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Periodontology > ICP-27 Epidemiology and Classification of Periodontal Disease > Flashcards

ICP-27 Epidemiology and Classification of Periodontal Disease Flashcards

1
Q

What are the important purposes of epidemiology

A
  • Determine amount and distribution of disease in a population
  • Determine the cause of the disease
  • Apply knowledge to control the disease, promote, protect and restore oral health
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2
Q

What does prevalence mean

A

The % or proportion of the population affected by the disease at a single point in time

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3
Q

What does incidence mean

A

The number of new cases of a disease occurring in the population over a defined period of time

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4
Q

What do we look at when measuring periodontal disease

A

Measure:

  • Current disease: pocketing or probing measurements that reflect current level of inflammation
  • Historic disease: bone loss, clinical attachment loss (CAL)
  • Treated disease: pockets or probing depths that have reduced to <4mm, bone loss is irreversible when occurs
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5
Q

What are the different measures of plaque levels

A
  • Detection: look visually or use a probe to detect
  • Identify presence of quantify: dichotomous scoring, indices
  • Full mouth assessment of plaque: 4 or 6 points/tooth
  • Partial assessments: plaque index, turesky scores
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6
Q

What are the different measures of bleeding

A
  • Detection: use of a probe on gentle use
  • Timing of bleeding: immediate = marginal gingival health shows inflammation
    delayed = more common when marginal health is good but associated with deep pockets
  • Identify or quantity: dichotomous scoring, indices
  • Full mouth assessment: 4 or 6 points/tooth
  • Partial assessments: gingival bleeding index
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7
Q

What is measured when carrying out full periodontal charting

A
  • Probing pocket depth (PPD): distance from gingival margin to base of pocket in mm
  • Recession: distance from gingival margin to the CEJ in mm
  • Clincial attachment loss (CAL): distance from CEJ to pocket (recession + PPD) in mm
  • Mobility: horizontal or vertical mobility
  • Furcation involvement
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8
Q

How do we scale tooth mobility in periodontal charting

A

In degrees from 0-3

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9
Q

Describe what a BPE probe looks like

A

BPE probe - generic af, has ting ball at end and black bands 3.5-5.5mm and 8.5-11.5mm

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10
Q

Describe what a Naber’s probe looks like and what it is used for

A

Like a fish hook sorta, it is curved and has markings every 3 mm
Used to investigate furcation involvement

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11
Q

Describe what a William’s probe looks like and what it is used for

A

More generic than fookin BPE probe and has markings at 1,2,3,5,7,8,9 and 10 mms.
Used for full 6 point pocket charts

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12
Q

Describe what a UNC probe looks like and what it is used for

A

Similar to BPE probe and has markings for all mms. and has black bands at 4-5mm, 9-10mm and 14-15mm,

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13
Q

What is the difference between PPD and CAL

A
  • Probing Pocket Depth (PPD): distance from gingival margin to base of pocket in mm.
  • Clinical Attachment Loss (CAL): distance from CEJ to pocket base in mm.
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14
Q

What % of adults have some bleeding

A

50-60%

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15
Q

As a general trend what has happened to the prevalence of periodontal pocketing over time

A
  • Reduction in mild disease
  • Slight increase in the prevalence of more severe disease
  • Severe disease are concentrated in a relatively small proportion of the population
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16
Q

What local risk factors can affect the risk of periodontal disease/pocketing

A
  • Anatomical
  • Enamel pearls/root grooves/ furcations/ recession
  • Tooth position
  • Malalignment/ crowding/ tipping
  • Iatrogenic
  • Restorative margins/ partical dentures/ orthodontic appliances
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17
Q

Name some modifiable systemic risk factors for periodontal disease/pocketing

A
  • Specific bacteria
  • Smoking
  • Diabetes Mellitus
  • Oral Hygiene
  • Stress
  • Obesity
  • Immunodeficiency
  • Certain medications
  • Diet
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18
Q

Name some non-modifiable systemic risk factors for periodontal disease/pocketing

A
  • Age
  • Genetics
  • Hormonal influences (like those related to pregnancy)
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19
Q

What are the models for the progression of periodontitis

A

Gradual destruction model: assumes a slow continuous rate of progression
Burst Theory: Periods of rapid breakdown interspersed with long periods of quiescence

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20
Q

What factors need to be considered in a periodontal diagnosis

A
  • Health of Disease?
  • Form of disease: is there gingivitis (reversible) or periodontitis (irreversible)
  • Distribution/Extent: affects only a few or all of the teeth
  • Severity of the disease: how much disease has the patient and in the past
  • Speed of progression: how quickly has disease occurred
  • Stability: Is the disease currently active or is it stable
  • Risk factors: what is contributing to the disease
21
Q

What are the main forms of periodontal disease

A
  • Periodontal health: PPD <4mm and no/low levels of bleeding
  • Gingivitis: gingival bleeding without bone/attachment loss
  • Periodontitis: bone/attachment loss
22
Q

What forms does periodontitis present itself in

A
  • Periodontitis (most common): combines acute and chronic periodontitis
  • Necrotising periodontitis: necrotised papillae, halitosis, pain, stress
  • Periodontitis as a manifestation of systemic disease:
  • Genetic condition, metabolic disease, immunodeficiency
23
Q

What are some systemic genetic conditions that can lead to periodontitis

A
  • Papillon Lefecre syndrome
  • Leukocyte adhesion deficiencies
  • Chediak-higashi syndrome
24
Q

