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Perio I: Mrs. Francis > Final Review May 2020 > Flashcards

Final Review May 2020 Flashcards

1
Q

The _______ protects the underlying tooth structures from the oral environment

A

gingiva

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2
Q

In _________, the patient’s knowledge and preferences are considered, alongside the clinician’s expertise. The decisions they reachare founded on valid evidence.

A

shared decision making;

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3
Q

What are the characteristics of acute gingivitis?

A
  • Short duration
  • Resolves upon professional and good self-care
  • Tissues appear bright red and shiny due to increased blood flow
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4
Q

__________ occurs when thereis a balance between disease promoting factors and health-promoting factors.

A

Biologic Equilibrium

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5
Q

What is Phase I of periodontal therapy and what does it include? This phase includes bacterial control, anti-infective therapy, assessment and preliminary therapy, nonsurgical periodontal therapy (NSPT)

A

Initial Therapy:

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6
Q

What are 4 of the cellular defender and mediators in the infalmmatory response?

A
  1. PMN’s
  2. Macrophages
  3. Lymphocytes
  4. Chemical Mediators (IL1, IL6, TNF-a prostaglandins & leukotrienes)
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7
Q

What are the clinical and histological signs of periodontitis?

A

Clinical: tissue that is pink/purplish, swollen/fibrotic, and bleeding

Histological: (Periodontal pocket) JE on cementum, supragingical fiber destruction present, alveolar bone destruction, PDL destruction

*irrevesible*

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8
Q

Dilation of the blood vessels, enhanced permeability of the bold capillaries, increased blood flow and leukocyte movement to tissue are all charateristics of _____.

A

inflammation

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9
Q

Which medication is a calcium channel blocker that resembles phenytoin-associated enlargement? Surgical elimination of tissue is often required.

A. Cyclosporine

B. Nifedipine

C. Phenytoin

A

B. Nifedipine

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10
Q

What is Phase III of periodontal therapy?

A

Restorative Therapy

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11
Q

The ______ suspends and maintains the tooth in its socket, provides sensory feeling to the tooth, provides nutrients, builds and maintains cementum and alveolar bone, and can remodel the alveolar bone in response to pressure.

A

periodontal ligament (PDL)

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12
Q

Which medication is an anticonvulsant that is more common in children and young adults? It begins with enlargement of interdental papilla.

A. Cyclosporine

B. Nifedipine

C. Phenytoin

A

C. Phenytoin

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13
Q

Signs of disease are features of a disease that can be observed or are measurable by a ______.

A

Signs

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14
Q

What are the anatomical areas of the gingiva?

A
  1. Alveolar Mucosa
  2. Mucogingival Junction
  3. Attached Gingiva
  4. Free Gingiva
  5. Interdental Gingiva (papilla)
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15
Q

Fever, malaise and swollen lymph nodes are systemic signs and symptoms of __________.

A

necrotic diseases

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16
Q

The hyperinflammatory response to the microbial challenge in periodontitis and impaired repair are partly mediated by the ________ interaction.

A

AGE-RAGE

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17
Q

Medical dental history, gingival observations, perio charting and radiographs are all tools that help the hygienist arrive at a periodontal diagnosis. This infomation is all classified as ________

A

assessment data

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18
Q

What is cementums primary function?

A

PDL attachment

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19
Q

Excess cementum in apical third of root is called ______which appears radiopaque on an x-ray.

A

hypercementosis

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20
Q

Which cytokine stimulates bone resorption and inhibits bone formation?

A

IL-6

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21
Q

What are the following signs and symptoms indicative of?

  • Tissue enlargement
  • Tissue redness
  • Gingival bleeding upon probing
  • Periodontal pockets
  • Bone loss, which may be visible on radiographs
  • Tooth mobility
  • Suppuration (discharge of pus)
  • Presence of subgingival calculus
A

periodontitis

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22
Q

A. actinomyce, tannerella forsythia and porphyromonas gingivalis are all ______ that can lead to periodontitis.

A

periodontal pathogens

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23
Q

What are the functions of the supragingival fiber bundles?

