Interpretation of Periodontal Disease

Question 1

what is periodontal disease

Answer 1

destructive inflammatory disease affecting supporting structures of the teeth

Question 2

what is gingivitis

Answer 2

only the soft tissues are involved

Question 3

what is involved in periodontitis

Answer 3

soft tissues and supporting bone affected

Question 4

what is the major cause of tooth loss in patients over 35 yers old

Answer 4

peridontal disease

Question 5

severity of peridontal disease increases with:

Answer 5

• age
• amount of plaque
• amount of bacterial micro- flora

Question 6

what are the predisposing factors of periodontal disease

Answer 6

• plaque
• salivary immune factors
• cell mediated hypersensitivitty in crevicular plaque
• local dental factors

Question 7

what local dental factors are predisposing factors for perio disease

Answer 7

• poor restorations
• calculus
• tilted/rotated tooth
• thin bone

Question 8

what are the clinical signs of perio disease

Answer 8

• edema, erythema of the tissues
• loss of epithelial attachment to tooth surface and pocket formation
• bleeding on probing
• purulence

Question 9

what are clinical signs of periodontal changes

Answer 9

• erythema
• visible tissue recession
• periodontal pocket depth - probing

Question 10

what should be evaluated in bone in radiographs

Answer 10

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

Question 11

what are the classes of alveolar bone loss

Answer 11

• generalized
• localized
• horizontal
• vertical

Question 12

what qualifies as generalized bone loss

Answer 12

greater than 75% of existing dentition

Question 13

what qualifies as localized bone loss

Answer 13

specify locations ex: #7-D

Question 14

what features of the root should be examined in radiographs

Answer 14

• length
• shape- conical, diverging, curves, dilaceration
• crown:root ratio

Question 15

what root anatomy is observed in radiographs

Answer 15

• length
• atypical multiple roots
• proximity to adjacent roots
• shape

Question 16

what are the things to look for in root length

Answer 16

• atypical multiple roots

Question 17

what is root dilaceration

Answer 17

• abnormal angulation or bend in the root and occasionally crown of a tooth

Question 18

what are the causes of root dilaceration

Answer 18

• trauma during odontogenesis
• idiopathic

Question 19

how is calculus best demonstrated on radiographs

Answer 19

with bright densities

Question 20

what are the radiographic cahnges in periodontal disease

Answer 20

• horizontal bone loss
• vertical bone loss
• furcation involvement
• large crown:root ratio

Question 21

what is horizontal bone loss

Answer 21

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

Question 22

what does healthy posterior bone look like

Answer 22

• flat, corticated crest
• physiologic bone height is less than or equal to 2mm from CEJs

Question 23

what does healthy bone in anterior dentition look like

Answer 23

• pointed, corticated crest

Question 24

what is incipient bone loss

Answer 24

slight crestal bone loss of less than or equal to 1-2mm but less than 20%

Question 25

what is moderate bone loss

Answer 25

evidence of 20% up to 50% bone loss

Question 26

what is advanced bone loss

Answer 26

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

Question 27

what does incipient bone loss look like on radiographs

Answer 27

• blunted, non corticated crest
• bone level is apical to physiologic height
• less than or equal to 1-2mm but less than 20%

Question 28

what does moderate bone loss look like on radiographs

Answer 28

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

Question 29

what does advanced bone loss look like on radiographs

Answer 29

• 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

Question 30

what is the definition of vertical bone loss

Answer 30

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

Question 31

describe furcation defects in radiographs

Answer 31

• loss of bone in the furcation area of a multi rooted tooth
• can occur with HBL and VBL

Question 32

what is the crown:root ratio defined as

Answer 32

length of radiographic crown/length of radiographic root

Question 33

what does the crown:root ratio tell us

Answer 33

an indication of a tooth’s prognosis

Question 34

a crown:root ratio of more than _____ has a poor prognosis

Answer 34

1:2

Question 35

what are the limitations to radiographic examination

Answer 35

• 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

Question 36

what are the treatments for perio disease

Answer 36

• plaque control
• antimicrobial agents: topical or systemic
• professional cleaning: scaling, root planning, curretage
• surgical techniques to re-establish physiologic contours