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Dr Keaton Perio > First Exam > Flashcards

First Exam Flashcards

1
Q

Form is the morphology of the teeth bone and tmj whereas function includes the jaw muscles and neuromuscular system

A

True

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2
Q

A complex apparatus that has an amazing adaptive capacity to function.

A

Masticory system

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3
Q

When the masticory systems adaptive capacity is exceeded l, dysfunction can range from

A

Discomfort to debilitating pain

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4
Q

Good oral health requires the functional harmony of the

A

Teeth muscles and tmj

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5
Q

Causative factor in perio disease is

A

Plaque biofilm

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6
Q

The role of the hygienist is to recognize the signs and symptoms of pain and dysfunction

Record the parameters of these signs and symptoms and refer the patient for diagnosis and treatment

A

True

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7
Q

The Oral cavity is in what state of function when talking chewing and swallowing

In occlusal and I

A

Is dynamic

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8
Q

State of morphofuncitonal harmony in which the forces developed during function are within an adaptive physiologic range

A

Orthofunction

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9
Q

Orthofunction means — and — for patient

A

Health and comfort

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10
Q

This term indicates physiologic and physical comfort for thre patient a normal adaptive situation

A

Physiologic occlusion

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11
Q

An occlusal relationship that functions for the patient is considefed —- and does not follow a particular occlusal configuration

A

Optimum

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12
Q

A malocclusion can still be in orthofunction

A

True

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13
Q

State of morphofunctional disharmony in which the forces developed during function cause pathological changes in the tissues

A

Dysfunction

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14
Q

—- forces directed along the tooth and periodontium usually meet the demands necessary for normal function

A

axial

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15
Q

Such as grinding or clenching can stress the system if axial forces

A

Parafunctional activity

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16
Q

Antiaxial forces directed along the tooth and periodontium can cause —- or a —- response

A

Resorption

Hypertrophic response

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17
Q

Certain factors effect response of teeth

A

Size shape of roots
Quantity quality of alveolar bone
Presence of biofilm

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18
Q

An occlusal contact relationship that is harmonious does not produce a painful response in the masticory system

A

True

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19
Q

When the condyles of the tmj rest in the normal closed super anterior position and the mandible has a well distributed even contact with the maxilla the max system is in a stable relationship

A

True

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20
Q

Occlusion that has caused injury to the teeth muscles or tmj

A

Traumatic occlusion

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21
Q

Heavy occlusal forces exceed the adaptive range in normal periodontium causing injuries to tissues and bone

A

Primary traumatic occlusion

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22
Q

when normal occlusal force exceed the capabiltiy of a periodontium that is already affected by perio disease

A

secondary traum. occl

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23
Q

trauma from occlusion does not initate gingiviis and perio

A

true

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24
Q

traumatic occlusion does not refer to a maloclusion as described by angles three classifications

A

true

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25
Q

1,2,3 classify and describe the skeletal relationship of the max and man teeth.

A

angles classes 1-3

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26
Q

the occlusal relationship of the teeth is not a predictor of pain or problems in the tmj

A

true

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27
Q

pain in a joint structure

A

arthralgia

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28
Q

puncture of a joint space with a needle and removal of fluid

A

arthrocentesis

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29
Q

grinding or gnashing of the teeht usualy during sleep

A

bruxism

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30
Q

clamping and forcing the teeth togehter without grinding

A

clenching

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31
Q

cracking or snapping noise in the tempromandibular joint because of disk and condyle incoordination can occur in one or both joints

A

clicking

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32
Q

grating noise in the temporomandibular joint becayse of damage to the disk and articulation joint surfaces

A

crepitus

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33
Q

abnormal movement can describe masticory muscle incoordination or spasm

A

dyskinesia

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34
Q

mandible in movement from side to side and forward movement away from the intercuspal position.