A
  1. Brace the free gingiva firmly against the tooth and reinforce the attachment of the JE to the tooth
  2. Provide the free gingiva with the rigidity needed to withstand the frictional forces that result during mastication
  3. Unite the free gingiva with the cementum of the root and alveolar bone
  4. Connect adjacent teeth to one another to control tooth positioning within the dental arch
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24
Q

________ biofilms are the cause of initial inflammation, but the ________ determines if periodontal destruction progresses.

A

Plaque ; host

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25
Q

______occurs when there is a balance between disease-promoting factors and health-promoting factors.

A

(Biologic) Periodontal equilibrium

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26
Q

______ is an intensive information-gathering process used to gather the detailed data needed to make a periodontal diagnosis and to document the periodontal health status to allow for long-term monitoring of the patient.

A

Comprehensive periodontal assessment CPC

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27
Q

List the 5 principle fiber groups of the PDL.

A
  1. Alveolar crest fibers
  2. Horizontal fibers
  3. Interradicular fibers
  4. Oblique fibers
  5. Apical fibers
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28
Q

What is Phase IV of the periodontal therapy?

A

Periodontal maintenance

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29
Q

_________ are biologically active compounds secreted by the immune cells that activate the body’s inflammatory response. They are the “middlemen” sent by the immune cells to activate the inflammatory response.

A

Biochemical mediators

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30
Q

________, also referred to as cribriform plate, is a thin layer lining the socket

A

Alveolar bone proper

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31
Q

The ______ is a layer of connective tissue that covers the outer surface of bone.

A

periosteum

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32
Q

_____ is an efficient information-gathering process used to determine the periodontal health status of the patient (health or disease?)

A

Periodontal Screening (PSRs)

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33
Q

What kind of pocket is shown in the image?

A

suprabony

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34
Q

A ____ is performed on all patients over age 12 using 5 teeth and a UNC probe by swiping approx. 1mm into sulcus to detect plaque.

This score would be a % of these areas WITHOUT PLAQUE. Must be 75% or greater.

A

PASS Score

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35
Q

Which cytokine stimulates connective tissue destruction and stimulates bone resorption?

A

IL-8

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36
Q

__________ are the terminal endings of periodontal ligaments attached to cementum, they are embedded in bone and cementum.

A

Sharpey’s Fibers

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37
Q

An increase in plaque biofilm retention and biofilm pathogeenicity as well as damage to the periodontium are all considered _______ factors.

A

local contributing

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38
Q

What are the characteristics of chronic gingivitis?

A
  • May exist for years without ever progressing to periodontitis; resolves upon professional and good self-care
  • Tissues can appear bluish red to purplish red
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39
Q

What are the clinical and histological characteristics of gingivitis?

A

Clinical: red, swollen, bleeding likely

Histological: JE at CEJ and supragingival fiber destruction are present. The alveolar bone and periodontal ligament are still intact

*reversible damage*

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40
Q

Which cytokine stimulates bone resorption and induces breakdown of collagen matrix in gingiva, pdl, and alveolar bone?

A

THF-a

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41
Q

What type of periodontal pocketing tshown in the image?

A

Infrabony

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42
Q

**Double check question**

A. Tooth morphology, calculus formation, and trauma are all considered ____ contributing factors

A

calculus formation

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43
Q

_____ of disease include features of a disease that are noticed by the patient.

A

Symptoms

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44
Q

The zone of soft tissue occupied by the junctional epithelium and connective attachment tissue fibers, approx. 2mm is called the _____. When violated, the body attempts to re-establish this zone through the inflammatory process

A

biologic width

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45
Q

When determiningthe periodontal dianosis, Confirmation that a patient is a periodontal case should include the _______ at two nonadjacent teeth, and whether it is necrotizing periodontitis, a manifestation of systemic disease, or periodontitis

A description of aggressiveness of disease should also be included by providing the Stage and Grade.

