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Perio Comps > Intro > Flashcards

Intro Flashcards

1
Q

biologic width (dentogingival jxn)

A

~2 mm

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2
Q

what does the dentogingival jxn comprise of?

A
  1. junctional epithelium (epithelial attachment) = 1 mm

2. connective tissue attachement = 1 mm

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3
Q

what happens if crown margin encroaches on biologic width?

A

will need crown lengthening with flaps and osseous resection

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4
Q

plaque induced gingivitis

A

plaque induced only

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5
Q

how is plaque induced gingivitis modified?

A

by systemic factors (e.g. horomones) or medications/nutrition

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6
Q

chronic periodontitis

A

relatively slow progression, many local factors (plaque and plaque retention)

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7
Q

aggressive periodontitis

A
  1. systemically healthy patient
  2. rapid bone loss
  3. familial aggregation
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8
Q

localized aggressive periodontitis

A
  1. adolescent African American male

2. 1st molar/incisor distribution

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9
Q

the severity of localized aggressive periodontitis is not consistent with what?

A
  1. local factors
  2. PMN (neutrophil) chemotaxis defect
  3. robust serum antibody response
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10
Q

generalized aggressive periodontitis typically affects who?

A

young adults (under 30) and is episodic

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11
Q

examples of periodontitis as a manifestation of systemic disease

A
  1. cyclic neutropenia and other PMN defects
  2. Down’s syndrome
  3. Papillon-Lefevre syndrome
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12
Q

what may be significant modifiers of any periodontal disease entitiy?

A
  1. diabetes

2. smoking

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13
Q

what was necrotizing periodontal disease was previously classified as what?

A
  1. acute necrotizing ulcerative gingivitis (ANUG)

2. periodontitis (NUP)

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14
Q

acute periodontal abscess may result in what?

A

the most rapid destruction of alveolar bone

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15
Q

other periodontal entities

A
  1. periodontitis associated with endodontic lesions
  2. developmental or acquired deformities (tooth morphology changes, mucogingival deformities/recession)
  3. periodontal occlusal trauma
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16
Q

immune cells in gingival and periodontal diseases

A
  1. neutrophils
  2. lymphocytes
  3. macrophages
  4. plasma cells
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17
Q

what is the 1st line of defense immune cells?

A

neutrophils

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18
Q

initial lesion and acute episodes of gingival and periodontal diseases are caused by what?

A

loss of collagen

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19
Q

early lesion of gingival and periodontal diseases are caused by what?

A
  1. lymphocytes

2. macrophages

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20
Q

examples of lymphocytes

A
  1. cell mediated immunity/cytokines (IL-1, TNFα)
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21
Q

role of macrophages

A

process antigens

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22
Q

role of plasma cells

A

produce immunoglobins

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23
Q

which immune cells caues an established lesion?

A

plasma cells

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24
Q

periodontal pathogens are generally what?

A
  1. gram negative anaerobic

2. frequently motile

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25
Q

what type of bacterial forms microbial complexes (biofilm)?

A

specific gram negative periodontal pathogens

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26
Q

what are putative (suspected) genera of periodontal pathogens?

A
  1. Aggregatibacter - Aa (formaly Actinobacillus)
  2. Bacteroides
  3. Campylobacter
  4. Eikenella
  5. Fusobacterium nucleatum
  6. Prevotella intermedia
  7. Porphyromonas gingivitis (Pi)
  8. Peptostreptococcus
  9. Treponema denticola
  10. Eubacteria
  11. Tannerella forsythia
27
Q

what type of periodontal pathogens are associated with early plaque and periodontal health?

A

gram + rods and cocci

28
Q

what is the most pathogenic in chronic periodontitis?

A

red complex

29
Q

red complex in chronic periodontitis

A
  1. P. gingivalis
  2. T. denticola
  3. T. forsythia
30
Q

what are some proven major risk factors for periodontal disease other than plaque and age?

A
  1. diabetes

2. smoking

31
Q

possible risk indicators (not conclusive) for periodontal disease?

A
  1. age
  2. male gender
  3. race
  4. socio-economic status
  5. stress
  6. alcoholism
  7. IL-1 polymorphism
  8. osteoporosis/osteopenia
  9. obesity
32
Q

periodontal disease may be a risk for what?

A
  1. certain pathogens cardiovascular disease
  2. non-bleeding type (non-hemorrhagic) strokes
  3. low birth-weight pre-term babies (if mother has perio disease)
  4. chronic obstructive pulmonary disease
  5. control of diabetes
  6. osteopenia
  7. obesity
33
Q

treatment order of periodontal disease

A
  1. manage acute and urgent problems
  2. dental disease control
  3. evaluate response to initial therapy
  4. periodontal and pre-prosthetic surgery
  5. reconstruction (cast restorations)
  6. periodontal maintenance
34
Q

dental disease control includes what?

