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Oral Radiology > Interpretation of periodontal disease > Flashcards

Interpretation of periodontal disease Flashcards

1
Q

Destructive inflammatory disease affecting supporting structures of the teeth:

A

periodontal disease

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2
Q

Destructive inflammatory disease affecting only the soft tissues:

A

gingivitis

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3
Q

Destructive inflammatory disease affecting soft tissues and supporting bone

A

periodontitis

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4
Q

The extent of periodontal disease is based on:

A

how apically alveolar bone moves

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5
Q

How would you describe these images?

A

Healthy teeth & gums

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6
Q

How would you describe these images?

A

gingivitis

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7
Q

How would you describe these images?

A

early periodontitis

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8
Q

How would you describe these images?

A

moderate periodontitis

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9
Q

How would you describe these images?

A

advanced periodontitis

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10
Q

The major cause of tooth loss in patients greater than 35 years of age:

A

periodontal disease

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11
Q

The severity of periodontal diseases increases with: (3)

A
  1. age
  2. amount of plaque
  3. amount of bacterial micro-flora
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12
Q

Predisposing factors for periodontal disease include: (4)

A
  1. plaque
  2. salivary immune factors
  3. cell mediated hypersensitivity in crevicular plaque
  4. local dental factors
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13
Q

T/F: Immune response to the bacteria in the oral cavity can have negative effects on the periodontal tissues

A

true

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14
Q

What are some local factors that are deemed predisposing factors for periodontal disease? (4)

A
  1. poor restorations
  2. calculus (tartar)
  3. tilted/rotated tooth
  4. thin bone
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15
Q

Clinical signs of periodontal DISEASE include: (4)

A
  1. edema & erythema of tissues
  2. loss of epithelial attachment to tooth surfaces and pocket formation
  3. bleeding on probing
  4. purulence
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16
Q

What can be seen in this image?

A

early, mild periodontal changes

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17
Q

What can be seen in these images?

A

chronic periodontitis with a favorable immune response

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18
Q

What can be seen in this image?

A

inflammatory periodontal changes

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19
Q

What can be seen in this image?

A

advanced periodontal changes

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20
Q

What can be seen in the following image?

A

Chronic advanced periodontal change

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21
Q

Clinical signs of periodontal CHANGES include: (3)

A
  1. erythema
  2. visible tissue recession
  3. periodontal pocket depth (probing)
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22
Q

During radiographic examination of the bone what should be evaluated?

A
  1. bone quantity; relative to root length
  2. bone quantity; crestal evaluation
  3. bone quality (how dense the bone is/ trabecular pattern)
  4. furcation
  5. PDL space
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23
Q

When bone loss affects furcation this =

A

furcation defect

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24
Q

What is more critical?

  • bone loss with longer roots
  • bone loss with shorter roots
A

bone loss with shorter roots

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25
Q

What do radiographs allow us to visualize in regards to alveolar bone?

A

alveolar bone level

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26
Q

What are the types of alveolar bone loss categorized as?

A
  1. generalized
  2. localized
  3. horizontal
  4. vertical
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27
Q

Alveolar bone loss is considered _____ when there is greater than 75% of existing dentition effected

A

generalized

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28
Q

Specific locations of alveolar bone loss such as “around #7D and #30 MD” would be considered ____.

A

localized

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29
Q

What must be done with localized alveolar bone loss?

A

specify locations

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30
Q

When radiographically examining the roots, we should evaluate: (5)

A
  1. length
  2. shape
  3. crown-root ratio
  4. proximity to adjacent roots
  5. atypical/multiple roots
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31
Q

When using terms such as conical, diverging, curved, or dilacerations, we are describing the ___ of the root

A

shape

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32
Q

What is the concern with roots being closer together in periodontal disease?

A

If roots are closer together, then the bone is more thin in between and disease can advance quicker

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33
Q

What can be seen in this image? How does this affect the prognosis?

A

3rd lingual root; helps anchor tooth

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34
Q

What can be seen in this image? How does this affect the prognosis?

A

Short roots; bad prognosis

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35
Q

What can be seen in this image? How does this affect the prognosis?

A

Long roots; good prognosis

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36
Q

describe this picture:

A

red= thinner bone- diseases advances faster
green= nice spacing (better prognosis)
yellow = plaque trap due to impaction

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37
Q

How would we describe the root in this image? How does this affect prognosis?

A

converging; poor prognosis due to less anchorage

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38
Q

How would we describe the root in this image? How does this affect prognosis?

A

dilacerating; good prognosis

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39
Q

How would we describe the root in this image? How does this affect prognosis?

A

diverging; good prognosis

40
Q

Abnormal angulation or bend in the root (and occasionally the crown ) of a tooth

A

dilaceration

41
Q

Some dilacerations are related to:

A
  1. trauma during odontogenesis
  2. idiopathic
42
Q

Describe the roots in this image:

A

dilacerated

43
Q

What can be seen in the following image?

A

hypercementosis

44
Q

What can be seen in the following image?