A

CAL

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46
Q

__________ produced by immune cells are largely responsible for the tissue destruction seen in periodontitis.

A

Biochemical mediators

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47
Q

Which cytokine stimulates osteoclast activity resulting in bone resorption and induces breakdown of collagen matrix in gingiva,
pdl and alveolar bone

A

IL-1

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48
Q

Who is responsible for the treatment of the patient?

A

the provider who performs the treatment

49
Q

What is the prime purpose of the human immune system?

A

to defend the life of the individual (host).

50
Q

________ are conditions or diseases that increase an individual’s susceptibility to periodontal infection by modifying or amplifying the host response to microbial infection.

A

Systemic risk factors

51
Q

What sis Phase II of periodontal therapy?

A

Surgical Therapy

52
Q

What are the clinical and histological presentations of a healthy periodontium?

A

Clinical: pink, firm, no bleeding

Histological: JE coronal to CEJ, supragingival fibers intact, alveolar bone intact, PDL intact.

53
Q

Which biomediators are powerful inflammatory mediators that work to increase permeability and dilation of blood vessels, trigger osteoclasts to destroy alveolar bone, promote overproduction of MMP enzymes and play an important role in bone destruction in periodontitis.

A

Prostoglandins

54
Q

___________ may play a role in the etiology of some systemic diseases/conditions

A

Systemic risk factors

55
Q

The _____ is a valley-like depression apical to the contact area of 2 adjacent teeth. It connects facial and lingual papillae, and will not be present if there is a large space between 2 teeth or there is notable gingival recession

A

gingival col

56
Q

_______ is the body’s protective response to pathogens, foreign bodies, or an injury. It concentrates host defense components at the site of an infection or injury to eliminate microorganisms and heal damaged tissue.

A

Inflammation

57
Q

____________ is the proces by which epithelial cells on the surface of the skin become stronger and waterproof.

A

Keratinization

58
Q

What surrounds the cells of a tissue and is comprised of fibers and a gel-like substance?

A

extracellular matrix

59
Q

The ______ is the body’s response to bacteria and the immune system strives to defend the body against bacteria present in plaque biofilm.

A

host response

60
Q

Smokers are ___ times more likely to develop periodontal disease than non-smokers.

A

7 times

61
Q

Where is the junctional epithelium (JE) located?

A

at the base of the sulcus

62
Q

Which cellular defender is characterized by the following?

  1. Capture and destroy bacterial invaders.
  2. Short-lived cells that die when they become engorged with bacteria.
  3. Attracted to bacteria by a process called chemotaxis.
  4. PMN contains many strong bactericidal and digestive enzymes, called lysosomes.
  5. Periodontal pathogens are most effectively destroyed by PMNs.
  6. Essential for the control of bacterial infections.

*Rapid Responders, providing the 1st line of defense*

A

PMNs (Polymorphonuclear Leukocytes)

63
Q

Where is the oral epithelium (OE)?

A

it covers the free and attached gingiva

64
Q

Complete the following sentences to identify the various types of ginigval distribution:

_____ gingivitis affects the interdental ginigva.

______ gingivitis affects the margins and papillary gingiva.

______ gingivitis pertains to the gingival margin, papilla, AND the attached gingiva.

A
  • Papillary
  • Marginal
  • Diffuse
65
Q

______ defines the sequence of events that occur during the development of a disease or an abnormal condition.

A

Pathogenesis

66
Q

¨A _________ is a gray layer of tissue that covers the necrotic areas of the gingiva.

A

pseudomembrane

67
Q

Findings from studies indicate that diabetes mellitus leads to a ______ response to oral microbial biofilms and ______ resolution of inflammation and repair.

A

hyperinflammatory response

68
Q

______ seal the ends of open dentinal tubules, compensates for occlusal attrition to maintain tooth length.

A

Sharpey’s Fibers

69
Q

Direct visual examination, visual examination using compressed air, tactile examination using explorer, and radiographic evaluation are all ways to evaluate the presence and amount of ______ deposit.

