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Year 3 Perio > General perio qs > Flashcards

General perio qs Flashcards

1
Q

How may asthma inhalers affect perio condition?

A

Steroids may thin mucosa

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2
Q

clinical signs of gingivitis v perio

A 
gingivitis 6:
-redness
-loss of stippling
-smooth and glossy
-swelling (oedema)
-rolling of gingival margin/ loss of triangles in interdental papillae
-BoP
Perio 8:
-all signs of gingivitis (6) PLUS
-true pocketing on probing (>4mm)
-recession
-pus (suppuration)
-mobility 
-drifting
-furcations
-radiographic bone loss
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3
Q

calculation for pocket depth

A

top of pocket- base of pocket

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4
Q

calculation for attachment loss (CAL)

A

cemento-enamel junction (original point of JE in health)

- base of pocket

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5
Q

% of population with periodontal disease

A

~50%

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6
Q

distribution of % perio disease

a. mild
b. mod
c. severe
d. over 65yo

A

a. mild: 8.5%
b. mod: 30%
c. severe: 8.5%
d. over 65yo: 64% moderate/severe perio

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7
Q

% aggressive perio in

a. caucasians
b. black african

A

a. caucasians: 0.1%

b. black african: up to 6%

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8
Q

bacteria involved in

a. aggressive perio
b. chronic perio

A

a. aggressive perio: Aa

b. chronic perio: porph gingivalis

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9
Q

balance between what 2 factors contributes to perio disease

A 
host immune factors (inflammatory response/ immune response)
 parasite factors (bacterial load/ composition)
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10
Q

immune cell dominant in gums in

a. health
b. perio disease

A

a. health: PMNs

b. perio disease: plasma cells

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11
Q

pathogenesis of how plaque causes immune response

A

plaque –> endotoxin –> complement activation + inflammatory response –> gingival tissue damage

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12
Q

do single gene conditions or complex diseases cause more more severe perio? explain

A

single gene conditions. gene mutations –> alter gene/ protein
complex: normal variant, subtle changes to gene/ protein

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13
Q

examples of a. chromosomal
b. single gene
disorders that predispose to perio

A

a. chromosomal: down syndrome

b. single gene : Gorlin syndrome, papillon lefevre syndrome, amelogenesis imperfecta

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14
Q

name a polymorphism linked to perio

A

IL1

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15
Q

% attachment loss with
1 cig/day
10 cigs/day
20 cigs/day

A

1 cig/day: 0.5%
10 cigs/day: 5%
20 cigs/day: 10%

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16
Q

links between smoking and perio 4

A
  • worse attachment loss
  • more calculus (due to tar?)
  • ANUG more likely
  • less likely to respond to tx
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17
Q

effects of nicotine on the gums/ teeth 2

A
  • Vasoconstriction (masks BOP, inc HR/CO/BP)

- adsorbed to root surface –> fibroblast differentiation

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18
Q

2 carcinogens of tobacco

A

N-nitroso compounds

Polycyclic aromatic hydrocarbons

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19
Q

things in periodontium that tobacco INCREASES

A
  • saliva flow, calculus
  • cancer risk
  • candidosis risk
  • staining
  • rough surface (plaque accumulation)
  • NUG
  • gingival fibrosis
  • B forsythus
  • destruction of ECM proteins
  • release of TNF alpha, IL1B, IL6
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20
Q

things in periodontium that tobacco DECREASES

A
  • PMN chemotaxis/ phagoytosis/ migration
  • salivary IgA
  • serum IgG2
  • phagocyte free radicals/ lysozymes
  • t helper cells
  • success of perio tx
  • BOP
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21
Q

effect of smoking on specific bacteria

A

increases B FORSYTHUS

makes all bacteria harder to eradicate

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22
Q

what immunoglobin is affected in aggressive perio. how and why

A

smoking –> dec IgG2

aggressive perio has 2 SMALL gs

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23
Q

signs of periodontal disease indicitave of diabetes-influences perio

A
  • interproximal bone loss
  • atypical / recurrent periodontal abscesses (do not respond to tx)
  • post-puberty presentation
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24
Q

why diabetes predispose to periodontal disease

A

-COLLAGEN: less synthesis,/ solubiltity
collagenase/ cross-linking
-impaired PMN function (less chemotaxis, migration, phagocytosis
-inc IL1, TNF alpha, PGE2

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25
Q

what periodontal problems does stress predispose to

A

chronic perio

NUG

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26
Q

things in periodontium that stress INCREASES

A
  • cortisol
  • cathecholamines in saliva (used by bacteria)
  • adrenaline/ NA (vasoconstriction, masks BOP)
  • saliva viscosity/ acidity/ glycoproteins favouring plaque accumulation
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27
Q

things in periodontium that stress DECREASES

A

saliva flow

28
Q

effect of ultrasonic on tissues

a. pulp
b. root surface
c. enamel
d. periodontal tissues

A

a. pulp: heats. with water- 8 degrees. no water- 35 degrees
b. root surface: less damage than hand instruments
c. enamel:reduced hardness (v bad if demineralised)
d. periodontal tissues: minor histological changes