A
  1. control inflammation
  2. remove plaque retentive factors (calculus, defective restorations)
  3. caries control
  4. pulpal disease treatment
  5. strategic extractions
35
Q

T/F: abx should be prescribed for patients with chronic perio disease

A

false

36
Q

first option of abx used to manage aggressive periodontitis

A

metronidazole + amoxicillin

37
Q

which abx should be used to manage aggresive periodontitis if patient is allergic to amoxicillin?

A

ciprofloxacin + metronidazole

38
Q

abx to manage acute perio disease (perio abscess)

A

amoxicillin

39
Q

abx to manage acute perio disease (perio abscess) if patient is allergic to amoxicillin, metronidizole

A

clindamycin

40
Q

management of ANUG/NUP (including NUP found in HIV positive patients)

A
  1. ultrasonic debribement
  2. use of chlorhexidine (Peridex) disinfectant/antiseptic rinses
  3. if fever, l
41
Q

abx to manage ANUG/NUP pts with fever, lymphadenopathy, severe pain

A

metronidazole (effective against anaerobes)

42
Q

sustained release local delivery agents

A

at isolated sites perio-reeval or maintenance: chlorhexidine or minocycline

43
Q

root planing

A

involves some cementum removal, which may have residual calculus

44
Q

scaling

A

calculus removal (calculus retains plaque)

45
Q

limitations for periodontal surgery including crown lengthening

A
  1. external oblique line
  2. pterygomandibular raphe
  3. mylohyoid ridge
  4. shallow vestibule
46
Q

perils for periodontal surgery including crown lengthening of maxillary palatal flaps, second molars

A

greater (anterior) palatine artery

47
Q

perils for periodontal surgery including crown lengthening of mandibular lingual flaps or wedge distal to second molars

A
  1. lingual n.

2. lateral pharyngeal space

48
Q

perils for periodontal surgery including crown lengthening of mandibular buccal first/second premolar

A

mental artery and n.

49
Q

examples of periodontal surgery

A
  1. resective
  2. conservative
  3. regenerative
  4. mucogingival
50
Q

examples of resective (pocket elimination) periodontal surgeries

A
  1. gingivectomy
  2. apically positioned flaps
  3. osseous surgery
  4. root resections
51
Q

examples of conservative (for access to roots) periodontal surgeries

A
  1. flap curettage
  2. modified Widman flap
  3. ENAP (excisional new attachment procedure)
  4. open flap debridement
52
Q

examples of regenerative (new bone, cementum, PDL) periodontal surgeries

A
  1. bone grafts
  2. growth factors
  3. guided tissue regeneration
  4. root treatment
53
Q

examples of mucogingival periodontal surgeries

A
  1. free gingival graft
  2. pedicle graft
  3. subepithelial connective tissue graft
  4. acellular dermal matrix
54
Q

what are the different types of bone grafts?

A
  1. allograft (FDBA and DFDBA)
  2. autograft (osteogenesis, osteoinduction and osteoconduction)
  3. heterografts (xenografts)
  4. synthetic materials (alloplastic)
55
Q

what is the most utilized graft material?

A

mineralized freeze dried bone allograft (FDBA)

56
Q

intraoral autograft

A
  1. osseous coagulum
  2. tuberosity
  3. healing extraction site
57
Q

extraoral autograft

A

iliac crest

58
Q

examples of heterografts (xenografts)

A
  1. anorganic bovine bone
  2. horse bone
  3. porcine (pig) bone
59
Q

synthetic materials (alloplastic)

A
  1. bioactive glass
  2. hydroxyapatite
  3. tricalcium phosphate
60
Q

T/F: alloplastic materials are osteoconductive (regeneration)

A

false, NOT

61
Q

guided tissue regeneration (periodontal regeneration)

A

collagen membrane (bovine/porcine) barrier membrane excluding gingival epithelium and gingival CT

62
Q

what does guided tissue regeneration (periodontal regeneration) promote?

A

multi-potential mysenchymal (progenitor) cells to migrate from the PDL and bone to differentiate into osteoblasts, cementoblasts and fibroblasts

63
Q

growth factors (biologics) to gingival and periodontal diseases

A
  1. PDGF
  2. bone morphogenetic proteins (BMP-2,7)
  3. fibroblast GF
  4. vascular endothelial GF (VEGF)
  5. enamel matrix derivative (EMD, Emdogain)
64
Q

root treatment (root conditioning)

A
  1. citric acid
  2. tetracycline hydrochloride
  3. EDTA

Perio Comps (12 decks)

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