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Periodontics D2 > Intro to Perio > Flashcards

Intro to Perio Flashcards

1
Q

What are the Dentist’s LEGAL responsibilities ?

A

1) Diagnose disease
2) Inform patient of existing disease
3) Offer appropriate Tx or refer
4) Treat to standard of care

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2
Q

What are the 5 F’s of Perio?

A

1) Failure to diagnosis
2) Failure to treat
3) Faulure to refere for Tx
4) Failure to establish and follow an appropriate maintenance schedule
5) Failure to accept treatment (patient)

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3
Q

What is the rational for Tx of Perio disease?

A

1) Control etiology
2) Control inflammation
3) Control pain & discomfort
4) Restore perio health
5) Maintain long term function of the dentition
6) Regeneration of lost bone & soft tissues
7) Maintain or restore to esthetic level as desired
8) Control local inflammatory response contributes to control of the systemic inflammatory response and promote good general systemic health

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4
Q

What are the gingival diseases?

A

1) Plaque induced

2) Gingival disease modified by Systemic Factors:
- Endocrine system (puberty, pregnancy, diabetes)
- Blood dycrasias (Leukemia)

3) Gingival diseases modified by Medications:
- Gingival enlargement

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5
Q

What are the Gingival Enlargement Medications?

A

1) Phenytoin sodium (Dilantin)
2) Cyclosporine (Sandimmune)
3) Ca Channel Blockers (Nifedipine)

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6
Q

What are the non-plaque induced gingival diseases?

A

1) Bacterial origin: Neisseria gonorrhea, Treponema pallidum, Streptococcal (Beta Hemolytic)
2) Viral: (Herpes I and II) & Varicella-zoster infections
3) Fungal: Candidia albicans, Histoplasmosis, & Linear gingival erythema

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7
Q

What is the gingival disease of genetic origin?

A

Hereditary Gingival Fibromatosis

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8
Q

What are the Mucocutaneous Disorders that are gingival manifestations of systemic conditions?

A

1) Lichen planus
2) Pemphigoid
3) Erythema Multiforme
4) Lupus Erythematosus

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9
Q

What are the Allergic Reactions that are gingival manifestations of systemic conditions?

A

1) Nickel
2) Acrylic
3) toothpaste
4) Mouthrinses
5) Chewing Gum Additives

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10
Q

What are the gingival manifestation of systemic conditions?

A

1) Mucocutaneous disorder
2) Allergic rxn
3) Traumatic lesions
4) Foreign body reactions

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11
Q

What are the 2 types of Chronic Perio?

A

1) Localized Chronic Perio
Less than 30% of teeth involved (Slight, Moderate, and Severe)
2) Generalized Chronic Perio
More than 30% of teeth involved (Slight, Moderate, and Severe)

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12
Q

What is the MOST COMMON periodontitis?

A

Generalized Moderate w/ localized severe

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13
Q

What is Aggressive Perio?

A

1) Localized Aggressice Perio

2) Generalized Aggressive Perio

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14
Q

What is Perio as a Manifestation of Systemic Disease associated with?

A

1) Hematological Disorders

2) Associated w/ Genetic Disorders

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15
Q

What are the 2 examples of Hematological disorders

A

1) Acquired Neutropenia

2) Leukemia

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16
Q

What are the 5 examples of genetic disorders associated with systemic disease?

A

1) Familial & cyclic neutropenia
2) Down syndrome (Defective neut chemotaxis)
3) Leukocyte Adhesion Deficiency Syndrome
4) Papillion-Lefcre Syndrome
5) Chediak Higasi syndrome

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17
Q

What is NUG?

A

Necrotizing Ulcerative Gingivitis

REVERSIBLE and there is NO ATTACHMENT LOSS

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18
Q

What is NUP?

A

Necrotizing Ulcerative Periodontitis

IRREVERSIBLE and ATTACHMENT loss (w/ punched out papilla)

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19
Q

What is a Periodontal Abscess? What is it caused by?

A

It is deep into the periodontium caused by,
1) Bacteria due to calculus that is logged
2) Fracture of the root w/ flexing over time (hot & cold)
Fracture will propagate apically & internally

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20
Q

What is a Gingival Abscess? What causes it?

A

Just damage to gingival tissue caused by food particles or maybe trauma

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21
Q

What are the localized TOOTH-RELATED Factors that modify or predispose to plaque induced gingival disease/periodontitis?

A

1) Tooth anatomic factors
2) Dental restorations & appliances
3) Root fracture
4) Cervical root resorption

22
Q

What are Mucogingival deformities?

A

1) Gingival/soft tissue recession
2) Lack of keratinized gingiva
3) Decreased vestibular depth
4) Aberrant Frenum/Muscle attachment
5) Gingival excess

23
Q

What is primary occlusal trauma?

A
  • Primary occlusal trauma will occur when there is a normal periodontal attachment apparatus and, thus, no periodontal disease ( periodontally-uninvolved tooth).
  • Tx may include either a removable prosthesis or implant-supported crown or bridge.
24
Q

What is secondary occlusal trauma?

