Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

perio > intro to perio > Flashcards

intro to perio Flashcards

1
Q

periodontics is that specialty of dentistry which encompasses the prevention, dx, and tx of ___1___, and ___2___ or their substitute and the ___3___, __4__ and ___5__ of these structures and tissues.

A
  1. ds of the supporting
  2. surrounding tissues of the teeth
  3. maintenance of the health
  4. function
  5. esthetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the major reason for adult tooth loss

A

periodontal ds (70%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how much of the american adults have periodontitis.
how much is severe?
how much is non-severe?

A

42%
severe: 7.8%
non severe: 34.4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

for a successful perio tx you need to be able to:

A
  1. dx
  2. tx
  3. refer for it
  4. follow ups after tx and maintenance on pt
  5. communicate well with pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

court dictated role for general dentists, they must:

A
  1. dx periodontal ds
  2. inform the pt of clinical findings
  3. refer pt to periodontist or tc themselves
  4. treat to the current standard of care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

professional, legal and ethical responsibility of a dentist

A

to dx ds, inform pt of ds, and refer or offer tx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

definition of periodontal ds

A

bacterial dysbiosis in a susceptible host causing loss of periodontal attachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is wrong:

A
  1. attachment loss
  2. at incisors, crown was following the margin of the gingiva and now it has attachment loss
  3. lots of plauqe accumulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

probing depth

if it is red or blue what does that mean

A

red = bleeding upon probing depth

blue = probing depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
A

Parts of the periodontium

top to bottom :

gingiva

pdl

cementum

alveolar process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the fibrous investing tissue, covered by keratinized epithelium, that immediately surrounds a tooth and is contiguous with its periodontal ligment and with the other mucosal tissues of the mouth.

A

definition of the gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

gingiva - macroscopic (clinical features)

A

gingival margin

gingival sulcus

attached gingiva

interdental gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

gingiva - micrscopic gingiva

A

oral epithelium

sulcular epithelium

junctional epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A

attached gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

gingival margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

attached gingiva is portion of the gingiva bound to the tooth and to the alveolar bone extending from ___ to ___

A

free gingival groove to mucogingival junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
A

top: free gingival groove
bottom: free gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

gingival sulcus is

A

not attached to enamel or cementum and is bounded apically by the free gingival groove on the oral epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

periodontal pocket

A

when attachment loss occurs in the gingival sulcus

3-4mm, not healthy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

attached gingiva

A
  • bound to underlying periostueum of alveolar bone
  • firm, resilient
  • bordered apically by the mucogingival junction
  • varies in width in max (I wider) and mand (thinner in M)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which are the keratinized tissues

A

attached gingiva and free gingival margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

interdental gingiva aka papilla

A
  • it occupies the embrasure
  • pyramid or col shaped
  • the interproximal space beneath the area of tooth contact (COL)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

gingiva - microscopic components

A
  • oral epithlium
  • sulcular epithelium
  • junctional epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

oral epithelium

A

= attached gingiva and free gingival margin

turnover of 30 days

microscopic anatomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

sulcular epithelium

A

unattached to enamel

non-keratinized stratified squamous epithelium. Not firm, its flabby.

(~1mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

junctional epithelium

A
  • its attached by hemidesmosomes
  • non-keratinized stratified squamous epithelium
  • high rate of turnover (7-10 days)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
A

yellow: junctional epithelium
green: sulcular epithelium
blue: oral epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

oral epithelium

types of keratinized stratified squamous epithelium

and which has keratin**

A
  • stratum corneum **
  • stratum granulosum
  • stratum spinosum
  • stratum basale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

oral epithelium - types of cells

A
  • keratinocytes (the majority)
  • non- keratinocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are keratinocytes

A

the majority of the cells in oral epithelium and produce keratin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

oral epithelium - which cells are non-keratinocytes and what do they do

A
  • melanocytes (produce melanin)
  • langerhands cells (capture, uptake and process of antigens)
  • merkel cells (sense of touch and found in stratum basale)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

sulcular epithelium- importance and what types of cells

A

importance: it is a semi-permeable membrane against bacterial products passing into underlying tissue
- non-keratinized, stratified squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

sulcular epithelium - lacks what

A

stratum corneum (this has keratin) and granulosum

and langerhans cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

junctional epithelium - types of cells

A

non-keratinized

stratifed squamous epithelium

rapid turnover 10.4 days

has few layers 3-20

attachment to the tooth surface via hemidesmosomes and non-collagenous proteins (proteoglycans and glysosaminoglycans)

