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Periodontics > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What is the basis for patient care?

A
  • ADPIED
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2
Q

What do we do for documentation?

A

Reference
History
Educational
Medical and legal

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3
Q

What do take for medical history ?

A
  • Ensures safety of PT
  • Aids Clinician
  • Verified with interview
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4
Q

What do we take for Dental History ?

A

Chief Complaints
All dental past and present history
ORal practices
Habits

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5
Q

Why do we do EO/IO?

A

To know the presence of path

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6
Q

What are the gingival caracteristics?

A

Color
Contour
Consistency
Texture

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7
Q

What does OH assess?

A

Plaque
Calculus
Tooth Topograghy
Stain

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8
Q

What are the different types of stains?

A

Brown: Tobacco and Stainous Flouride
Green: Enamel cuticle, flurorescent bacteria
Orange : Chromogenic bacteria
Black: Ferric Sulfide (With Good Oral Hygiene)

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9
Q

What is Probing depth ?

A
  • Support treatment decisons
  • Cannot detect disease activity or predict destruction
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10
Q

What are the furcation involvement grades?

A

Grade I- Interradicular bone intact
Grade II- Interradicular bone loss
Grade III- Complete loss no communication to otherside
Grade IV- Loss attachment and gingival recession

FITS

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11
Q

What are the mobilty grade?

A

Grade 0; physiological
1: Slight BL
2: Moderate BL
3: Severe BL, MD and depression

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12
Q

What is Fremitus?

A

Vibrational movement- only maxillary teeth tested

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13
Q

What is the G.V blacks classifications?

A
  • Class 1: Pits and fissures
  • Class 2: Proximal areas Premolars and molars
  • Class 3: Proximal incisors and Canine ( No edge)
  • Class 4: Proximal incisors and Canine ( with edge)
  • Class 5: Gingival third cavities
  • Class 6: Incisal and cusp tip
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14
Q

What type of epithelium is the gingiva?

A

Stratified squamous epithelium

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15
Q

What is the gingival epithelium?

A

Protection of underlying structures

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16
Q

What are the epithelial layers of the oral cavity?

A
  • Corneum
  • Granulosum
  • Spinosum
  • Basal
  • Lamina propria
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17
Q

What are the major cell types within the mouth?

A
  • Kerotinocytes- Responsible for color
  • Melanocytes- Dendritic cell and synthesizes melanin
  • Langerhans cells- Spinosum, phagocytes: early defense
  • Merkel cell- touch cell
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18
Q

What are the sulcular epithelium?

A
  • Lines the gingival sulcus
  • Acts as a semipermeable membrane
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19
Q

What is the Junctional epithelium?

A
  • As two layers: Basale and spinosum
  • Attached by epithelial attachment
  • Basement lamina and hemidesmosomes from enamels
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20
Q

What are the turn over time ?

A

Palate , tongue, cheek: 5-6 days
Gingiva: 10-12 days
JE: 4.7 days

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21
Q

What does the disease needs to developement ?

A

Causative Agent
Environment
Host

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22
Q

Bacterial plaque contributes to periodontal breakdown by:

A

Direct injury to tissues
Indirect activation of host immune and inflammatory systems

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23
Q

What are the host responses?

A
  • Protective: defence mechanism
  • Destructive: Tissue destruction
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24
Q

What are the stages of inflammation ?

A
  • Immediate
  • Acute
  • Chronic
  • All is controlled by granulocytes and agranulocytes
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25
Q

What is acute inflammation?

A

Calls other cells
* neutrophils
* macrophages
* lymphocytes

neutro and macro eliminates = phagocytosis

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26
Q

What is Chronic Inflammation ?

A

Immune System activated

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27
Q

What are the leukocytes?

A

Granulocytes:
neutrophils= 1st to arrive and PMNS
eosinophils= Allergic respinse
basophils= increase vascular permeability

Agranulocytes: Lymphocytes- blastlike cells multiply as immunologic needs arises.
Monocytes: 2nd cell to help in inflam response ( For Chronic inflammation)

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28
Q

What does neutrophils produce?

A

Prostaglandins and cytokines

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29
Q

Macrophages produces?

A
  • Destructive enzymes
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30
Q

Mast cells produces?

A

Inflammatory mediator and anaphylaxis

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31
Q

What does the complement system do?

A

Destroys pathogens (lysis)

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32
Q

What is the function of leukocytes?

