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perio > lecture 5 (E2) > Flashcards

lecture 5 (E2) Flashcards

1
Q

what 4 things do you notice:

A
  • see recession
  • see CEJ
  • see roots
  • see bone loss
  • so pt has some type of periodontal ds
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2
Q

hispanic children born after __1__ have __2__ in getting diabetes

hispanic men that __3__ have __4__ of peridontal ds

A
  1. 2000
  2. 1 in 2 chances
  3. smoke
  4. higher chance

men have 50% and mexican americans have 59.7%

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3
Q

the 2017 classifciation staging is divded into what 3 things:

A
  • severity
  • complexity
  • extent and distribution
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4
Q

considerations of staging (6)

A
  • CAL - using the WORST site
  • amount and % of BL
  • Probing depth
  • presence/extent of ridge defect and furcation involvement
  • tooth mobility
  • tooth loss (due to periodontitis if known)
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5
Q

what is the criteria for defining periodontitis?

A
  • interdental CAL at 2 or more NON-ADJACENT teeth

or

  • Buccal or oral CAL more than or equal to 3mm, with pocketing more than 3mm on 2 or more teeth
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6
Q

CAL for the differnt stages

  1. stage 1
  2. stage 2
  3. stage 3
  4. stage 4
A
  1. 1-2mm
  2. 3-4mm
  3. more than or equal to 5
  4. more than or equal to 5
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7
Q

severity is based off of

A

CAL

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8
Q

complexity is based off of

A
  • takes into account overall probing depths
  • evaluates radiographic BL, horizontal and vertical
  • evaluates furcation involvement, # of missing teeth, function
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9
Q

staging depending on complexity factors

A
  1. max probinng depth less than or equal to 4 mm. Mostly horizontal BL
  2. max probinng depth less than or equal to 5mm. mostly horiztonal BL
  3. max probinng depth more than or equal to 6mm. Vertical bone loss more than or equal to 3mm. Class II or III furcations. Moderate ridge defects too
  4. Stage III, plus need for complex rehab due to masticatory disfuction and other failed occlusion reasons.
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10
Q

how many teeth loss and staging

A

stage 1 or 2: no tooth loos likely

stage 3: risk of tooth loss (up to 4)

stage 4: risk of loosing arch or dentition (more than 5)

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11
Q

what makes up stage 1

A
  • 1-2mm CAL
  • less than 15% BL around root
  • no tooth loss due to periodontal ds
  • PD 4mm or less
  • mostly HBL
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12
Q

what makes up stage 2

A
  • 3-4mm CAL
  • 15% to 33% BL
  • No tooth loss due to peridontal ds,
  • PD 5mm or less
  • mostly HBL
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13
Q

what makes up stage 3

A
  • severe with potential for additional tooth loss
  • 5mm or more CAL
  • BL beyond 33%
  • tooth loss of 4 teeth or less
  • PD 6mm or more
  • VBL 3mm or more
  • Class II or III furcations
  • moderate ridge defects
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14
Q

what makes up stage 4

A
  • all that stage 3 has plus:
  • needs complex rehabilitation due to masticatory dysfunction
  • secondary occlusal trauma
  • severe ridge defects
  • bite collapsed
  • pathologic migration of teeth
  • less than 20 remaining teeth (10 opposing pairs)
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15
Q

what trumps other things in periodontitis staging

A
  • ANY tooth loss due to periodontitis –> stage III or IV
  • furcation involvement of grade 2 or 3 –> Stage III or IV
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16
Q

what is extent and distribution in staging

A

you want to know if its the whole mouth or only an area that will be impacted by periodontitis

concept is to konw % of teeth affected by periodontitis of ANY stage

localized, generalized, molar-incisor

17
Q

extent and distribution

  1. localized
  2. generalized
  3. molar-incisor
A
  1. Localized –> BL involves less than 30% of teeth in mouth
  2. Generalized –> BL involves more than 30% of teeth in mouth
  3. Molar-Incisor –> BL is found around M (usually 1M) and ant incisors. This is Stage 3 Grade C.
18
Q

what are the 3 grading

A

A: low risk of progression

B: moderate risk of progression

C: high risk of progression

you should initially assume Grade B and then see specific evidence to shift to A or C.

19
Q

what is the %bone to pt age ratio

A

an indirect evidence to grading

  • if your pt is 40 yo with 40% BL - ratio is 1, so its high risk is up to 1, 0.5 is moderate and 0.25 is low risk*
  • but if your pt is 40 yo but with 50% BL, ratio is more than one and not good. %BL/age*
20
Q

what makes up the indirect evidence for grading

A

- %BL/age

- case phenotype

  • heavy plaque accumulation but minimal destructions vs minimal plaque but major destruction
21
Q

%BL to age radios

slow

moderate

rapid

A

slow less than or equal to 0.25

modertate- 0.5

rapid more than or equal to 1. If over one then loosing it much more rapidly.

22
Q

grading modifers for each grade

A

modifiers aka risk factors

A. slow rate = non smoker, non diabetic

B. moderate rate less than or equal to 10 cigs/day. Diabetic with hbA1c less than 7%

C. Rapid rate equal to or more than 10 cigs/day. Diabetic with hbA1c more than or equal to 7%

depending on how much they smoke, it could be a trump card.

perio (9 decks)

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