Interpretation of periodontal disease Flashcards
1
Q
Destructive inflammatory disease affecting supporting structures of the teeth:
A
periodontal disease
2
Q
Destructive inflammatory disease affecting only the soft tissues:
A
gingivitis
3
Q
Destructive inflammatory disease affecting soft tissues and supporting bone
A
periodontitis
4
Q
The extent of periodontal disease is based on:
A
how apically alveolar bone moves
5
Q
How would you describe these images?
A
Healthy teeth & gums
6
Q
How would you describe these images?
A
gingivitis
7
Q
How would you describe these images?
A
early periodontitis
8
Q
How would you describe these images?
A
moderate periodontitis
9
Q
How would you describe these images?
A
advanced periodontitis
10
Q
The major cause of tooth loss in patients greater than 35 years of age:
A
periodontal disease
11
Q
The severity of periodontal diseases increases with: (3)
A
- age
- amount of plaque
- amount of bacterial micro-flora
12
Q
Predisposing factors for periodontal disease include: (4)
A
- plaque
- salivary immune factors
- cell mediated hypersensitivity in crevicular plaque
- local dental factors
13
Q
T/F: Immune response to the bacteria in the oral cavity can have negative effects on the periodontal tissues
A
true
14
Q
What are some local factors that are deemed predisposing factors for periodontal disease? (4)
A
- poor restorations
- calculus (tartar)
- tilted/rotated tooth
- thin bone
15
Q
Clinical signs of periodontal DISEASE include: (4)
A
- edema & erythema of tissues
- loss of epithelial attachment to tooth surfaces and pocket formation
- bleeding on probing
- purulence
16
Q
What can be seen in this image?
A
early, mild periodontal changes
17
Q
What can be seen in these images?
A
chronic periodontitis with a favorable immune response
18
Q
What can be seen in this image?
A
inflammatory periodontal changes
19
Q
What can be seen in this image?
A
advanced periodontal changes
20
Q
What can be seen in the following image?
A
Chronic advanced periodontal change
21
Q
Clinical signs of periodontal CHANGES include: (3)
A
- erythema
- visible tissue recession
- periodontal pocket depth (probing)
22
Q
During radiographic examination of the bone what should be evaluated?
A
- bone quantity; relative to root length
- bone quantity; crestal evaluation
- bone quality (how dense the bone is/ trabecular pattern)
- furcation
- PDL space
23
Q
When bone loss affects furcation this =
A
furcation defect
24
Q
What is more critical?
- bone loss with longer roots
- bone loss with shorter roots
A
bone loss with shorter roots
25
What do radiographs allow us to visualize in regards to alveolar bone?
alveolar bone level
26
What are the types of alveolar bone loss categorized as?
1. generalized
2. localized
3. horizontal
4. vertical
27
Alveolar bone loss is considered _____ when there is greater than 75% of existing dentition effected
generalized
28
Specific locations of alveolar bone loss such as "around #7D and #30 MD" would be considered ____.
localized
29
What must be done with localized alveolar bone loss?
specify locations
30
When radiographically examining the roots, we should evaluate: (5)
1. length
2. shape
3. crown-root ratio
4. proximity to adjacent roots
5. atypical/multiple roots
31
When using terms such as conical, diverging, curved, or dilacerations, we are describing the ___ of the root
shape
32
What is the concern with roots being closer together in periodontal disease?
If roots are closer together, then the bone is more thin in between and disease can advance quicker
33
What can be seen in this image? How does this affect the prognosis?
3rd lingual root; helps anchor tooth
34
What can be seen in this image? How does this affect the prognosis?
Short roots; bad prognosis
35
What can be seen in this image? How does this affect the prognosis?
Long roots; good prognosis
36
describe this picture:
red= thinner bone- diseases advances faster
green= nice spacing (better prognosis)
yellow = plaque trap due to impaction
37
How would we describe the root in this image? How does this affect prognosis?
converging; poor prognosis due to less anchorage
38
How would we describe the root in this image? How does this affect prognosis?
dilacerating; good prognosis
39
How would we describe the root in this image? How does this affect prognosis?
diverging; good prognosis
40
Abnormal angulation or bend in the root (and occasionally the crown ) of a tooth
dilaceration
41
Some dilacerations are related to:
1. trauma during odontogenesis
2. idiopathic
42
Describe the roots in this image:
dilacerated
43
What can be seen in the following image?
hypercementosis
44
What can be seen in the following image?
dilacerated
45
List the local factors you should be looking for during radiographic examination:
1. restorations
2. calculus
3. tilted rotated teeth
46
How would you determine if a tooth on a radiograph is tilted/rotated?
uneven marginal ridges
47
What type of bone loss are we seeing in this image?
vertical bone defect
48
What can be seen in this image?
plaque trap because of poor restorations (overhang)
49
What stands out in the following image?
calculus
50
What stands out in the following image?
calculus
51
When evaluating a radiograph for calculus, what may be helpful?