What metabolic diseases can lead to periodontitis

A

Hypopohosphatasia

25
Q

What are the 4 factors to consider when scaling the degree of periodontitis in a patient

A
  • Distribution/extent
  • Type of periodontitis
  • Stage (I-IV) - severity
  • Grade (A-C) - speed of progression
26
Q

What ways can the extent of periodontitis disease/distribution of periodontitis occur

A
  • Molar incisor - only molars and incisors affected
  • Localised - <30% of teeth affected
  • Generalised - >30% of teeth affected
27
Q

What types of periodontitis can affect a patient

A
  • Periodontitis: chronic and acute included in this category
  • Necrotising periodontitis
  • Periodontitis as a manifestation of systemic disease
28
Q

Describe stage 1 of periodontitis severity

A
  • Interdental CAL at site of greatest loss: 1-2mm
  • Radiographic bone loss: coronal third (<15%)
  • Tooth loss: none
  • Max probing depth: 4mm
  • Mostly horizontal bone loss
29
Q

Describe stage 2 of periodontitis severity

A
  • Interdental CAL at site of greatest loss: 3-4mm
  • Radiographic bone loss: coronal third (15-33%)
  • Tooth loss: none
  • Max probing depth: 5mm.
  • Mostly horizontal bone loss
30
Q

Describe stage 3 of periodontitis severity

A
  • Interdental CAL at site of greatest loss: > or equal to 5mm
  • Radiographic bone loss: Extending to middle or apical third of the root
  • Tooth loss: < or equal to 4 teeth lost due to periodontitis
  • Probing depth: 6mm
  • Vertical bone loss >3mm
  • Furcation involvement
31
Q

Describe stage 4 of periodontitis severity

A
  • Interdental CAL at site of greatest loss: > or equal to 5mm
  • Radiographic bone loss: extending to middle or apical third of the root
  • Tooth loss: > or equal to 5 teeth lost due to periodontitis
  • Ur just fucked
32
Q

Describe grade A speed of periodontitis progression

A
  • Slow rate of progression
  • Evidence of no loss over 5 years using radiographic bone loss or CAL
  • <0.25% bone loss
  • Heavy biofilm deposits with low levels of destruction
33
Q

Describe grade B speed of periodontitis progression

A
  • Moderate rate of progression
  • Radiographic bone loss and CAL show <2mm loss over 5 years
  • 0.25-1% bone loss
  • Destruction commensurate with biofilm deposits
34
Q

Describe grade C speed of periodontitis progression

A
  • Rapid rate of progression
  • > 2mm of radiographic bone loss/CAL over 5 years
  • > 1.0% of bone loss
  • Destruction exceeds expectation given biofilm deposits
35
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

Smoking and diabetes are risk factors that can act as grade modifiers on the rate at which periodontitis can evolve

36
Q

Give examples of how to write a diagnosis for gingivitis or periodontitis

A
  1. Describe distribution: Localised, Generalised, Molar-Incisor
  2. Type of periodontitis: Gingivitis, periodontitis, necrotising etc
  3. Stage of severity: I-IV
  4. Speed progression grade: A-C
37
Q

What are the 6 factors in a periodontitis diagnosis established by the BSP (one you’ll be using broooo)

A
  • Distribution
  • Type of periodontitis
  • Staging
  • Grading
  • Current disease activity/status
  • Risk factors
38
Q

Describe how the BSP categorise the distribution (extent) of periodontal disease

A

Same as WWP:

  • Molar incisor: only affects molars and incisors
  • Localised: <30% of teeth
  • Generalised: >30% of teeth
39
Q

What types of periodontitis does the BSP disease classification use

A
  • Periodontitis: Acute and Chronic in this group
  • Necrotising periodontitis
  • Periodontitis as a manifestation of systemic disease
40
Q

Describe Stage I of BSP periodontitis

A
  • Very early bone loss

- Bone loss % at worst site: 0-15%

41
Q

Describe Stage II of BSP periodontitis

A
  • Coronal 1/3 bone loss

- Bone loss % at worst site: 15-33%

42
Q

Describe Stage III of BSP periodontitis

A
  • Middle 1/3 bone loss

- Bone loss % at worst site: 33-66%

43
Q

Describe Stage IV of BSP periodontitis

A
  • Apical 1/3 bone loss

- Bone loss % at worst site: >66%

44
Q

Describe grade A (progression) of periodontitis established by the BSP

A
  • Rate: slow
  • Bone loss(%)/Age: 0 - 0.5
  • BL < 1/2 age
45
Q

Describe grade B (progression) of periodontitis established by the BSP

A
  • Rate: Moderate

- Bone loss(%)/Age: 0.5-1

46
Q

Describe grade C (progression) of periodontitis established by the BSP

A
  • Rate: rapid
  • Bone loss(%)/Age: >1
  • BL > Age
47
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

Starting assumption is that patients are a grade B

48
Q

Before periodontitis treatment describe if the state of the current patient disease is stable of unstable

A

Healthy + stable:
- If there aren’t probing depths greater than 3mm
- BoP < 10%
Unstable + requires treatment:
- If there are probing depths great than 3mm. and BoP > 10%

49
Q

What are some risk factors that contribute to periodontitis risk

A
  • Smoking
  • Uncontrolled diabetes
  • Stress
  • Immunosuppression
  • Genetics

Periodontology (12 decks)

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