A
  • Phagocytic, immunologic and of functions related to inflammatory process
  • Detection and monitoring of disease states
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33
Q

T- Lymphocytes comes from?

A

Derived from stem cells and matures in thymus

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34
Q

What are the inflammaortoy biochemical mediators?

A

Cytokines
Prostaglandins
Matrix Metalloproteinases

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35
Q

What interleukin ( Cytokines) are important to periodontitits?

A
  • Interleukin 1,6,8 and TNF-a (Tissue neucrosis factor)
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36
Q

What are other protective response?

A

Gingival sulcular fluid: present during inflammation
Saliva: Lubrication, physical protectionm cleaning, buffering, remineralizing

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37
Q

What is material alba vs Oral biofilm?

A

Material alba- loosely adherent
mass of bacteria, viruses and yeasts.
Oral Biofilm- Attached to surfaces and one another

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38
Q

Describe bacteria microcolonies?

A
  • Not evenly distrubuted
  • Forms mushroom shaped
  • Attached to tooth with narrow base
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39
Q

What is the glycocalyx (slime layer)?

A

Glucose polymer glucan (made by bacteria)
Protective barrier- adherence and aggregation

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40
Q

what is the fluid channels?

A

Fluid channels that penetrates slime layer and provides nutrients and oxygen to bacteria. This helps with movement

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41
Q

What is dental biofilm?

A
  • Adherenes tenaciously to tooth surfaces and restorations and others
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42
Q

What is symbiosis and dysbiosis?

A

Sym: Normal flora
Dysbiosis: imbalance

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43
Q

What is subgingival biofilm?

A

It is resistant to everything except mechanical removal.

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44
Q

What is the pattern of development?

A
  • Attachement
  • inital colonization (2 days)
  • Secondary colonization
  • Extracelluar slime layer
  • Formation
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45
Q

What is subgingival plaque?

A
  • supragingival plaque influences it
  • anaerobic
  • Motile
  • Gram-
  • Causes direct injury
  • HAs 3 zones
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46
Q

What are the 3 zones of subgingival plaque?

A
  • Tooth attachemnt- Less Varelent (Gram +)
  • Epithelial (Densly pack)- More varelent ( Gram -)
  • Unattached (Gram + -)
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47
Q

What are the two bacterial characteristics ?

A

Health- Gram pos, saccharolytic (needs sugar)
Disease- Gram Neg, Asaccharolytic (needs protein)

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48
Q

What are the two bacterias assoicated with health?

A

Streptococci and Actinomyces

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49
Q

What Red Complex bacteria is associated with periofontitis?

A
  • Porphyromonas Gingivalis ( Destroys host cytokines and chemokines)
  • Tannerella Forsythia- Chronic and recurrent periodontitits: S’, aids in phagocytosis
  • Treponema Denticola-Chronic periodontitis
50
Q

Fusobacterium nucleatum is?

A

ASSOCIATED WITH EARLY STAGES OF GINGIVITIS

51
Q

What bacteria can be transfered and associated with agrressive and refractory periodontitis?

A

Aggregatibacter actinomycetemocomitians

52
Q

What bacteria initiates early tissue changes and severe to attachment loss?

A

Fusobacterium nucleatum

53
Q

What is T. Denticola?

A

Makes lipopolysaccharides

54
Q

Which group of bacteria directly invades the host tissue cells?

A

A.a
P. Gingivalis
T. Denticola
T. Forsythia

55
Q

What two bacteria has easier penetration of sulcular epithelium?

A

A.a
P.Gingivalis

56
Q

What is the 1989 system shortcomings?

A
  • Overlap
  • Abscences of gingival disease components
57
Q

What is the 1999 classification?

A

Eliminate refractory periodontittis
Has NUG AND NUP

58
Q

What is the 2017 Classifications?

A

Removed chronic and aggressive forms of periodontitits and incorporated staging and grading

59
Q

What is dental calculus ?

A
  • Irrritant
  • biofilm retentive- rough and porous, irregular surface and ledges
  • Reservoir for bacteria and toxins
60
Q

What is supragingival calculus ?

A
  • Does not interlock
  • Forms on crowns, restorations prothesis exposed roots
  • site specific
  • 30 % minerlized by saliva
  • 70-90 % inorganic components: Calcium phosphate
  • 10-30% Organic: colonies, proteins, cells, WBC, lipids
  • Changes through crystalline forms: new (Brushite), less than 6 months is whitokite and more than 6 months is hydroxypatite
    *
61
Q

What is the subgingival Calculus?