A

excursive movement

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35
Q

vibration or movement of a tooth when in function can be observed or felt by placing a finger over the tooth

A

fremitus

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36
Q

enlargement

A

hypertrophyq

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37
Q

the maximum intrercuspation of the mandibular and max teeth also called centric occlusion and habitual occlusion

A

intercuspal position

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38
Q

tooth contact that does not allow the teeth to achieve stable interdigitation also called supra contact

A

interference

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39
Q

mandibular movement away from the midline the laterotrusive side moves away from the midline infunction

A

laterotrusion

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40
Q

mandibular movement toward the midline the mediotrusive side moves toward the midline in function

A

meditrusion

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41
Q

relationship of form and function

A

morpho function

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42
Q

pain in a muscle

A

myalgia

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43
Q

inflammation in a muscle

A

myositis

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44
Q

treatment that alters the occlusal contacts or mandibular position of the jaw

A

occlusal therapy

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45
Q

pathologic changes in the oral cavity as a result of occlusal forces an occlusion producing injury

A

occlusal trauma

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46
Q

a state of morphofunction harmony in which the forces developed during function are within an adaptive physiologic range

A

orthofunction

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47
Q

movement of the mandible outside the range of function

A

parafunction

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48
Q

an occlusion that is free of disease and dysfunction and has adpated to some physiologic changes

A

phyisologic occlusion

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49
Q

the mandible in the end point of the terminal hinge closure also called centric relation position

A

retruded contact position

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50
Q

involuntary contract of a muscle or muscles usually painful and interefring with function

A

spasm

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51
Q

spasm in the masticory muscles associated with a disturbance in the trigeminal nerve

A

trismus

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52
Q

it is now widely accepted that in the absense of marginal gingival irritation trauma from occlusion does not produce gingival inflammation

A

true

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53
Q

trauma associated with orthodontic movement of teeth is

A

self limiting

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54
Q

when an individual can attain and maintain good oral hyg. —– is of no perio significance

A

maloclusion

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55
Q

most patients have difficult with——- making maloclusion a fator to be considered in perio

A

biofilm

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56
Q

the normal position of the teeth in max intercuspation is called

A

centric occlusion

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57
Q

in the intercuspal position the anterior teeth may have only

A

light or no contact

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58
Q

normal movement of the jaw with the teeth in contact should be smooth symmetric and able to achieve about —-mm

A

8

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59
Q

area on a tooth that may prevent well distribute stable contact between max and mand

A

supracontact

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60
Q

occlusal interferences are

A

supracontacts

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61
Q

latermal movement is examined starting from the —

A

intercuspal position

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62
Q

slight mobiliity of the teeth especially the lower incisors is normal

A

true

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63
Q

occurs because the conical roots of a single rooted teeth are suspendied in the perio ligament which allows them to mve very slightly

A

physiologic mobility

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64
Q

wear caused by tooth to tooth contact is called

A

attrition

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65
Q

is a otth surface worn by attrition from functional or parafunctional causes

A

facet

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66
Q

a facet that is shiny is known as

A

active facet

non shiny is passive

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67
Q

when the facet is angular the occlusal forces are directed — and increase the risk of perio injury

A

laterally

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68
Q

the widening of the perio ligament is caused by

A

resoprtion of bony support from the excessive occlusal forces

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69
Q

osteosclerosis and hypercementosis are —- responces to the occlusal forces

A

hypertrophic

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70
Q

physcial exam for this expanded evaluation include

A 
examing man motion in all planes
palpating the tmj
palpatin the masticory muscles
examining and listening to joint sounds 
palpating the cervical musculature
determing the stability of the dentition and skeleton
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71
Q

the goal of treatment of tmd is to reduce pain and improve jaw system functionality

A

true

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72
Q

Clarks three criteria

A

based on correct differential diagnoses
selected with reason and purpose
directed toward eliminating or neturalixzzing the cause of the symptoms

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73
Q

tmd treatement is conservative and

A

reversible

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74
Q

conseritive approach use simple non invasive methods rather than irreversible methods

A

true

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75
Q

the most frequent approach for tmd tx is

A

physical medice with a strong behavior educational component.

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76
Q

the first step in the treatment of patient with a tmd is to recommend

A

initail therapy

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77
Q

inital therapy

A

soft diet
limited movement of jaw
moist heat
non narcotic analgesic

improve after 2-3 weeks

78
Q

set of simple noninvasive steps that can provideimmediate comfort and relief of symptomsthe first step is to instruct the patient to eat soft foods only

A

initial therapy

79
Q

include ultrasound massage electrical stimulation of the muscles soft tissue manipulation and exercise progroams

A

physical therapy

80
Q

made of hard acrylic resin and fit over the occlusal and incisal surfaces of the max or mad teeth they are usually called splint nightguards or biteguard