A

calculus deposit

70
Q

What is the CAL in the first image?

A

3mm probe depth

Attachment at CEJ

Negative recession

0 mm CAL

Gingivitis

71
Q

A specialized cell junction that connects two neighboring epithelial cells and their cytoskeletons together is called a _________.

It is a cell-to-cell connection that is found in gingival epithelium.

A

desmosome

72
Q

Use understandable language, provide oppurtunities tof patient questions and assess patient understanding are all guidelines for ___________.

A

obtaining informed consent

73
Q

Which enzymes act together to break down the connective tissue matrix and with increased levels cause the collagen destruction that occurs in the periodontal tissues.

A

MMPs

74
Q

What drives tissue destruction?

A

uncontrolled host infalmmatory and immune responses

75
Q

The ______ surrounds and supports the roots of the tooth

A

alveolar bone

76
Q

In regards to periodontal health, a(n) _______ periodontium presents with no loss of periodontal tissue (past or present).

*Non-periodontal patient*

A

intact periodontium

77
Q

Periodontal biotype, gingival/soft tissue recession, lack of keratinized gingica, decreased vestibular depth, aberrant frenum postition, gingival excess, and abnormal color are all types of mucogingival _____ and conditions around teeth.

A

deformities

78
Q

Provide health promotion education that contributes to overall systemic and periodontal health and _______ with medical team for joint patient management.

A

health promotion, collaborate

79
Q

What is the network of ropelike collagen fiber bundles located coronal to (above) the crest of the alveolar bone called?

A

supragingival fiber bundles

C = Circular

AG = Alveologingival

DG = dentogingival

PG = periosteogingival

80
Q

_______epithelial cells have no nuclei and form a tough, resistant layer on the surface of the skin

A

Keratinized

81
Q

In regards to periodontal health, a(n) _______ periodontium exhibits pre-existing loss of periodontal tissue with NO current activity or loss of connective tissue and/or alveolar bone.

A

reduced periodontium

82
Q

Attachment loss CANNOT be due to ______ causes such as, dental caries extending to or apical to CEJ, the presence of CAL on the distal aspect of a second molar associated with extraction of a third molar or a vertical root fracture.

A

non periodontitis

83
Q

_______ is a living film containinga WELL ORGANIZED community of bacteria that grows on a surface

A

Biofilm

84
Q

What type ofcementum covers the apical half of the root, is continuously deposited throughout the life of the tooth, and increases in thickness with age?

A

cellular

85
Q

________ leads to a hyperinflammatory response to the microbial challenge in periodontitis. These effects are at lest partly mediated by the signaling mechanisms of the ________ interaction.

A

Diabetes mellitus; AGE-RAGE

86
Q

What are the three different medications that can lead to gingival enlargment?

A

Phenytoin, Cyclosporine, Nifedipine

87
Q

The _____ is a layer of yellow, hard, mineralized tissue attached to the dentin. It anchors the ends of the periodontal ligament fibers to the tooth, protects dentin and compensates for tooth wear.

A

cementum

88
Q

_________ are regenerated continuously across the crest of bone separate the site of inflammation from the remaining alveolar bone.

A

Transeptal fibers

89
Q

_________ is an established risk factor for periodontitis.

A

Diabetes mellitus

90
Q

Cytokines, Matrix Metallo Proteinases (MMP’s), and Prostoglandins are all ____________.

A

biochemical mediators

91
Q

____ levels of cytokines, RANKL, MMPs and PGE2 characterize periodontitis.

A

High levels

92
Q

______ are more likely to have more colonization by periodontal pathogens. These individuals also experience effects on both the human system and inflammatory response.

A

Smokers

93
Q

In _______ (disease) the crest of the alveolar bone is located more than 2mm apical to the CEJ

A

periodontitis

94
Q

______________ are large leukocytes with one kidney-shaped nucleus and some granules. They are highly phagocytic cells that actively engulf and destroy microorganisms.

They are slower to arrive at the infection site than PMNs, but are long-lived cells.

