Interpretation of Periodontal Disease Part C

Question 1

predisposing factors and local irritants may contribute to

Answer 1

periodontal disease

Question 2

dental images aid in detection of irritants such as

Answer 2

calculus
defective restorations
trauma from occlusion

Question 3

calculus may also appear as a

Answer 3

ring like opacity encircling cervical portion of tooth
a nodular radiopaque projection
a smooth opacity on a root surface

Question 4

what is a restoration margin

Answer 4

marks the transition between the restoration itself and the adjacent tooth tissue
weakest links in the tooth restoration

Question 5

margins placed within biologic width breach biologic principle leading to

Answer 5

alveolar bone resorption
periodontal breakdown
aggregation of subgingival microflora
chronic inflammatory process followed by iatrogenic periodontal disease and restoration failure

Question 6

faulty restorations may act as

Answer 6

food traps and lead to the accumulation of food debris and bacteria

Question 7

faulty restorations may be detected both

Answer 7

clinically and on radiographic images

Question 8

what defects can contribute to perio disease

Answer 8

open or light contacts
poor contour
uneven marginal ridges
overhangs
inadequate margins

Question 9

open contact

Answer 9

space between adjacent teeth when the teeth are neither touching nor a sufficient distance from each other to potentially allow the space to naturally remain free of debris
can occur naturally or by inadequately contoured restorations
may lead to food packing

Question 10

overhang

Answer 10

restoration is too bulky in the area where the restoration meets the tooth
causes: gingival inflammation, perio tissue destruction, decreases alveolar bone height, caries recurrence

Question 11

poorly contoured crown

Answer 11

over contouring can cause a loss of the normal self-cleansing morphology of the tooth, resulting in potential perio problems

Question 12

trauma from occlusion

Answer 12

increased width of the PDL space on mesial and distal due to resorption of the lamina dura
widening/compression of the PDL
root resorption
cemental tears
vertical or angular bone destruction

Question 13

benefits of radiographs for perio eval

Answer 13

assessment of bony changes
extent or direction of bone loss
assessment of bone loss
assessment of furcation involvement
identification of local contributing risk factors

Question 14

limitations for radiographs for periodontal evaluation

Answer 14

2D image of a 3D structure; palatal root obscures furcation involvement of max molar
superimposition of the bone and tooth structures
no info about non-calcified structures
only shows past disease activity

Question 15

limited info on periodontium

Answer 15

periodontal pockets (soft tissue needed)
can see where bone is lost but cannot see if pocket or recession is present
does not indicate the internal morphology or depth of the crater-like interdental defects
bone destruction on the mesial & distal root surface may be partially hidden by a dense mylohyoid ridge

Question 16

limited information of periodontium: very early bone loss:

Answer 16

interseptal bony defects smaller than 3 mm usually cannot be seen
actual bone height in facial and lingual are difficult to evaluate
can not accurately display the shape of bony deformities due to 2D
accuracy of bone loss can be obscured by poor technique and excessive vertical angulation

Question 17

limitations of radiographs: early furcation involvement

Answer 17

may show more interradicular bone between roots of the teeth because the facial and lingual bone are superimposed over the furcation and hide bone loss
poor technique can conceal the presence or extent of furcation involvement
furcation probe

Question 18

vertical bitewings

Answer 18

can be used to examine level of alveolar bone
patients with bone loss due to perio disease
post-treatment
follow up images
more than 15% bone loss
4-6 images depending on number of erupted molars
caries

Question 19

modifications: edentulous

Answer 19

may cause problems in bite-wing receptor placement
cotton roll may be placed in the area of the missing tooth to support the bite-wing tab or the beam alignment device
when patient closes, opposing teeth occlude on the cotton roll and support the bite-wing tab or the beam alignment device
failure to support the bite-wing tab or the beam alignment device results in a tipped occlusal plane on the resulting image

Question 20

modifications: bony growths

Answer 20

receptor must be placed between the tori and the tongue and then exposed
with large tori, the receptor is pushed away from teeth
PSP receptors should not be creased to accommodate bony growths