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Periodontics > Local Contributory Risk factors > Flashcards

Local Contributory Risk factors Flashcards

1
Q

Why do these risks leads to more disease ?

A
  • increase biofilm retention
  • increase biofilm pathogenicity
  • Inflict direct damage to periodontium
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2
Q

What are the major etiologic factors of Plaque Biofilm

A
  • Development of dental caries
  • Initiation and progression of periodontal disease etiologic factors
  • Contains bacteria which is detrimental to tissue
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3
Q

What are the 2017 classification of periodontal diseases?

A
  • Periodontal health, gingival disease and conditions
  • Periodontal manifestations of systemic diseases and developmental and acquired conditions: trauma occlusal force
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4
Q

What are naturally occuring contributing factors?

A

Classification: periodontal health givingival diseases and conditions
Category: Gingivitis-dental biofilm-induced
Subcategory: local risk factors

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5
Q

What is the most important local contributing factor?

A

dental calulus

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6
Q

What is dental calculus?

A
  • Secondary risk factor for periodontal disease
  • Most important local contributing factor
  • Significant role in pathogenesis of periodontal disease
  • irritant to gingival/sulcuar tissue
  • Biofil retentive
  • Reservoir for bacteria and toxins
  • Interferes with self cleansing
  • mineralized substances
  • Covered on external surfaces by nonmineralized living biofilm
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7
Q

What are the locations of deposits?

A

Supragingival
Subgingival

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8
Q

Where does supragingival calculus forms?

A
  • Form on clinical crowns, restorations, prothesis or exposed roots
  • Site specific: salivary ducts
  • Crowded teeth or malcocculsion
  • Localized distribution
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9
Q

What are the mineral of supra calculus derive from?

A

Saliva

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10
Q

What is the formation time?

A

Varies by individuals
Content of saliva
Ability to remove biofilm

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11
Q

When does mineralization process begins in supragingival calculus?

A

48hrs to 14 days

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12
Q

Supragingival calculus is?

A

Yellow-white and formation occurs in incremental layers

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13
Q

What is percent of supragingival calculus is mineralized?

A

30%

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14
Q

What is the composition of suprgingival calculus?

A

Inorganic
* makes up 70-90%
* primarily calcium phosphate
* Similar to inorganic bone components

**Organic **
* Make up 10-3-%
* bacterial colonies, proteins and cells
* carbohydrate and lipids from bacteria and saliva
* dead epithelial cells and white blood cells

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15
Q

The inorganic component of supragingival calculus changes through?

A

Different Crystalline forms

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16
Q

What are the different types of crystalline forms?

A
  • Newly formed- brushite
  • Less than 6mon- octocalcium phosphate whitlockite.
  • Matured- hydroxyapaptite
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17
Q

What are the modes of attachement for supragingival calculus?

A
  • Pellicle surface
  • Occurs on enamel
  • not interlocing to tooth
  • easy to remove deposits
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18
Q

What is Subgingival calculus?

A
  • Not site specific
  • Evenly distributed
  • Needs explorer and radiographs to detect
  • Forms slower
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19
Q

Where does the subgingival calculus mineral components comes from?

A

Gingival crevicular fluid
(GCF)

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20
Q

Describe subgingival calculus.

A
  • Dark green to gray to black (bacterial or heme pigment)
  • Shaped guided by pressure of pocket wall
  • Rings, ledges or veneers
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21
Q

What percentage of Subgingival Calculus is mineralized?

A

60%

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22
Q

What are the composition of subgingival calculus?

A

Inorganic
* more minerals
* Calcium Magnesium, floride
* Crystal of hydroxyapatite, brushite, whitlockite
* Sodium amount increase with pocket depth

**Organic **
* No salivary proteins
* Bacterial cells mineralized and within channels
* attached biofilm
* Epithelial cells from pocket wall
* WBC (exudate)

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23
Q

What are the modes of attachment for subgingival calculus?

A
  • Pellicle
  • Mechanical lock into cemental irregularities
  • Cracks, openings from PDL fibers, grooves from over instrumentation
  • Tenacious
  • Diffiult removal
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24
Q

If subgingival calculus is covered by biofilm, then bioflim it is associted with

A

Greater disease progession than biofilm alone

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25
Q

What percentage of radiographs shows visible calculus detection?

A

only 45%

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26
Q

What are the anticalculus agents?

A

Pyrophosphates

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27
Q

What are pyrophospathes?

A
  • inhibits hydropaptite growth
  • Supragingival calculus
  • Do not eliminate existing cal
  • useful for pt who builf up cal and on chlorhexidine
28
Q

What are the classification and category for anatomic contributing factors?

A

Other conditons affecting the periodontium: periodontal manifestations of systemic disease and developmetnal and acquired conditions

Catergory: Tooth and prosthesis-related factors

29
Q

What is tooth anantomic factors?

A

varitations in normal bone structure:
* non pathologic
* Relevant when affected by periodontal disease
* Can alter prognosis

30
Q

What are some examples of tooth anatomic factors?

A

Fenestrations
Dehisences
Root Proximity

31
Q

What is dehiscence ?