29
Q

contraindications of ultrasonic 9

A
  • TB
  • comp immunity
  • implants (dont use metal tips)
  • resp problems
  • swallowing probs
  • primary teeth
  • newly erupted teeth
  • decalcified enamel
  • pacemakers (maybe)
30
Q

what increases with power of ultrasonic

A

stroke length

31
Q

when to use beavertail ultrasonic

A

large supragingival deposits

32
Q

effect of faulty O ring on ultrasonic

A

water leak

33
Q

what is ultrasonic coil made of

A

copper

34
Q

best angle of ultrasonic tip on tooth

A

15 degrees

35
Q

when to disguard ultrasonic tip

A

2mm wear at tip

36
Q

4 modes of action of ultrasonic

A
  • lavage (removes debris)
  • mechanical (disrupts biofilm)
  • acoustic (vibration –> effects beyond tip surface)
  • cavitation (bacterial cell wall)
37
Q

what is stillmans cleft

A

the small fissures extending apically from the midline of the gingival margin in teeth subjected to trauma. Although these clefts may be found in traumatism, they are not necessarily diagnostic of occlusal trauma.

38
Q

is periodontal disease primary or secondary occlusal trauma? explain

A

secondary- teeth weakened, (primary is due to forces acting on teeth)

39
Q

response of periodontium to unilateral (sideways) forces

A

inc mobility, normal PDL width

40
Q

response of periodontium to jiggling forces

A

inc mobility, increased PDL width

41
Q

effect of scleroderma on periodontium

A

inc PDL width

42
Q

effect of vit c deficiency on periodontium

A

swollen bleeding gingivae, tooth hypermobility

43
Q

side effect of phenytoin

A

gingival hypertophy (50% pts) due to inc collagen, proteoglycans, GAGs, less immune response

44
Q

3 drugs that cause gingival hyperplasia and % pts affected

A
  • phenytoin (50%)
  • cyclosporin (30%)
  • calcium channel blockers (5-20%)
45
Q

diameter of ball end of WHO probe

A

0.5mm

46
Q

coloured band widths on WHO probe

A

3.5-5.5, 8.5-11.5

47
Q

target probing force in g and N

A

25g= 0.25N

48
Q

turesky scores

A

0=no plaque
1= flecks
2= band 2/3 of crown

49
Q

describe these tooth brushing techniques:

a. bass
b. modified bass
c. scrub
d. fone’s

A

a. bass: 45 degrees to gingival margin, small circles
b. modified bass: as above but roll brush to occlusal surface
c. scrub: similar but short scrub instead of small circles
d. fone’s: FOR KIDS. teeth in occlusion, circles on buccal surfaces and scrub remaining surfaces

50
Q

rank of perio as most prevalent disease

A

6th

51
Q

% prevalence of

a. peri implant mucositis
b. peri implantitis

A

a. peri implant mucositis:43%

b. peri implantitis: 22%

52
Q

force (N) of tooth brushing

A

4N

53
Q

how much does interdental brushing reduce interdental plaque

A

50%

54
Q

what does PMPR stand for and what does it involve

A

Professional Mechanical Plaque Removal
removal of supragingival plaque (supra scale,, OHI)
NOT RSD

55
Q

5 ingredients of toothpaste/ mouthwash that reduce gingivitis

A 
STECC:
stannous fluoride
triclosan
essential oils
chlorhexidine
CPC (centylpyridinum chloride)
56
Q

Loe and Silness 1963 gingival index

A

subjective assessment based on gum colour/ consistency/ bleeding; 4sites per tooth and divide (like Turesky)
0= normal
1= mild inflammation, slight colour change/ oedema, no bleeding
2= moderate inflammation, redness, oedema, BoP
3= severe inflammation, marked redness and oedema, ulceration, spontaneous bleeding

57
Q

diagnostic features of NUG

A
  • punched out papillae ulcers with creamy pus. bleed readily
  • painful gums
  • halitosis
58
Q

types of bacteria in NUG

A

fusobacterium and spirochetes (eg treponema)

59
Q

7 predisposing factors for periodontal abscess

A
  • perio
  • calculus remaining in pocket after debridement
  • penetration of bacteria in to soft tissue wall of perio pocket
  • recent course of antibiotics (can be non-dental reason)
  • diabetes mellitus
  • foreign body impaction
  • tooth fracture
60
Q

common cause of gingival abscess

A

foreign body impaction

61
Q

classes of perio-endo lesions

A

E BEFORE P
1= primary endo lesion draining through PDL
2= primary endo lesion with 2’ perio involvement
3= primary perio lesion (reaching apices?)
4= primary perio + endo

62
Q

tx of perio-endo lesions

A 
OBVIOUS
class 1 --> endo tx/ reassess
class 2--> combined tx
class 3--> perio tx and reassess
class 4 --> combined tx
63
Q

tx of perio-endo lesions

A 
OBVIOUS
class 1 --> endo tx/ reassess
class 2--> combined tx
class 3--> perio tx and reassess
class 4 --> combined tx
64
Q

define index

A

numerical value describing the relative status of the population on a scale with an upper and lower level

65
Q

PRIMARY clinical features of perio 4

A 
Perio Causes Big Gums:
-Pocketing >4mm
-CAL
-Bone loss
-Gingival inflammation
(additional= BoP, mobility, drifting etc)
66
Q

mm CAL and associated % bone loss

A

1-2mm - mild bone loss= 0-25%
3-4mm- mod bone loss= 25-50%
>5mm- severe bone loss= >50%

Year 3 Perio (2 decks)

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