Intro Perio (Lecture 1) Flashcards
What are the 4 LEGAL responsibilities the dentist MUST preform?
1.MUST diagnose disease 2.MUST inform patient of existing disease 3.MUST offer Tx or refer 4.MUST Tx to S.O.C.
Philosophy of Tx: the disease is an ______, initiated by _______, and it provokes a local AND systemic ________ response in the host.
INFECTION, bacteria, inflammatory
Philosophy of Tx: the disease is ______ and cannot be “______”, but it CAN be ______
chronic….cured….controlled
Philosophy of Tx: you CANNOT REMOVE all ______ & ______ so Re-infection can occur.
plaque & Calculus
The current classification of periodontal conditions is based on the _______ Workshop for the Classification of Periodontal Diseases and Condition
INTERNATIONAL
What are the 3 GINGIVAL DISEASES associated with the Endocrine System?…What is the gingival disease assoc. with blood dyecrasias?
1.POOOberty 2.Pregnancy 3.Diabetes…..blood dyscrasias-leukemia
What art the 3 medications that can cause gingival enlargement?
- Phenytoin Sodium (Dilantin) 2.Cyclosporine (Sandimmune) 3.Ca Channel Blockers (Ni-fed-ipine)
Which endocrine manifestation on the gingiva is most “granular”?
diabetes
What can the gingiva look like for someone with Leukemia?
gingival enlargement
NON-plaque induced Gingival Disease: What are the three specific BACTERIAL origin bugs?
Neisseria Gonorrhea, Treponema Pallidum, Streptocococcal (BETA-hemolytic)
NON-plaque induced Gingival Disease: What are the 3 viral sources?
Herpes Type I & II…and VZV
NON-plaque induced Gingival Disease: What are the three Fungal sources?
Candida Albicans, histoplasmosis, and Linear Gingival Erythema (huh, thats a fungus I’ve never heard of!) (I think its the gingival result of candida)
What is the GINGIVAL lesion of GENETIC ORIGIN???
hereditary Gingival Fibromatosis
Gingival Manifestations of Systemic Conditions: What are the 4 mucocutaneous disorders that cause gingival disease?
Lichen Planus, Pemphigoid (NOT pemphigous which is worse-hemidesmosomes loss), Erythema Multiforme, Lupus Erythematosus
Gingival Manifestations of Systemic Conditions: What are 5 sources for ALLERGIC reactions that cause Gingival Disease?
- Nickel (get it FIVE causes!) 2.Acrylic (thats not good for dentures) 3.Toothpaste 4.Mouthrinses 5. Chewing gum
Gingival Manifestations of Systemic Conditions: What are the 2 “other” causes of gingival disease other than mucocutaneous or allergic?
- Trauma 2. Foreign Body Stuck up in there
LOCALIZED Chronic Periodontitis is LESS THAN or equal to _____ % of Teeth involved. What are the three sizes? small medium and what?!?!
30%…Slight, Moderate, Severe
__________ Chronic Periodontitis is GREATER THAN (not or equal to :)) 30% of teeth involved.
GENERALIZED
NOT to be confused with severe, local, chronic periodontitis: LOCALIZED _______ periodontitis is found frequently in younger populations and is caused by AA.
AGGRESSIVE
________ aggressive periodontitis is mostly associated with immune deficiency.
GENERALIZED
PERIODONTITIS as a manifestation of Systemic Disease (we aint talkin bout no gingivitis no mo): What are the 2 hematological disorders assoc. with periodontitis? (hint: 1 is also found in gingival disease)
1.Aquired Neutropenia 2.Leukemia
What are the 5 periodontitis manifestations of systemic disease assoc. with GENETIC disorders?
1.Familial and Cyclic Neutropenia 2. Down Syndrome (defective neutrophil chemotaxis) 3.Leukocyte Adhesion Deficiency Syndrome 4.Papillon-Lefvre Syndrome 5.Chediak-Higashi Syndrome
Localized aggressive periodontitis is normally what type of bone loss? and is therefore possibly treatable…
verticle
Generalized aggressive periodontitis is normally what type of bone loss? and therefore not very treatable..
horizontal
What is the OLD name for GENERALIZED Aggressive Periodontitis?
Generalized JUVENILE Periodontitis
What are the three types of Abscesses of the Peridontium?