A

occlusal applicance

81
Q

counseling for stress or anxiety depression

A

behavioral therapy

82
Q

meds prescribed as paharmacologic treatment of tmd

A

pharmcologic therapy

83
Q

pharm therapy can be used to help trigger pain which is a painful hypersensitive band of muscle tissue

A

true

ex carbocaine

84
Q

partial removal

A

condylotomy

85
Q

any surgical procedure should be completed only after a careful diagnosis and the consideration ofa second or third opinion

A

true

86
Q

cause and effect relationship between accumlulation of plaque and gingivitis in adults is within

A

21 days

87
Q

gingivitis was reversible within — days when proper plawur control was initatied

A

7

88
Q

supra ging plauque becomes dominated by —- — microbial species as it ages

A

gram negative

89
Q

these gram - bacteria are resp. for the develop. of subging biot asso with

A

perio disesase

90
Q

mature plaque biofilm is

A

heterogeneous mass with open fluid filled channels used for the movement of nutrients and waste products.

91
Q

most challenging aspect of plaque control for perio pt is

A

motivation to initate and continue a life long process of improved daily biofilm removal.

92
Q

first brushes were made of hog bristile often with bone or ivory ahnes

A

true

93
Q

because of the work of pioneers usch as arnim barclay and dr. bass soft bristled brushes used with a controlled bioilm removal tech have become the standard

A

true

94
Q

ideal tooth brush

A

straight 6 inches long 7/16 wide
three evenly spaced rows with 6 tufts each
80 nylon bristles per tuft .007 inches in diameter 13/32 inches llong and rounded finish

95
Q

the oldest tooth brush method

A

scrub

96
Q

most popular method taught today

A

bass method 1948 it provides mechanical plaque removal at the ging margin and minimizes trauma

97
Q

simplest brushing techniques consisting of placing the brsitles on teeth and moving them backand forth, snearly everyone including kids can become adept at this tec.

it can lead to trauma and recession

A

scrub

98
Q

brushing teeth the way grow bristles placed on gingica

A

roll

99
Q

requires placement of the brush at a 45 egree angle to the tooth surface with the bristle ends pointing away from the gingiva but toward the interproximal surfaces of the teeht.

A

charter

100
Q

charter also recommended the use of metal or wooden toothpicks for interproximal stimulatoion. dental floss was to be used only to remove fibrous food caught between fualt contacts

A

true

101
Q

placement of the bristles pointing apically but not at right angles to the gingiva to minimize puncture. pressure is placed on the bristle cause them to flex and the tissue to blanch. brush is rinsed several times with a salt water sodium bicarbonate solution. this techinique may result in plaque removal although its effectigvness around the ging margin is questionable

A

stillamn

102
Q

soft multitufted toothbrush to be place at 45 degree angle to the long axis of teeth. the vibratory motion is used to force the bristles intol sulci and between the teeth effect as possible

A

bass

103
Q

headed portion of powered brush is

A 
vibrating
osciallation
rotary
counter roatery 
soncic vibtration feature
104
Q

rotating oscilliating is the best powered toothbrush

A

true

105
Q

designed spec. for access to prximal areas have shaped tips and can readily be applied to both the interproximal surfaces when there is sufficient space and the gingival margin

A

rotary powered same as convenetional

106
Q

most accepted

A

bass

107
Q

— will clean interproximal surfaces of the teeth extending under ging margin often to junctional epithelim where a toothbrush cannot reach, however it is likely to miss plaque in root surface grooves and cannot clean furcations

A

floss

108
Q

proper flossing requires a piece of floss about —- incles long both hands. a small portion one inch is held between thumb and fingers

A

18

109
Q

dental floss can be used to clean under the pontic of fixed partial dentures and around abutement teeth when it is threaded under the soldered joints of fixed restorations.

A

true

110
Q

needle like deice called a — or —-. threaded through the eye of device and theen inserted under contact areas of bridge

A

floss threader

111
Q

reusable floos tools have – or — shaped working ends

A

c u

112
Q

c shaped

A

anterior areas

113
Q

u shaped

A

posterior

114
Q

disposable floss helper tools are convenient when

A

traveling and for kids

115
Q

ideas to clean large interproximal spaces facester and easier to grasp

A

yarn or gauze

116
Q

facilitate the mechanical cleaning of proximal root surfaces and provide improved access into develiping grooves and furcations. useful for perio patient who have attachment loss long exposed root surfaces and complex root arch.

