanium advantages
Biocompatible, poor conductor
63
Disadvantages of titanium
Soft, scratches Easy. Particles in tissue can cause periimplantitis and periomucositis in some patients
64
Implant abutment
Attaches to implant body Supports restoration Transition between crest of bone and oral cavity Soft tissue Adapts to titanium surface
65
Natural tooth vs implant
Implant has bio seal No cementum CT fibers run parallel No pdl
66
Prevalence of periimplant mucositus
80% of subjects, 50% of implant sites
67
Periimplantitis prevalence
27-56% of subjects 12-43 of implant sites

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