A

Mineral from gingival crevicular fluid
60& mineralized
No salivary proteins

62
Q

What is the radiographic evaluation of subgingival calculus in percentage?

A

onky 45% if surfaces

63
Q

What is Plyrophosphates?

A
  • inhibits hydroxyaptitecrystal growth
  • Do not elimate existing cal
64
Q

What is fenestration?

A

Looks like a window. when the marginal bone is still intact

65
Q

What is Dehescences?

A

Looks like a door, mo marginal bone

66
Q

What is the cervical enamel projection?

A

Extension of enamel from CEJ to the entrance of furcation only on Bucal mandibular 2nd molars

67
Q

What are determinats within gingival disease?

A
  • Host
  • Microbiological
  • Environemntal
68
Q

What are the periodontal health levels?

A
  • pristine periodontal health
  • Clinical periodontal health
  • Periodontal disease stability
  • Periodontal disease remission/ control
69
Q

What is gingivitis manifestation?

A
  • enlarged contours
  • Red/Bluish tissue
  • BOP
  • Discomfort on probing
70
Q

What is the Extent of inflammation?

A
  • Localized
  • Generalized
71
Q

What is gingivitis biofilm induced ?

A
  • Plaque at gingival margin
  • Redness and tenderness
  • swollen rolled margins
  • Bleeding
  • Reversiable with removal
72
Q

What is reduced successfully treated perio?

A
  • History of attachment loss which is not progressing
  • controlled and redeveloped gingivitis
73
Q

What can occur on the gingva during the 2nd and 3rd trimester of a pregnancy?

A

Pyogenic granoluma on the maxilla or papilla- maxillary most common

74
Q

What are some dental biofilm induced systmic factors?

A
  • Diabetes, Leukemia, Smoking and nutrition
75
Q

What is leukemia?

A

Braod group of disorders characterized by overproduction of atypical wbc

76
Q

What are some oral factors for dental biofilm induced?

A
  • Subgingival restoration margins
  • Oral dryness
77
Q

What does the gingiva look like with drug influenced gingival enlargement?

A
  • Gingival enlargement- from medications= no attachement loss.
  • Exaggerated inflammatory response to plaque and a systemic medication
78
Q

What are the most common medications associated with enlargement ?

A

Anticonvulsant Drugs
Calcium channel blocker
Cyclosporine

79
Q

What are the mechanisms for action of a drug influenced gingival enlargement ?

A
  • Individual susceptibitlity
  • Immunological and genetic factos
  • Fibroblast Sensitivity
80
Q

Gingival diseases of non dental biofilm induced is?

A
  • Not caused by bacterial plaque
  • Do not disappear after plaque removal
  • Presence of plaque could increase severity of inflammation
81
Q

What is a genetic development disorder that affects the gingiva?

A

Hereditary Gingival fibromatosis

82
Q

What are some gingival lesions caused by ?

A

STDS: Neisseria gonorrhea, treponema pallidum
Stretocci: pharyngitis

83
Q

Vitamins C, A and B helps the oral cavity how?

A

Vitmain A- Healthy sulcular epithelium
Vitamin B- Mucosal tissue
Vitamin C- Absorbic acid

84
Q

What is periodontal disease?

A

BActerial infection of the periodontium

85
Q

What is a pseudopocket/ false pocket?

A

Deeping of sulcus and enlargement

86
Q

What is the difference between actue and chronic gingivitis ?

A

Acute: Swelling
Chronic: Repair attempts- excess collagen= fibrosis

87
Q

What is periodontitis?

A
  • Bacterial infection of all parts of the periodontium
  • Marked changes in the CT and JE
  • Regeneration of transseptal fibers
88
Q

What is the attachement apparatus?

A

PDL and Alveolar bone

89
Q

What is the suprabony pocket/supracrestal ?

A
  • pocket adjacent to alveolar bone
  • horizontal bone loss
90
Q

What is infrabony/ subcrestal?

A
  • pocket adjacent to alveolar bone
  • vertical bone loss
91
Q

What is the pathway of inflammation for both horizontal and vertical bone loss?

A

Vertical: CT, PDL then bone
Horizontal: CT, Bone then PDL

92
Q

Where are the different bone loss located?