A

interdental brushes

117
Q

usually include a reusable handle and a dispoable brush tip. tip is inserted in the end of the handle. secured at 90 degree angle to handle and used to brush interproximally in spaces that are large enough to permit access

A

interdental brush.

118
Q

some practictinoers recommend soaking the tip before use to soften it so that it frays slightly and covers more surface area

A

the tooth pick

119
Q

gingival masasge

A

interdental stimulation

120
Q

popular concept in plaqe control until the 0s

A

rubber tip stimulator

121
Q

inflammation starts in the

A

sulcus

122
Q

rubber tip stimulators are

A

convenitnat inexpensive devices that can be useful to perio patients

123
Q

tip is a conical piece of firm rubber or plastic tht is several mm long. placed proximally resting the dsde of the cone on the gingiva and worked in small circular motion.

A

rubber tip stimulator

thoughtt to increase keratinixtion clean the surface of gingiva stimulate blood flow and sqeeze fluid from sulcus

124
Q

patients who never floss or are afraid to floss suggest

A

rubber tip

125
Q

—- – is a good tool for perio patients but is rarely the only interproxiam aid needed

A

dental floss

126
Q

studies show that 40 percent of americans report using floss only 10 percent floss daily and another 10 floss one or twice a week.

A

true

127
Q

forcing water between the teeth with a single jet or multiple jet of pulsed beads of water

A

supragingival irrigation

128
Q

studies showed that irrigation really only helped reduce

A

calculaus formation

129
Q

plaque scores were not always reduced by irrigation corroborating the results of the earlier work but bleeding of the gingiva was reduce significatnly

A

true

130
Q

oral irrigation is associated with —— occurng in as many as — of patients with perio

A

bactermia

50 percent

131
Q

if irrigation is recommended for perio patients after perio surgary it should be postponed for atleast

A

1 month longer in case of regenerative surgery to permit healing of tissues

132
Q

subgingival irrigation can be accomplished with the use of a special soft rubber tib that permits the irrigant to be directed under the gingiva. tip is slipped gently under the gingiva in areas with deep pockets and irrigant is flushed into pickets

A

true

133
Q

pressure for irrigation should be set on —–

this tech extends the cleansing action of irigation beyond the generally accepted — mm depth reached with standard tec

A

low

3mm

134
Q

irrigation is good for people who really have no interest in flossing etc

A

true

135
Q

chemical agents can clearly assist in plaque control programs but they are not a sub for good oral hyg practices

A

true

136
Q

chemical antiplaque agents should have these properties

A

`.antiplaque action
substantivity
low toxicity and nonirriating
low permeability

137
Q

abiliity to adhere to structure in the oral environment and be realease slowly over time

A

substantivity

138
Q

low permeability allows

A

retention in the oral cavity

139
Q

most efective anti bacterial agent available today is

A

chlorohexidine mouthwash containg .12 of active ingredeient

140
Q

1989 chlorex. reduced plaque and givetis by

A

60 in short term studies and 55 and 45 respective in seperate long term

141
Q

chrlohexidine highly substantive not being cleared from the mouth for several hours

A

true

142
Q

chlorexidine availbe in

A

gelatin chip
toothpastes
mouthwash

143
Q

side effects of chlor

A 
brown staining
increased supra ging calc formation
reversible desquaation of oral tissue.
taste bitter a
alter taste sensation
144
Q

chlorexidine containt —- alchol.

A

11.6

145
Q

the dental hygenist should recommend the use of chloredine as a mouth rinse full strenth .12 twice daily for 30 seconds using 15 ml of rinse

A

true

146
Q

chlorexidine reduces gingivits when used once daily in supragingival irrigation with an oral irrigator in a 1:1 dilution with water .06

A

true

147
Q

mouthwashes containing essential oils thymol eucaluptol menthol and methy salicylate have been shown to reduce plaque and gingivist by about

A

30

alters cell walls

148
Q

essential oil mouthwash contain a subtantial percent of alchol up to

A

26.4 have a strong flavor can cause staining

149
Q

__ toothpastes with either zinc citrate or a copolymer of methoxyethylene and maleic acid asthe active agent have been shown in numerous studies to reduce plawue by about 25 and ging by 20

