INTERPRETATION of PERIODONTAL DISEASE

Question 1

Periodontal Disease:

Answer 1

Destructive inflammatory disease affecting
supporting structures of the teeth

Question 2

❑Gingivitis:

Answer 2

only the soft tissues are involved

Question 3

❑Periodontitis:

Answer 3

soft tissues and supporting bone
affected

Question 4

Periodontal Disease
* Major cause of tooth loss in
patients > — years

Answer 4

35

Question 5

Severity of disease increases with
(3)

Answer 5

*Age
*Amount of plaque
*Amount of bacterial micro-flora

Question 6

Periodontal Disease
Predisposing Factors I
(4)

Answer 6

A) Plaque
B) Salivary Immune Factors
C) Cell mediated hypersensitivity in crevicular
plaque
D) Local dental factors

Question 7

D) Local dental factors
(4)

Answer 7

• poor restorations
• Calculus (tartar)
• Tilted/rotated tooth
• Thin bone

Question 8

Periodontal disease:
Clinical Signs
(4)

Answer 8

• Edema, erythema of the tissues
• Loss of epithelial attachment to
  tooth surface and pocket formation
• Bleeding on probing
• Purulence

Question 9

Radiographic Examination
* Bone
(5)

Answer 9

–quantity; relative to root length
- quantity; crestal evaluation
- quality
- furcation
- PDL space

Question 10

RADIOGRAPHIC EXAMINATION OF
ALVEOLAR BONE LOSS
(4)

Answer 10

• GENERALIZED
• LOCALIZED
• HORIZONTAL
• VERTICAL

Question 11

RADIOGRAPHIC EXAMINATION OF
ALVEOLAR BONE LOSS
* Generalized or Localized???
* Generalized:
* Localized:

Answer 11

> 75 % of existing dentition
Specify locations i.e. #7-D,
#30-M,D

Question 12

Roots
(3)

Answer 12

• length
• shape –conical, diverging, curves,
  dilaceration, etc…
• crown:root ratio

Question 13

Radiographic examination of
ROOT ANATOMY
(4)

Answer 13

• Length
• Atypical multiple roots
• Proximity to adjacent roots
• Shape

Question 14

Shape
(5)

Answer 14

• Conical
• Curves (accentuated or “S”)
• Dilaceration
• Diverging vs. converging
• Hypercementosis
• Etc.

Question 15

Radiographic examination of
ROOT ANATOMY
Length
(2)

Answer 15

• Atypical multiple
• roots

Question 16

Dilaceration
(3)

Answer 16

• Abnormal angulation
  or bend in the root
  (and occasionally the
  crown) of a tooth
• Some related to
  trauma during
  odontogenesis
• idiopathic

Question 17

Local factors
(3)

Answer 17

• restorations
• calculus
• tilted rotated teeth
  ie, uneven marginal
  ridges

Question 18

Radiographic Changes in
Periodontal Disease
(4)

Answer 18

• 1. Horizontal Bone Loss
• 2. Vertical Bone Loss
• 3. Furcation Involvement
• 4. Large crown:root Ratio

Question 19

Horizontal Bone Loss (HBL)
* Definition of Horizontal Bone Loss:

Answer 19

Even/uniform apical movement of the alveolar
crestal bone height along adjacent root surfaces
between affected tooth/teeth

Question 20

Posterior Dentition
Health
(2)

Answer 20

• flat (plateau), corticated crest
• physiologic bone height is
  <2.0mm from CEJs

Question 21

Anterior Dentition
Health
(2)

Answer 21

• pointed, corticated crest
• physiologic height is <2.0mm
  from CEJs

Question 22

• 1. Incipient bone loss –

Answer 22

slight crestal bone loss of < 1.0 –2.0mm, but less than 20%

Question 23

• 2. Moderate bone loss –

Answer 23

evidence of ~20% up to 50% bone loss

Question 24

• 3. Advanced bone loss –

Answer 24

evidence of 50% or more of bone loss; evidence of vertical defects

Question 25

Incipient bone loss (3)

Answer 25

- blunted, non-corticated crest - bone level is apical to physiologic height - < 1.0 – 2.0mm, but less than 20%

Question 26

Moderate Bone Loss (2)

Answer 26

- blunted, non-corticated crest - prominent loss of alveolar bone height

Question 27

Advanced (severe)Bone Loss (3)

Answer 27

- blunted, non-corticated crest - prominent loss of alveolar bone height; evidence of 50% or more of bone loss; evidence of vertical defects - crown:root ratio > 1:2

Question 28

Posterior Dentition Health (2)

Answer 28

- flat (plateau), corticated crest - physiologic bone height is <2.0mm from CEJs

Question 29

Vertical Bone Loss (VBL) * Definition of Vertical Bone Loss:

Answer 29

Angular bone loss along a root that more severely involves the affected tooth/teeth than the adjacent teeth

Question 30

RADIOGRAPHIC EXAMINATION OF FURCATIONS (2)

Answer 30

* Loss of bone in the furcation area of a multi- rooted tooth * Can occur with HBL and VBL

Question 31

Crown:Root Ratio * Defined as:

Answer 31

Length of radiographic crown/ Length of radiographic root

Question 32

Crown:Root Ratio * An index expressed as a ratio that gives an indication of a

Answer 32

tooth’s prognosis

Question 33

Crown:Root Ratio A ratio of more than --- has a poor prognosis

Answer 33

(>) 1:2

Question 34

Radiographic examination limitations (6)

Answer 34

* Accuracy 40 - 50% demineralization necessary for radiographic changes * 2-D Infra-bony defects difficult to observe * Soft-tissue Changes edema, color, plaque * No Information on relationship of soft tissue to hard tissue i.e., pocketing * Difficult to assess disease on B and Li bone plates adjacent B and Li tooth surfaces * Mobility

Question 34

Periodontal Disease Treatment (4)

Answer 34

* 1. Plaque control * 2. Antimicrobial agents – Topical – systemic * 3.Professional Cleaning scaling, root planning, curretage * 4.Surgical techniques to re-establish physiologic contours