Lighten the image (calculus demonstrates best with "bright" densities)
52
What button would you use to adjust brightness to reveal calculus more easily on a radiograph?
Sun button
53
Radiographic changes seen in periodontal disease may include:
1. horizontal bone loss
2. vertical bone loss
3. furcation involvement
4. large crown-to-root ratio
54
Even/uniform apical movement of the alveolar crestal bone height along adjacent root surfaces between affected tooth/teeth
horizontal bone loss (HBL)
55
T/F: The alveolar bone should be at the CEJ of the teeth:
False- the alveolar bone is NEVER at the CEJ of teeth, there is a little space between the bone and crest called the follicular space
56
The normal bone level is slightly ___ to the CEJ ~___mm
apical; 1mm
57
What do we consider a healthy bone level?
Within 2mm of the CEJ
58
If there is more than a 2mm space between the bone level and the CEJ, this indicates:
bone loss
59
If the bone level is coronal to the CEJ, this indicates:
a neoplasm or other issue
60
Describe health in posterior bone levels:
1. flat (plateau), corticated crest
2. physiologic bone height is less than or equal from CEJs
61
This measurement tooth is being used to look at:
bone level
62
Slight crestal bone loss of less than or equal to 1.0-2.0 mm, but less than 20%
incipient bone loss
63
Evidence of ~20% and up to 50% bone loss:
moderate bone loss
64
Evidence of 50% or more of bone loss; evidence of vertical defects:
advanced bone loss
65
- blunted, non-corticated crest
- bone level is apical to physiologic height
- less than or equal to 1.0-2.0 mm of bone loss
- less than 20% of bone loss
incipient bone loss
66
What type of bone loss is seen in this radiograph?
Incipient bone loss
67
- blunted, non-corticated crest
- prominent loss of alveolar bone height
- less than 1/2 root length (no greater than 50%)
moderate bone loss
68
What type of bone loss is seen in this radiograph?
moderate bone loss
69
Determine which radiograph shows moderate bone loss and which shows advanced bone loss:
Left= moderate
Right= advanced
70
- blunted, non-corticated crest
- prominent loss of alveolar bone height
- crown:root ratio greater than 1:2
advanced bone loss
71
What characteristic can be seen with advanced bone loss?
hyperplasia of nutrient canals
72
What can be seen in this image? What does this indicate?
hyperplasia of nutrient canals; advanced bone loss
73
What is indicated in this image?
follicular space
74
How can you tell when loss of cortication begins with periodontal disease?
Less of a well defined line of alveolar bone (it gets kinda blurred)
75
Angular bone loss along a root that more severely involves the affected tooth/teeth than the adjacent teeth:
vertical bone loss (VBL)
76
What type of bone loss is seen in these images? Why?
Vertical bone loss; more advanced in specific areas (non-uniform)
77
What type of bone loss is seen in these images? Why?
Vertical bone loss; more advanced in specific areas (non-uniform)
78
Loss of bone in the furcation area of multi-rooted teeth:
furcation defect
79
Furcation defects can occur with:
HBL and VBL
80
What can be seen in the following images?
furcation defects
81
Diagnose the bone loss in this image:
furcation defect with HBL
82
Diagnose the bone loss in these images:
Furcation with VBL
83
The crown:root ratio is an indicator of how much:
bone is supporting the tooth
84
Length of crown / Length of radiographic root
crown: root ratio
85
An index expressed as a ratio that gives an indication of a tooth's prognosis
crown: root ratio
86
A crown:root ratio of greater than ____ has a poor prognosis
1:2
87
What is worse, a crown:root ratio of 2:1 or 1:2
2:1 (if you actually divide these, the one with the bigger number will be worse)
88
Accuracy of ____ demineralization is necessary for radiographic changes
40-50%
89
____ defects may be difficult to observe on a radiograph
2-D infra-bony
90
In addition to a radiograph, what else needs to be examined:
- soft-tissue changes
- edema
- color
- plaque
91
A radiographic examination limitation is that there is not information on the relationship of:
soft tissue to hard tissue (i.e. pocketing)
92
It is especially difficult to assess disease on ____ & ____ bone plates and adjacent __ and ___ tooth surfaces
B& Li; B& Li
93
Can mobility be assessed on a radiograph?
No
94
What four facets are involved in treating periodontal disease?
1. plaque control
2. antimicrobial agents (topical or systemic)
3. professional cleaning (SRP)
4. surgical techniques to re-establish physiologic contours
95