A

triclosan

150
Q

quaternary ammonium compounds have limited substantivity and are not accepted by the ADA because there ability to reduce ging as not been adequately documented in long term studies

A

true

151
Q

alters bacteria cell metabolism and cell adhesion prioperties in addition to reacting with tooth surace for caries prevention

A

stannous fl

152
Q

the usual strengeth for daily home use is …. stannous flu delivered in gel or toothpaste

A

.4

153
Q

stannous fl. negative

A

staining

154
Q

there is no single agent that is recommend for sub irrigation and no compelling evidence that the procedeure provides sign benefits

A

true

155
Q

clinical studies show approx a – to —- reduction in supra calculys formation wen anticalculus toothpastes are used

A

20-40

156
Q

all of the following are charcterisitc of chlorhexidine except

A

anticalculus agent

157
Q

irrigation is auseful component of home care for the perio patient. bactermia has bee nshown to be asso with orig.

A

both are true

158
Q

which of the following oral hy aaid are best suited to areas of furcation onvolvement

A

tooth picks

159
Q

toothbrush focused on ging margin

A

bass

160
Q

technical skill of the dental hygi is critcal element in succlssful

A

non surgical perio therapy

161
Q

achieving root smoothness is important for evalutatin short term goals during treatment appointments.

A

true

162
Q

—- sense is used to determine the amount of caluclus presenti n the untreated pt the existanece of irriating factors such as overhands and the point at which thouroug hinstrumentation is finised at each app

A

tactile

163
Q

glassy smooth root surfaces are not end poitns in treatemetn

A

true

164
Q

smooth surfaces are easier to clean
smooth surfaces rerard plaque formation
rough surfaces mechanically irriate gingival tissue
smooth surfaces promote ginigival healing

A

true

165
Q

no exp evidence indicated that rough root surfaces are mech irriatnt woule dtherefore delay healing

A

true

166
Q

roughness has no effect on wound healing

A

true

167
Q

—– do not pentrate deeply into cemental surfaces and that retained toxins are associated with missed calculus and plaqure rather than diseased cementum

A

endotoxins

168
Q

the thinning is an example of over instrumentation or rootplaning without rationale.

A

true

169
Q

other termss used to describe non surgical perio therapy include

A

intial therapy
phase 1
eitotropic phase
perio debridement

170
Q

goals

A

remove plaque to restore perio health
slow/stop perio
prepare tissue for surgical therapy

171
Q 
emergency care
oral hyg instruct
nutrition counseling
perio debride
anti microb therapy
fluoride application
smoking cessation 
extraction
A

phase one

172
Q

surgical abcess if patient does not respond to one than do this

A

2

173
Q

restorative and prsthetic care

A

phase 3

174
Q

evaluation of patients oral hyg
smoking cessation
tx depends on con

A

phase 4

175
Q

nonsurgical procedures

A 
scaling
hand instruments
root planing 
gingival curettage
polsihing
176
Q

instrumentation of the crown adn rooth srufaces of teeth to remove plaque calculus and stains from surfaces

A

scaling

177
Q

treatment designed to remove cementum or surface dentin that is rough imprenated with calculus or contaminted with toxins

A

root plaingn

178
Q

polishing agents can scratch amalgom compositie resin and gold

A

true

179
Q

air polishing works by mechanical abrasion using slurry of

A

sodium bicarbonate and water

180
Q

polishing has

A

no therapeutic value

181
Q

scraping or cleaning the walls of a cavity or surface by meeans

A

curettage

182
Q

invovles the removal of inflamed soft tissue laeral to pocket wall

A

gingival curettage

183
Q

traditionaly gingival curettage was called closed curettage or nonsurgical gingial curettage and was performed to remove inflamed pocket lining

A

true

184
Q

curettage no longer considered standard tx

A

true

no longer method of tx

185
Q

short term go of non surgical

A

promote plaque biofilm control and to instrument hte tooth surface until clean and smooth

186
Q

long term goal

A

restore gingival health

187
Q

actinobacillus actinomycetemocimtinas have been associated with agress perio

A

true

188
Q

calculus adheres to tooth surfaces through pellicle attachment mechanical locking and intercrystalline forces.

A

truew

189
Q

calculus is an inert substance plaque biofilm retention

A

true

190
Q

studies show that — do not pentrate deeply into cemental surfaces

A

endotoxins

Dr Keaton Perio (1 decks)

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