1.Gingival 2.Periodontal 3.PeriCoronal
What are the two main causes for periodontal abscesses?
- Fractured Root 2. Residual Calculus after cleaning
What is an example of an acquired deformity/condition of the periodontium?
Occlusial Trauma (primary/secondary. we skipped over this slide)
What art the 4, yes FOUR, components of the PERIDONTIUM?
- Gingiva 2.PDL 3.Cementum 4.Alveolar Bone Proper (no, proper, with the back of the right hand)
What structure lies in between the gingiva and the alveolar bone proper in a cross section of the peridontium?
Lamina Propria
In the good ole cross section, what is the epithelium that is coronal to the junctional epithelium?
Sulcus Epithelium
Clinical Features of GINGIVA: Color: _____ with some variable _____ pigmentation.
PINK…melanin
Clinical Features of GINGIVA: Contour: depends on location—ANTERIOR=the gingival papillae are distinctly _______ and in the POSTERIOR=gingival papillae are only Slightly this…
Pyramidal
Clinical Features of GINGIVA: Contour: it has a _______ outline
SCALLOPED
Clinical Features of GINGIVA: Consistency- firm and _____
resillient
Clinical Features of GINGIVA: Contour: Texture- it is variably _______ depending on location. This feature is also used for adaptive specialization or reinforcement for ______ and it takes up about ___% of the overall gingival population.
stippled…function…40%
What is the normal length of attached gingiva? How do I find it?
about 5mm. its the distance from the gingival margin to the mucogingival junction (6mm) minus the depth of the gingival sulcus (1mm)
What type of perio probe do we use at asdoh? What are the markings like?
the CP-12….3-6-9-12
Which has the larger probe tip diameter? plastic or metal?
plastic=0.7mm metal 0.3mm
All of these are variables that impact ______: Inflammation
Probe Diameter Tapered vs. Parallel Force (0.15 N to 0.75 N) Band Width (0.7 mm to 1.0 mm)
PD….Probing Depth
What is the range of PD (probing depth) for Normal/Healthy Periodontum?????
0-3mm
What is the standard deviation for Probing Depth between different operators?
+/- 1mm
What are the probes that check for furcation bone loss? What type of bone loss is indicated with a loss of bone in the furcation?
NA-BOR’s furcation probes…..HORIZONTAL bone loss
FINDING CAL (Clinical Attachment LEVEL)….GM=CEJ, PD=6mm…what is CAL?
6mm + 0mm = 6mm CAL
FINDING CAL (Clinical Attachment LEVEL)….GM = 3mm apical to CEJ, PD = 3mm
3mm + 3mm = 6mm CAL
FINDING CAL (Clinical Attachment LEVEL)….GM=3mm coronal to the CEJ, PD = 9mm
9mm+ (-3)mm = 6mm CAL
No Active Disease, Healthy Microbial Flora, Sulcus/Pocket Epithelial Integrity Intact….. YOU are probably going to be BOP ______
Bleeding on Probing NEGATIVE
Active Disease, Presence of Microbial Biofilm/Plaque, Ulcerative Sulcus/Pocket Epithelium….you are probably BOP _______
Positive
How do I find biological width? What is a normal range?
Distance from the CEJ to the Crest of Alveolar Bone….1.5-2mm
What are the two components of Biological Width?
Attachment Epithelium + Gingival Fiber Ligament
What is the average width of the PDL in the adult?
0.17mm
What is Class I Tooth Mobility?
> 0.2mm but
What is Class II Tooth Mobility?
> 1mm
What is Class III Tooth Mobility?
> 1mm + Axial Displacement (can press down!)
What is the key to measuring tooth mobility?
ALWAYS USE 2 INSTRUMENTS!! NEVER WITH FINGER(S)!
Which set of teeth have the thinnest amount of gingival tissue?
Mand PMs (facial)
if the CEJ’s of adjacent teeth are PARALLEL to the pattern of bone loss, it is most likely _______ bone loss
horizontal
What are the 9 methods of clinical diagnosis of periodontal disease?
1.Probing Depth 2.Bleeding on Probing 3.Clinical Attachment Levels 4.Width of Attached Gingiva 5.Gingival Recession 6.Furcation Involvements 7. Tooth Mobility 8.Radiographic Evidence of Bone Loss 9.Plaque and Calculus