37
Q
A

this shows histological (top) vs clinical sulcus

  • clinical sulculs is about the area where the probe actually ends at when probing.
38
Q

what used to be called biological width

A

supracrestal tissue attachment

39
Q

JE + CT Attachment = ?

sulcular epithelium #

A

= ~2mm

sulcular epithelium can be avg of 1mm up to 7mm

40
Q

supracrestal tissue attachment is

A

sulcular epithelium

junctional epithelium

connective tissue attachment

if you invade this space you will get inflammation and problems.

41
Q

gingival fibers are in close proximity to the alveolar crest and it contributes to the ct attachment component of the ____

A

supracrestal tissue attachment

42
Q

types of collagen in gingival fibers

A

type 1 and 3 collagen are the most abundant

43
Q
A
  1. gingivodental group (cementum to gingiva)
  2. transeptal group (cementum to cementum)
  3. dentoperiostel group (cementum to periostium)
  4. circular group (around the tooth)
44
Q

what is the periostium

A

a thin layer that covers bone. you can find nerves and some blood supply here

45
Q

healthy gingiva

color:

contour:

consistency:

texture:

A

color: coral pink, melanin makes it variable
contour: scalloped outline but also depends on location of teeth
consistency: firm and resilient
texture: stippling

46
Q

where is stippling found

what % of people

A

attached gingiva

40%

47
Q

PDL

A
  • suspensory mechanism attaching tooth to alveolar bone
  • absorbs occlusal forces
  • transmits occlusal forces to bone
  • contains blood vessels
48
Q

PDL contains

A
  • contains collagen I, III, and IV
  • contains proprioceptive nerve endings: transmits pressure and pain via trigeminal nerve
49
Q

types of cells in PDL

A
  • undifferentiated mesenchymal cells
  • fibroblasts
  • cementoblasts/cementoclasts
  • osteoblasts/osteoclasts @ alveolar bone
  • inflammatory cells (in ds)
  • epithelial rests of malassez: remants of hertwig’s root sheath
50
Q
A

purple: alveolar crest fibers
blue: horizontal fibers
red: interradicular fibers
green: oblique fibers
yellow: apical fibers

51
Q
A
52
Q

purpose of alveolar crest pdl fibers

A

prevents extrusion and lateral movements

this is what you break when extracting.

from cementum to crest alveolar bone

53
Q

purpose of horizontal pdl fibers

A

opposes lateral forces

54
Q

purpose of oblique

A

resists vertical masticatory forces

THE LARGEST GROUP

cementum to alveolar bone coronal direction

55
Q

purpose of apical

A

resists tipping

cementum to apical alveolar bone

56
Q

purpose of interradicular pdl fibers

A

resists luxation and tipping

cementum to furcation bone

57
Q

mineralized tissue that covers the tooth rooth and blends with the periodontal ligaments to hold the tooth in place

A

definition of cementum

58
Q

what is cementum

A
  • mineralized tissue
  • calcified mesenchymal tissue (the types of cells here)
  • contains 45-50% HA
  • non-vascularized
  • no nerves
  • no lymphatics
  • grows by apposition
  • attached to the fibers of the pdl (aka sharpey’s fibers)
59
Q

exposed cementum:

  • rough surface
  • porosities
  • smear layer
A
  • rough surface texture facilitates plaque adherence
  • porosities facilitate attachment of calculus

and facilitate absorption of bacterial enzymes

  • smear layer inhibits attachment of connective tissue
60
Q

alveolar process

A
  • supports the teeth and covers the bonen
  • vascularized
  • nerves are not in bone but in the periosteum
  • lymphatics
  • attachment of pdl fibers (sharpey’s fibers)
61
Q

components of alveolar process

A
  • external plate
  • inner socket wall: alveolar bone proper

bundle bone

  • cancellous trabeulae
62
Q

what is bundle bone

A

bundle bone: attachment of pdl fibers into the bone

when you extract a tooth, you remove the bundle bone therefore you have less blood supply in that area and causes the bone to resorb.

