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Perio Exam 1 > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

what is the sulcus?

A

marginal gingiva

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2
Q

what is the healthy gingival sulcus?

A

a potential space

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3
Q

where does the perio probe penetrate to in health?

A

free gingival groove

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4
Q

where does the perio probe penetrate to in disease?

A

past junctional epithelium into connective tissue

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5
Q

when does periodontitis increase?

A

in inflammation due to swelling and probing error

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6
Q

what is the diagnosis of periodontitis based on?

A

attachment loss, not probe depths

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7
Q

when does periodontitis occur?

A

when junctional epithelium migrates apically down root surface

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8
Q

what is necessary for pocket formation?

A

viable junctional epithelium

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9
Q

what is cal?

A

pocket depth+gingival recession

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10
Q

what does the shape of interdental papilla depend on?

A

the contact relationships between adjacent teeth
width of approximal tooth surfaces
course of CEJ
col- concavity seen in contact areas of premolar and molar region

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11
Q

how is the probe angulation in posterior teeth determined?

A

position and dimensions of the contact area determine probe angulations in posterior teeth

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12
Q

correct probe angulation and position

A

find interproximal contact
use contact as guide to insert probe
open angulation by 10 degrees

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13
Q

what were the initial theories on gingival width and recession?

A

width of keratinized tissue <2mm predisposes too recession
narrow gingiva cannot protect from friction
cannot buffer against muscle pull
facilitates subgingival plaque formation since mobile tissue causes pocket to open, facilitates food impaction, impedes oral hygiene

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14
Q

what is the theory on gingival width and recession now?

A

gingival health can be maintained independent of its dimensions
narrow gingiva has same resistance to attachment loss as wide gingiva

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15
Q

what are two phenotypes of gingival tissue?

A

scalloped- thin

flat- thick

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16
Q

what is different between thin and thick phenotype?

A

increased recession
more vulnerable to trauma
more inflammation
less favorable treatment outcome

17
Q

when would you recommend gingival grafts?

A

when recession causes symptoms- caries, esthetic concerns, progressive recession, sensitivity
subgingival restoration margins on thin biotype
preorthodontic therapy- final tooth position will be buccal

18
Q

is tissue differentiation in the adult organism influenced by environmental or genetic factors?

A

the characteristics of the gingiva are genetically determined rather than being the result of functional adaptation to environmental stimuli

19
Q

what were the early clinical theories on tissue differentiation?

A

gingiva will become keratinized in response to friction

20
Q

what are the clinical theories now on tissue differentiation?

A

connective tissue determines epithelial characteristics

21
Q

what were the early grafting procedures

A

free gingival grafts

coronally advanced flaps

22
Q

what are the grafting procedures now?

A

connective tissue grafts

23
Q

what is the rationale behind early grafting procedures?

A

keratinized epithelium converted to firm attached gingiva

epithelium directs new epithelium

24
Q

what is the rationale behind grafting procedures now?

A

connective tissue determines epithelial prototype

25
Q

what is necrosis of junctional epithelium?

A

junctional epithelial cells die, so no pocketing

bone exposed

26
Q

what is biologic width?

A

soft tissue attachment to tooth has two parts-
fibrous tissue
junctional epithelium

27
Q

what is the biologic width of connective tissue attachment?

A

1.06 to 1.08 mm

28
Q

what is the biologic width of connective tissue attachment?

A

1.4mm

29
Q

what is the distance from cej to alveolar crest?

A

3mm so distance from crown margins to alveolar crest has to be 3mm

30
Q

what do you do if the distance from crown margins is under 3mm?

A

crown lengthening

31
Q

how does the mouth heal after extraction?

A 
clot formation
wound cleansing- PMNs, monocytes, macrophages migrate into wound
new vasculature, mesenchyma cells (from pdl) form granulation tissue
provisional connective tissue
immature bone forms
bundle bone (socket proper) is resorbed
wound filled with woven bone
bone maturation
32
Q

why is socket preservation important?

A

for preserving bone morphology

33
Q

what is the principle of guided tissue regeneration?

A

epithelium grows faster than bone or connective tissue

epithelial exclusion will allow selective growth of these cells

Perio Exam 1 (6 decks)

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