*Most numerous cells in chronic inflammation*

A

monocytes (when in bloodstream)

macrophages (when in tissue)

95
Q

When uncontrolled, the prevalence of periodontitis is ______ and symptoms more severe in individuals with diabetes mellitus compared with nondiabetics

A

higher

96
Q

Systemic disease, periodontal pathogens, social atmosphere nad habit are all _____ for periodontal disease.

A

risk factors

97
Q

Explain why there is a band of intact transseptal fibers even in the presence of severe bone loss.

A

because a band of intact transseptal fibers ALWAYS seperate the site of inflammationfrom the remaining alveolar bone.

98
Q

What is the CAL determination in the last image?

A

4mm probe depth

Gingival margin below CEJ 3 mm recession

7 mm CAL

Stage 3 or 4 Periodontitis

99
Q

_________ cells work by secreting antibodies that neutralize microorganisms. They can further differentiate into plasma B-cells or memory B-cells. Once activated, they makes millions of antibodies and pours them into the bloodstream

A

B-cells, B-lymphocytes, Plasma cells

100
Q

_______ is a fibrous protein found in skin and nails.

A

Keratin

101
Q

In_____ and ____ the crest of the alveolar bone is located approximately 2 mm apical to the CEJ

A

health

102
Q

A specialized cell junction that connects the epithelial cells to the basal lamina is called a ________.

It is a cell-to-basal lamina connection also found in gingival epithelium

A

hemidesmosome

103
Q

What are the 3 possible arrangements of enamel & cementum?

(OMG)

A
  1. Overlap
  2. Meet the enamel
  3. Doesn’t meet, leaving a gap between the cementum and enamel
104
Q

It is theroized that ______ has an impact on bone metabolism

A

smoking

105
Q

_____are regulatory proteins released by host immune cells that influence behavior of other cells, initiate tissue destruction and bone loss

A

Cytokines

106
Q

Where is the sulcular epithelium (SE) located and what does it line?

A

•lines the sulcus

107
Q

Which medication is used for paients who are immunosuppresive, mediacally compromised, and similar in appearance to phenytoin-associated gingival enlargement?

A. Cyclosporine

B. Nifedipine

C. Phenytoin

A

A. Cyclosporine

108
Q

_________ are regulatory proteins released by host immune cells that influence behavior of other cells. They initiate tissue destruction and bone loss

A

Cytokines

109
Q

_______ also known as the (spongy bone) that fills the interior portion of the alveolar process is found mostly in the interproximal areas.

A

Cancellous bone

110
Q

Progressive alveolar bone loss is present is ______. This bone destruction may eventually lead to tooth mobility or loss

A

periodontitis

111
Q

_______ is a layer of compact bone that forms the outer wall on facial and lingual.

A

cortical bone

112
Q

Development of a fiery red gingiva with spontaneous gingival bleeding, intense oral pain, fetid oral odor (bad breath), and excessive salivation are all clinical symptoms of _________.

A

necrotizing diseases

113
Q

What are the three basic states of the periodontium?

A
  1. Health
  2. Gingivitis
  3. Periodintitis
114
Q

The extracellular protective layer more commonly referred to as the _____ is a dense protective barrier that protects from antibiotics, antimicrobials,
and the body’s immune system.

A

slime layer

115
Q

_______removes or disrupts the dental plaque biofilm and is best achieved by brushing, interproximal plaque removal,
and periodontal instrumentation. This is the most effective way to control dental plaque biofilms.

A

Mechanical cleaning

116
Q

_________ is tissue death resulting in partial loss of interdental papillae. It gives the appearance that the papillae have been punched-out or cratered

A

Gingival necrosis

117
Q

What type of cementum covers approximately the cervical third or half of the root, and is normally not produced after the tooth has reached its occlusal plane?

A

acellular

118
Q

What is the CAL determination in the second picture?

A

4mm probe depth

Gingival margin at CEJ

No recession

4mm CAL

Stage II Periodontitis

119
Q
A

Perio I: Mrs. Francis (3 decks)

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