63
Q

shape of alveolar process

ant and post

A

ant: scalloped
post: flattened scallop

64
Q

alveolar process distance from CEJ in health

A

1 to 1.5mm

1.5-2mm in adult taking into consideration the supracrestal tissue attaachment concept

65
Q

cortical bone aka

A

lamina dura that surrounds the pocket

66
Q

alveolar process

  • dehiscences
  • fenestrations
A
  • dehiscences: lack of bone on the F or L of the tooth but with interprox bone
  • fenestration: is a lack of bone on the F or L of the tooth resembling a “window”
67
Q

the inflammation of the gingival tissues without loss of CT attachment

A

gingivits

68
Q

inflammation of the gigival tissues iwth apcial migration of the junctional epithelium with concomitant loss of CT attachment and bone

A

periodontitis

69
Q

distance from the soft tissue margin to the tip of the periodontal probe

A

probing depth

70
Q

distance from the cementoenamel junction (CEJ) to the tip of the periodontal probe during normal probing

A

clinical attachment level (CAL)

71
Q

staging is based upon

A

Severity and complexity of case mgmt

72
Q

staging considerations

A
  • CAL
  • amount and % of bone loss
  • PD
  • presence/extent of ridge defects and furcation involvement
  • tooth mobility
  • tooth loss (due to periodontitis)
73
Q

grading considerations:

biological features

A
  • RATE of ds progression
  • RISK of further advancement
  • potential threats to GENERAL HEALTH (smoking, diabetes)
74
Q

grading scale: A to C

A

a - low risk of progression

b - moderate risk

c - high risk

75
Q

how is staging and grading determined

A

every patient categorized based on the worst periodontal site and specific factors that may impact long term managment

76
Q

types of grading

A
  • A: slow rate
    • radiographic: so no loss over 5 years
    • progression: <0.25
    • phenotype: heavy biofilm deposits with low levels of destruction
    • risk factors: non-smoker
  • B: moderate rate
    • radiographhic: <2mm over 5 years
    • progression: 0.25 to 1.0
    • phenotype: destruction commensurate with biofilm deposits
  • C: rapid rate
    • radiographic: 2mm or more over 5 years
    • progression: over 1.0
    • destruction exceeds expectations given biofilm deposits.
    • more than 10 cigarettes a day
77
Q

3 steps to staging and grading a patient

A
78
Q

chronic periodontitis

A
  • is mild (incipient), moderate or severe but depends on CAL

can be localized (<30%) or generalized (>30%)

79
Q

chronic periodontitis: CAL mm

mild

moderate

severe

A

mild: 1-2 mm CAL
moderate: 3-4 mm CAL
severe: more than 5mm CAL

80
Q

aggressive periodontits

A

NOT classified as mild, moderate or severe

it is assumed that all aggressive cases are severe cases due ot the rate of destruction and/or the age of onset.

81
Q

how to dx aggressive periodontitis

A

localized: when its at the 1st molars and incisors
generalized: when it is at 1st molars, incisors, and more than 3 other teeth (more than fourteen teeth)

82
Q

stage I (inital)

A
  • 1-2mm CAL
  • less than 15% BL around root
  • no tooth loss due to periodontitis
  • probing depth 4mm or less
  • mostly horizontal BL
83
Q

stage 2 (moderate)

A
  • 3-4mm CAL
  • 15-33% of BL
  • tooth loss
  • PD 5mm or less
  • mostly horizontal BL
84
Q

stage III (severe)

A
  • severe with potential for additional tooth loss
  • 5mm or more CAL
  • BL beyond 33%
  • tooth loss of four teeth or less
  • PD 6mm or more
  • vertical BL 3mm or more
  • Class II - III furcations and/or moderate ridge defects
85
Q

stage 4

A
  • severe with potential for loss of dentition
  • main difference here from stage III is that the bite is collapsed.
  • encompases all of stage III
  • will require the. need for complex rehabilitation due to masticatory dysfunciton
  • secondary occlusal trauma
  • severe ridge defects
  • bite collapse
  • pathological migration of teeth
  • less than 20 remaining teeth
86
Q

instead of periodontal biotype say

A

periodontal phenotype

87
Q

instead of excessive occlusal force

A

traumatic occlusal force

88
Q

instead of biological width

A

supracrestal tissue attachment

89
Q

instead of chronic periodontitis, aggressive periodontitis

A

periodontitis

perio (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions