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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 bone:

A

Periodontitis

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4
Q

Extend 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

Severity of periodontal disease 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 surface & 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 this image?

A

Advanced periodontal changes

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21
Q

Clinical signs of periodontal CHANGES include:

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-trabecular pattern)
  4. furcation
  5. PDL space
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23
Q

When bone loss affects furcation this =

A

furcation defet

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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 affected

A

generalized

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28
Q

Specific locations of alveolar bone loss such as “around #7D & #30MD” is 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 the: (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, curves 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 than 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

Third 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 image:

A

Red= thinner bone (disease 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; 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

How would you describe the roots in this image?

A

Dilacerated

45
Q

List some local factors we should be locking 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 is a main concern looking at this radiograph?

A

Plaque trap due to poor restorations

49
Q

What stands out in the following image?

A

calculus

50
Q

What stands out in the following image?

A

calculus

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:root ratio
54
Q

Even/uniform apical moment 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 the crest called the follicular space

56
Q

The normal level is slightly ____ to the CEJ around ____ mm

A

apical; 1mm

57
Q

What do we consider a healthy bone level?

A

within 2mm of CEJ

58
Q

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

A

bone loss

59
Q

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

A

a neoplasm or something else wrong

60
Q

Describe health in posterior bone levels:

A
  1. falt (plateau), corticated crest
  2. physiologic bone heigh is less than or equal to 2.0mm from CEJ
61
Q

This measurement tool is being used to look at:

A

Bone level

62
Q

Slight crestal bone loss of less than or equal to 1.0-2.00mm but less than 20%

A

Incipient bone loss

63
Q

Evidence of around 20% and up to 50% of 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 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 & which shows advanced bone loss:

A

Left= moderate
Right= advanced

70
Q

-blunted, non-corticated crest
-prominent loss of alveolar bone height
-crown:root ration > 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 kind of 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 (VBL); more advanced in specific areas (not uniform)

77
Q

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

A

Vertical bone loss; more advanced in specific areas (not uniform)

78
Q

Loss of bone in the furcation area of multirooted teeth:

A

furcation defect

79
Q

Furcation defects can occur with:

A

HBL & 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 defect with VBL

83
Q

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

A

bone is supporting the tooth

84
Q

Length of radiographic 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 more than ______ has a poor prognosis

A

1:2

87
Q

What is worse:

Crown:root ratio of 2:1 or 1:2?

A

2:1 (if you actually divide, the one that results in a bigger number is worse)

88
Q

Accuracy of _______ demineralization is necessary for radiographic changes

A

40-50%

89
Q

_____ defects may be difficult to observe on a radiograph

A

2D infra-bony

90
Q

In addition to a radiograph, what else needs to be examined? (4)

A

-soft tissue changes
-edema
-color
-plaque

91
Q

A radiographic examination limitation is that there is no information on the relationship of:

A

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

92
Q

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

A

B; Li
B; Li

93
Q

Can mobility be determined via radiograph?

A

No

94
Q

What four facets are involvement in treatment of periodontal disease?

A
  1. plaque control
  2. antimicrobial agents (topical or systemic)
  3. professional cleaning (SRP)
  4. Surgical techniques to re-establish physiologic contours
95
Q
A

Oral Radiology (21 decks)

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