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Perio > Final > Flashcards

Final Flashcards

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
Q

NSAIDS

A

Reduce inflammation by action of prostaglandins
Can inhibit osteoclast activity
Acceleration of bone loss when stopped
Not approved to treat perio

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26
Q

Bisohosphonates

A

They alter osteoclast activity. Inhibits resorption

Side effects include jaw osteonecrosis and reduction in osteoclast survival and function. Not approved to treat perio.

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27
Q

Statins

A

Appear to offer protection against systemic inflammation

28
Q

How many perio cases are attributed to current smoking

A

42.9%

29
Q

What’s the increased risk of perio in cigarette smokers?

A

2-3x

30
Q

True or false
Smokeless tobacco is associated with severe buccal recession

A

True

31
Q

In patients that smoke, what is their biofilm colonized by?

A

P. Gingivalis

32
Q

Why isn’t perio always clinically obvious in smokers?

A

Nicotine has vasoconstrictor qualities which impair blood flow. This will cause low signs of inflammation. Igg production is decreased, and so are neutrophils.

33
Q

True or false, bone loss in smokers is dose dependent

A

True. Usually 10 cigs

34
Q

What is biologic width?

A

Portion of the periodontium coronal to the alveolar crest. Basically the combined areA of the JE AND CT

35
Q

True or false, alveolar bone resorption can result from increased pressure from teeth

A

True

36
Q

What are clinical and radiographic signs of occlusal trauma?

A

Tooth mobility
Sensitivity to pressure
Migration of teeth
Widened funnel shaped pdl
Angular alveolar bone resorption

37
Q

What is primary occlusal trauma?

A

Wide pdl
Mobility
Tooth/jaw pain
REVERSIBLE WHEN TRAUMA IS REMOVED
Excessive occlusal forces on intact periodontium

38
Q

Secondary occlusal trauma

A

Normal or excessive forces on periodontitis
Inflammation plus OT-rapid bone loss
Addition damage due to lateral forces

39
Q

AGE

A

Advanced glycation end products

40
Q

RAGE

A

Receptor for advanced glycation end products

41
Q

Glycation

A

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
Q

Where is RAGE found

A

On cell membrane surface of endothelial, neurons, monocytes/macrophages and periodontium

43
Q

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

A

True

44
Q

True/false acute stress is immunoenhancing

A

True

45
Q

Linear gingival erythema

A

Associated with HIV, form of candidiases, non biofilm induced, not responsive to conventional therapy.

46
Q

Virulence factor

A

Mechanisms that enable biofilm bacteria to colonize and damage periodontal tissues

47
Q

LPS-lipopolysaccharide

A

Gram - bacteria responsible for initiating inflammation

48
Q

T/f prostaglandins initiate most of the alveolar bone destruction in periodontitis

A

True

49
Q

Innate

A

First line against pathogens
No memory

50
Q

Adaptive

A

Develops throughout life
Requires time to react
Memory. Reacts quick on second exposure to same pathogen

51
Q

PMNs and macrophages

A

Release cytokines which sends ADDITIONAL phagocytic cells
Release lysosomes

52
Q

B lymphocytes

A

Produce immunoglobulin

53
Q

Immunoglobulins

A

Neutralize bacteria
Activate complement system

54
Q

PMNs extended

A

First line of defense
Short lived
Chemotaxis
Pd bacteria get ate by pms

55
Q

Leukocytes

A

Numerous in chronic inflammation

56
Q

How long does it take for free floating microbes to attach to a surface?

A

Minutes

57
Q

How long does it take microbes to form strongly attached micro colonies

A

2-4 hrs

58
Q

How long does it take the production of extra cellular protective matrix to increase resistance

A

6-12 hours

59
Q

How long does it take for mature colonies to be resistant to antibiotics

A

2-4 days.

60
Q

T/f in health, all epithelial lined surfaces are colonized by biofilm

A

True

61
Q

What are the early colonizer bacteria’s?

A

Streptococcus, s.mitis, s.oralis

62
Q

Titanium advantages

A

Biocompatible, poor conductor

63
Q

Disadvantages of titanium

A

Soft, scratches Easy. Particles in tissue can cause periimplantitis and periomucositis in some patients

64
Q

Implant abutment

A

Attaches to implant body
Supports restoration
Transition between crest of bone and oral cavity
Soft tissue Adapts to titanium surface

65
Q

Natural tooth vs implant

A

Implant has bio seal
No cementum
CT fibers run parallel
No pdl

66
Q

Prevalence of periimplant mucositus

A

80% of subjects, 50% of implant sites

67
Q

Periimplantitis prevalence

A

27-56% of subjects
12-43 of implant sites

Perio (1 decks)

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