Interpretation of Periodontal Disease Flashcards
what is periodontal disease
destructive inflammatory disease affecting supporting structures of the teeth
what is gingivitis
only the soft tissues are involved
what is involved in periodontitis
soft tissues and supporting bone affected
what is the major cause of tooth loss in patients over 35 yers old
peridontal disease
severity of peridontal disease increases with:
- age
- amount of plaque
- amount of bacterial micro- flora
what are the predisposing factors of periodontal disease
- plaque
- salivary immune factors
- cell mediated hypersensitivitty in crevicular plaque
- local dental factors
what local dental factors are predisposing factors for perio disease
- poor restorations
- calculus
- tilted/rotated tooth
- thin bone
what are the clinical signs of perio disease
- edema, erythema of the tissues
- loss of epithelial attachment to tooth surface and pocket formation
- bleeding on probing
- purulence
what are clinical signs of periodontal changes
- erythema
- visible tissue recession
- periodontal pocket depth - probing
what should be evaluated in bone in radiographs
- quantity- relative to root length
- quantity- crestal evaluation
- quality
- furcation
- PDL space
what are the classes of alveolar bone loss
- generalized
- localized
- horizontal
- vertical
what qualifies as generalized bone loss
greater than 75% of existing dentition
what qualifies as localized bone loss
specify locations ex: #7-D
what features of the root should be examined in radiographs
- length
- shape- conical, diverging, curves, dilaceration
- crown:root ratio
what root anatomy is observed in radiographs
- length
- atypical multiple roots
- proximity to adjacent roots
- shape
what are the things to look for in root length
- atypical multiple roots
what is root dilaceration
- abnormal angulation or bend in the root and occasionally crown of a tooth
what are the causes of root dilaceration
- trauma during odontogenesis
- idiopathic
how is calculus best demonstrated on radiographs
with bright densities
what are the radiographic cahnges in periodontal disease
- horizontal bone loss
- vertical bone loss
- furcation involvement
- large crown:root ratio
what is horizontal bone loss
even/uniform apical movement of the alveolar crestal bone height along adjacent root surfaces between affected tooth/teeth
what does healthy posterior bone look like
- flat, corticated crest
- physiologic bone height is less than or equal to 2mm from CEJs
what does healthy bone in anterior dentition look like
- pointed, corticated crest
what is incipient bone loss
slight crestal bone loss of less than or equal to 1-2mm but less than 20%
what is moderate bone loss
evidence of 20% up to 50% bone loss
what is advanced bone loss
evidence of 50% or more of bone loss, evidence of vertical defects
what does incipient bone loss look like on radiographs
- blunted, non corticated crest
- bone level is apical to physiologic height
- less than or equal to 1-2mm but less than 20%
what does moderate bone loss look like on radiographs
- blunted, non corticated crest
- prominent loss of alveolar bone height
what does advanced bone loss look like on radiographs
- blunted, non corticated crest
- prominent loss of alveolar bone, evidence of 50% or more of bone less, evidence of vertical defects
- crown: root ratio > 1:2
what is the definition of vertical bone loss
- angular bone loss along a root that more severely involves the affected tooth/teeth than the adjacent teeth
describe furcation defects in radiographs
- loss of bone in the furcation area of a multi rooted tooth
- can occur with HBL and VBL
what is the crown:root ratio defined as
length of radiographic crown/length of radiographic root
what does the crown:root ratio tell us
an indication of a tooth’s prognosis
a crown:root ratio of more than _____ has a poor prognosis
1:2
what are the limitations to radiographic examination
- accuracy 40-50% demineralization necessary for radiographic changes
- 2D infra-bony defects difficult to observe
- soft tissue changes: color, edema, plaque
- no information on relationship of soft tisse to hard tissue
- difficult to assess disease on B and Li bone plates adjacent B and Li tooth surfaces
- mobility
what are the treatments for perio disease
- plaque control
- antimicrobial agents: topical or systemic
- professional cleaning: scaling, root planning, curretage
- surgical techniques to re-establish physiologic contours