A

dilacerated

45
Q

List the local factors you should be looking for during radiographic examination:

A
  1. restorations
  2. calculus
  3. tilted rotated teeth
46
Q

How would you determine if a tooth on a radiograph is tilted/rotated?

A

uneven marginal ridges

47
Q

What type of bone loss are we seeing in this image?

A

vertical bone defect

48
Q

What can be seen in this image?

A

plaque trap because of poor restorations (overhang)

49
Q

What stands out in the following image?

50
Q

What stands out in the following image?

51
Q

When evaluating a radiograph for calculus, what may be helpful?

A

Lighten the image (calculus demonstrates best with “bright” densities)

52
Q

What button would you use to adjust brightness to reveal calculus more easily on a radiograph?

A

Sun button

53
Q

Radiographic changes seen in periodontal disease may include:

A
  1. horizontal bone loss
  2. vertical bone loss
  3. furcation involvement
  4. large crown-to-root ratio
54
Q

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

A

horizontal bone loss (HBL)

55
Q

T/F: The alveolar bone should be at the CEJ of the teeth:

A

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
Q

The normal bone level is slightly ___ to the CEJ ~___mm

A

apical; 1mm

57
Q

What do we consider a healthy bone level?

A

Within 2mm of the CEJ

58
Q

If there is more than a 2mm space between the bone level and the CEJ, this indicates:

59
Q

If the bone level is coronal to the CEJ, this indicates:

A

a neoplasm or other issue

60
Q

Describe health in posterior bone levels:

A
  1. flat (plateau), corticated crest
  2. physiologic bone height is less than or equal from CEJs
61
Q

This measurement tooth is being used to look at:

A

bone level

62
Q

Slight crestal bone loss of less than or equal to 1.0-2.0 mm, but less than 20%

A

incipient bone loss

63
Q

Evidence of ~20% and up to 50% bone loss:

A

moderate bone loss

64
Q

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

A

advanced bone loss

65
Q
  • 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
A

incipient bone loss

66
Q

What type of bone loss is seen in this radiograph?

A

Incipient bone loss

67
Q
  • blunted, non-corticated crest
  • prominent loss of alveolar bone height
  • less than 1/2 root length (no greater than 50%)
A

moderate bone loss

68
Q

What type of bone loss is seen in this radiograph?

A

moderate bone loss

69
Q

Determine which radiograph shows moderate bone loss and which shows advanced bone loss:

A

Left= moderate
Right= advanced

70
Q
  • blunted, non-corticated crest
  • prominent loss of alveolar bone height
  • crown:root ratio greater than 1:2
A

advanced bone loss

71
Q

What characteristic can be seen with advanced bone loss?

A

hyperplasia of nutrient canals

72
Q

What can be seen in this image? What does this indicate?

A

hyperplasia of nutrient canals; advanced bone loss

73
Q

What is indicated in this image?

A

follicular space

74
Q

How can you tell when loss of cortication begins with periodontal disease?

A

Less of a well defined line of alveolar bone (it gets kinda blurred)

75
Q

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

A

vertical bone loss (VBL)

76
Q

What type of bone loss is seen in these images? Why?

A

Vertical bone loss; more advanced in specific areas (non-uniform)

77
Q

What type of bone loss is seen in these images? Why?

A

Vertical bone loss; more advanced in specific areas (non-uniform)

78
Q

Loss of bone in the furcation area of multi-rooted teeth:

A

furcation defect

79
Q

Furcation defects can occur with:

A

HBL and VBL

80
Q

What can be seen in the following images?

A

furcation defects

81
Q

Diagnose the bone loss in this image:

A

furcation defect with HBL

82
Q

Diagnose the bone loss in these images:

A

Furcation with VBL

83
Q

The crown:root ratio is an indicator of how much:

A

bone is supporting the tooth

84
Q

Length of crown / Length of radiographic root

A

crown: root ratio

85
Q

An index expressed as a ratio that gives an indication of a tooth’s prognosis

A

crown: root ratio

86
Q

A crown:root ratio of greater than ____ has a poor prognosis

87
Q

What is worse, a crown:root ratio of 2:1 or 1:2

A

2:1 (if you actually divide these, the one with the bigger number will be worse)

88
Q

Accuracy of ____ demineralization is necessary for radiographic changes

89
Q

____ defects may be difficult to observe on a radiograph

A

2-D infra-bony

90
Q

In addition to a radiograph, what else needs to be examined:

A
  • soft-tissue changes
  • edema
  • color
  • plaque
91
Q

A radiographic examination limitation is that there is not information on the relationship of:

A

soft tissue to hard tissue (i.e. pocketing)

92
Q

It is especially difficult to assess disease on ____ & ____ bone plates and adjacent __ and ___ tooth surfaces

A

B& Li; B& Li

93
Q

Can mobility be assessed on a radiograph?

94
Q

What four facets are involved in treating periodontal disease?

A
  1. plaque control
  2. antimicrobial agents (topical or systemic)
  3. professional cleaning (SRP)
  4. surgical techniques to re-establish physiologic contours

Oral Radiology (21 decks)

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