health and healthy in reduced periodontium Flashcards
biologic width
epithelial attachment plus supracrestal connective tissue attachment
pocket depth
gingival margin to base of sulcus
CAL formula
PD + recession
PD-overgrowth
what determines treatment needs?
probing pocket depth
what estimates tissue destruction?
clinical attachment level
what measures inflammation and disease activity?
bleeding on probing
periodontal indices
CAL
PD
BOP
inflammation shown by?
plaque
BOP
systemic condition
smoking
diabetes
disease affecting periodontium
periodontal health, gingival diseases and conditions
- periodontal health and gingival health
- gingivitis: dental biofilm-induced
- gingival disease: non-dental biofilm induced
what is the biology of clinical gingival health?
generally associated with an inflammatory infiltrate and a host response consistent with homeostasis
on a site level, how do we classify clinical gingival health?
- clinical gingival health on an intact periodontium
- clinical gingival health on a reduced periodontium
- -stable periodontitis patient
- -non-periodontitis patient (e.g. recession, crown lengthening)
what does the periodontium consist of?
- pdl
- gingiva
- bone
- cementum
clinical features of health on an intact periodontium
- no attachment loss
- probing depths less than 3 mm
- less than 10% BOP
- no bone loss–1.0-3.0 mm apical to CEJ
- no symptoms
clinical features of health on reduced periodontium
- no BOP, erythema, edema, or symptoms
- reduced clinical attachment and bone levels
- probing attachment loss
- pockets less than 3 mm
- less than 10% BOP
- possible bone loss
intact periodontium
NO loss of periodontal tissue
reduced periodontium
a periodontium with pre-existing loss or periodontal tissue and bone, but not progressive, ongoing loss of attachment
examples of attachment loss/bone loss due to non-periodontitis reasons
- ortho
- soft tissue recession after surgical crown lengthening
- gingival abrasion with tooth brushing
- cervical dental caries
- physiologic bone resorption in edentulous area
dental plaque biofilm-induced gingivitis
an inflammatory lesion from plaque biofilm and hosts immune response
-remains within gingiva and does not extend to periodontal attachment (cementum, periodontal ligament, alveolar bone)
signs of gingivitis
- swelling
- bleeding on probing
- redness
- discomfort on gentle probing
symptoms of gingivitis
- bleeding gums
- pain
- halitosis
- difficulty eating
- appearance
- reduced oral health – related to quality of life
T/F radiographs can be used to diagnose gingivitis
false
you can’t see bone loss bc it’s just soft tissue
classifications of gingivitis
- gingivitis on intact perio
- gingivitis on reduced perio in non-perio patient
- ging inflammation on reduced perio in a successfully treated perio patient
what is the main difference between gingivitis and periodontitis
bleeding on probing
difference between gingivitis on intact and reduced periodontium
-reduced perio has probing attachment loss and possible bone loss
stable periodontitis patient
perio patient who demonstrates clinical signs of perio health on periodontium who was previously diagnosed with perio but has been successfully managed in past and is currently stable (typical periodontal maintenance patient)
* probing depth less than 4 mm
non-dental plaque-induced gingival diseases
- genetic/developmental disorders
- specific infections
- inflammatory and immune conditions
- reactive processes
- neoplasms
- endocrine, nutritional, and metabolic diseases
- traumatic lesions
- gingival pigmentation
viral origins of gingival diseases
- coxsackie virus
- herpes I & II
- varicella zoster
- human papilloma virus
fungal origin of gingival dieases
- candidosis
- other mycoses, e.g. histoplasmosis
inflammatory and immune conditions
- hypersensitivity reactions
- autoimmune diseases
- granulomatous inflammatory lesions
- hypersensitivity reactions: contact allergy, plasma cell gingivitis, erythema multiforme
autoimmune diseases that cause gingival disease
pemphigus vulgaris
pemphigoid
lichen planus
lupus erythematosus
granulomatous inflammatory lesions
- crohn’s disease
- sarcoidosis
reactive processes
- epulides
- fibrous epulis
- calcifying fibroblastic granuloma
- vascular epulis (pyogenic granuloma)
- peripheral giant cell granuloma
neoplasms
I. premalignancy–leukoplakia, erythroplakia
II. malignancy–squamous cell carcinoma, leukemic cell infiltration, lymphoma (hodgkin or non-hodgkin)
endocrine, nutritional, and metabolic diseases
I. vitamin deficiences – vitamin C deficiency
traumatic lesions
- physical/mechanical trauma
- chemical (toxic) burn
- thermal insults
gingival pigmentation
- melanoplakia
- smoker’s melanosis
- drug-induced pigmentation
- amalgam tattoo
diagnosis is not only based on site evaluation but?
patient evaluation
periodontal health is defined by?
absence of clinically detectable inflammation
2 broad categories of gingival disease
- non-dental plaque biofilm-induced gingival diseases
2. dental plaque-induced gingivitis
dental plaque-induced gingivitis may arise on what or what
intact periodontium or on reduced periodontium
the treated and stable periodontitis patient with current gingival health still remains at risk for what?
recurrent periodontitis