A

Vertical (Wide crestal septum)- molars
Horizontal ( Narrow crestal septum)- MAndibular anteriors teeth

93
Q

What is hemiseptum?

A

One wall

94
Q

What is a interdental crater?

A

Facial and lingual wall remaining

95
Q

What is necrotizing periodontal disease associated with?

A

Host immune system impairment

96
Q

What are the 3 types of necrotizing periodontal disease?

A
  • Necrotizing gingivtis (trench mouth)
  • Necrotizing Periodontitis
  • Necrotizing stomatitis
97
Q

What is necrotizing gingivitis?

A
  • Only to the gingval tissue
  • Caused by fusiform bacillus and spirochetes
98
Q

What is the clinical features of * Necrotizing gingivitis ?

A
  • Pesudomembrane present
  • lymphodenopathy
  • fever
  • Fetid odor
  • metallic tatse
  • rapid onset
99
Q

What is the treatment for * Necrotizing gingivitis?

A

W/ fever and malaise- penicillin and metronidazole

100
Q

What is necrotizing mucositis?

A

Limited to the mucosa and areas not continous with gingiva

101
Q

What is the old name for necrotizing periodontitis?

A
  • HIV periodontitis
  • NUP
102
Q

What is the clinical features for Necrotizing periodontitis?

A
  • Rapid bone loss
  • extremely painful
  • halitosis
  • gingival bleeding
  • pseudo formation
  • deep crater
  • mimics odontogenic pain when roots become exposed
103
Q

What is * Necrotizing stomatitis Clinical features?

A
  • Bone exposed
  • Untreat NuP spreads
  • rapid progressive opportunistic infection
  • Normal flora becomes pathogenic
104
Q

What are the three componets of periodontitis?

A

Identifcation of pt as periodontitis case
Identification of specific form
Description of clinical presentation

105
Q

What causes periodontitis?

A

Bacteria

106
Q

What are the stages of periodontitis?

A
  • I- inital
  • II- moderate
  • III- severe- potential for bone loss
  • IV-severe- loss of dentition
107
Q

What are the three elements of periodontitis?

A

Severity
Complexity
Extent and distribution

108
Q

What are the parameters for periodontitis?

A
  • Role of progression
  • recognized risk factors
  • risk affecting systemic health
109
Q

What are symptoms of periodontitis?

A
  • painless
  • mimics odontogenic pain
  • itching
  • pain with food impaction
110
Q

What is the complexity of vertical bone loss molar incisor?

A
  • A. acinomycetemcomitis primary pathogen
  • Red comolex induced: P.gingivalis and T. Forsythia
111
Q

Describe horizontal bone loss

A
  • Greater than 30 years old
  • Slow rate
  • No familial nature
  • Local factors are abundant plaque and calculus
112
Q

Describe vertical boneloss/ molar-incisor pattern

A
  • Less than 30 year old
  • Rapid
  • Familial nature
  • Local factors- relative absence
113
Q

What is pericoronal abscess?

A
  • Tissue around the crown of partially erupted tooth
  • Has trimus
  • 3rds most common
114
Q

What is a gingival abscess?

A
  • occurs in the free gingival margin
  • acute localized pain
  • coronal infection
  • no sign of periodontitis
  • caused by foreign object
115
Q

What is periodontal abscess?

A
  • Within tissue adjacent to periodontal pocket
  • localized purulence in wall
  • pre-exisitng periodontitis
  • molar furcation area
  • Incomplete CAL removal
116
Q

What are differential diagnosis for periodontal abscess ?

A
  • pericoronitis
  • endo-perio abcess
  • pyogenic granuloma
  • osteomylitis
  • odontogenic keratocyst
  • tumors lesions
  • diabetes more suscepitble
117
Q

What is a periaprical abscess?

A
  • (MGJ)
  • results from infection and death of pulp by toxins
  • nonvital
  • untreated can lead to death
118
Q

What is a endo-periolesions ?

A
  • exist independently
  • caused by infection from pulp tissue
  • treatment: Both root canal and periodontal tissue
119
Q

What is endodontic lesion ?

A
  • Necrotic pulp
  • Chronic inflammation
  • border of lesion wider at apex
  • Isolated periodontal problem
120
Q

What is periodontal lesions?

A
  • Mimics endodontic lesion
  • wider at gingival margin
  • vital pulp
  • leads to endo infection

Periodontics (9 decks)

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