A
  • 30-50% bone loss, widened PDL space that involves compromised periodontal attachment &, thus, a pre-existing periodontal condition.
  • Can achieve through surgical periodontal procedures such as soft tissue & bone grafts, as well as restoration of edentulous areas
25
Q

What are the characteristics of Normal vs Diseased Periodontium?

A

1) Gingival color
2) Gingival contour
3) Gingival consistency
4) Gingival texture
5) Marginal/Free Gingiva & Attached Gingiva
6) Probing Depth (PD)
7) CAL
8) Bleeding on Probing (BOP)
9) Biological Width
10) Tooth mobility
11) Gingival recession
12) Evidence of radiographic bone loss
13) Genetic testing
14) Microbial testing

26
Q

What are the components of the Periodontium?

A

1) Gingiva
2) PDL
3) Cementum
4) Alveolar Bone Proper

27
Q

What is the color of gingiva?

A
  • Coral Pink

- Melanin Pigmentation may be present

28
Q

What is the contour of gingiva?

A

1) Depends on location
- Anterior: Gingival papillae are distinctly pyramidal
- Posterior: Gingival papillae are only slightly pyramidal

2) Scalloped outline

29
Q

What is the consistency and texture of gingiva?

A

firm and resilient with stippling (variable)

30
Q

What is stippling?

A

1) Adaptive specialization or reinforcement for function

2) ~40% of population

31
Q

What is the mucogingival junction?

A

The junction line between attached keratinized tissue and mucosa

32
Q

What is attached gingiva?

A

Extends apically from the free gingiva to eventually merge with the alveolar mucosa.

33
Q

What is free gingiva?

A

It surrounds the tooth & creates a cuff or collar of gingiva measured from the margin of the attached gingiva extending coronally ~ 1.5mm

34
Q

What are the 3 different perio probes?

A

1) Merritt B (1-2-3-5-7-8-9-10)
2) CP-12 (3-6-9-12)
3) UNC (1-2-3-4-5–15)

35
Q

What are the variables that impact probing depth?

A

1) Inflammation
2) Probe diameter
3) Tapered vs. Parallel
4) Force (0.5 N to 0.75 N)
5) Band Width (0.7 mm to 1.0 mm)

36
Q

What is the range of Probing Depth (PD) for healthly individuals?

A

0-3 mm

37
Q

When using a probe how do you measure the gum level?

A

DON’T place the probe straight but rather angle it under the contact point inter proximally (interdental crater) from BOTH LINGUAL & FACIAL

38
Q

What are the furcation probes?

A

1) 3 CH cowherd (Nabors Q-2N)
2) Nabors Q-2N Furca Probe
3-6-9-12

39
Q

What is a CLASS I furcation ?

A

The concavity—just above the furcation entrance—on the root trunk can be felt w/ probe tip; however, furcation probe cannot enter furcation area.

40
Q

What is a CLASS II furcation ?

A

The probe is able to partially enter the furcation—extending approximately one third of the width of the tooth— but it is NOT able to pass completely through furcation.

41
Q

What is a CLASS III furcation ?

A
  • In mandibular molars, probe passes completely through furcation between the mesial & distal roots.
  • In maxillary molars, the probe passes between mesiobuccal & distobuccal roots and touches the palatal root.
42
Q

What is BOP Negative?

A

1) No active disease
2) Healthy Microbial Flora
3) Sulcus/Pocket Epithelial integrity
4) Intact

43
Q

What is BOP Positive?

A

1) Active disease
2) Presence of Microbial Biofilm/Plaque
3) Ulcerative sulcus/pocket epithelium

44
Q

What is biological width?

A
  • Junctional epithelium (0.97mm) & CT (1.07mm) = 2 mm

- Important when placing sub gingival crown/restorative

45
Q

What happens when you violate BW?

A
  • Can lead to bone resorption (loss), & CAL.

- You will need to do crown lengthen to reestablish width

46
Q

CEJ to Crest of Alveolar bone = __________

This space accommodates the _________

A
  • 1.5 to 2 mm

- Biological width (i.e., attachment epic + gingival fiber ligament)

47
Q

Average width of the PDL in the adult = ____

A

0.17 mm

48
Q

What is Class I mobility ?

A

> 0.2 mm but less than 1 mm

49
Q

What is Class II mobility ?

A

> 1mm

50
Q

What is Class III mobility ?

A

> 1 mm + Axial displacement (REPRESSED in the bone)

51
Q

Which type of bone loss can be grafted?

A

Vertical/Angular bone loss can be grafted must have more than 1 wall

52
Q

What are the clinical diagnosis of perio disease?

A

1) PD
2) BOP
3) CAL
4) Width of attached gingiva
5) Gingival recession
6) Furcation involvement
7) Tooth mobility
8) Radiographic evidence of bone loss
9) Plaque & calculus

Periodontics D2 (12 decks)

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