A

Window
- root is denuded and covered only by periosteum and gingiva, marginal bone is intact

32
Q

What is dehiscence?

A
  • Denuded area extends trhough the marginal bone
  • Labial inclination

More like triangle

33
Q

What is root proximity ?

A
  • Poor alignment of teeth in arch

excessive rooth divergence of multirooted teeth

34
Q

What is cervical enamel projection?

A
  • Extension of enamel from CEJ apically to entrance of furcation
  • Allow for increased biofilm accumulation
  • Can predipose to furcation involvement
    *Treatment directed by periodontal treatment required for affected tooth
35
Q

For cervical enamel projections what are the highest incidences?

A

Buccal aspect mandibular second molar

36
Q

What is the percentage for cervical enamel projection isolated furcation involvements associated with CEPS?

A

90%

37
Q

What is enamel pearls?

A
  • Clump of enamel located in furcation area apical to CEJ
  • Often in bifurcation of molars
  • Mistaken for calculus
  • May be removed as part of therapy
38
Q

What is root anatomy palatogingival groove?

A
  • Can lead to periodontal pockets
  • 5-8% of maxillary incisors
  • Starts at cingulum and extends apically for variable distance
  • Shallow or deep invagination
  • Extends on root 50% of the time
39
Q

What is done to remove the palatogingival groove?

A

Odontoplasty

40
Q

What are cemental tears?

A
  • Piece of detached cementum/with dentin
  • Attached to PDL
  • Leads to rapid periodontal bone loss and vertical bony defect
  • Treatment involves debridement and removal of fragments
41
Q

What are cemental tears induced by?

A

Trauma

42
Q

What are accessory canals?

A
  • Provide a communication between pulp and PDL
  • Pulp necrosis can contribute to defect
  • 20-50% of molars
  • Isolated periodontal lesions one endodontically treated teeth should be evaluated for accessory canals
43
Q

What does exodontics affects?

A
  • Affects adjecent teeth if soft tissue and bone are damaged
  • Remnant calculus can negate healing and foster biofilm accumulation
44
Q

What are overhanging restorations?

A
  • Biofilm retentive are
  • Difficult access
  • Increase in flammation
  • Caries, bone and attachment loss
45
Q

What does overhangs alter?

A
  • The composition of subgingival flora
  • Periodontitis flora increase
  • More attachment loss
46
Q

Can early removal reverses gingival condition and helps prevent attachment loss?

A

Yes

47
Q

Crown Contours and margins helps with?

A

biofilm formation enhanced by subgingival restorations: surface roughness, marginal fit and contour

48
Q

What does rough margins do?

A
  • Promtoes biofilm growth
  • difficult to remove
49
Q

What does margin location cause?

A
  • crown margin closer than 2mm to bone = in bone resorption
  • bad fit= dull bule or deep red halo
  • perisiten bleeding or discomfort
  • Can lead to recession over time
50
Q

What type of crown contours are more compatible with periodontal health?

A

Flat- because excessive buldge accumulates biofilm and promotes inflammation.

51
Q

Cement can initiate what?

A

Inflammation

52
Q

What are pontic forms?

A
  • Contours and embrasures should be properly designed so patients can cleanse
  • Forms that cannot be cleaned should not be used
53
Q

What are removable partial dentures at risk for?

A
  • Supragingival calculus
  • Abutment teeth susceptinle to caries and periodontal associated problems
54
Q

Restorative Materials are?

A
  • Compatible with gingival tissue
  • Assocaited with Gingival inflammation
55
Q

What does open contacts do?

A

causes food impaction taht leads to inflammation, bone loss and attachment loss

56
Q

What are the predisposing factors for food impaction?

A
  • wider/open interproximal contacts
  • Uneven marginal ridge relations
  • small contact more likely than wide open contact
57
Q

What does untreated tooth decay do?

A
  • Results in defects in tooth structure
  • Biofilm retentive factors
58
Q

What does orthodontics appliances causes?

A
  • Brackets, bands and wires are associated with biofilm accumulation, gingivitis and caries
  • Elastics embedded in sulcus cause periodontal issues
  • oral hygiene stressed
59
Q

What does malocclusion cause?

A

Causes: biofil accummulation
limits access for oral hygiene care

60
Q

Unreplaced missing teeth does not ?

A

initiate periodontal disease

61
Q

What does mouth breathing cause?

A
  • confined to labial gingiva of maxillary teeth
  • increase susceptibility to localized inflammation
  • deydration of tissues
  • Red, swollen, shiny
  • Gingiival enlargement, (may not resolve)
  • Required excellent biofilm control
62
Q

Toothbrushing trauma can cause?

A
  • destruction of attached gingiva
  • abrade epithelium
  • Cause ulcerations
  • excessive recession and rooth exposure
  • result in extensive grooving of the root
  • biofilm traps and cleaning problems
63
Q

What does Floss trauma Create?

A
  • Flossing clefts
  • Grooves into tooth
64
Q

What does oral piercing cause?

A

Dental and periodontal injuries

lips: anterior facial
Tongue: mandibular anterior lingual

65
Q

Self inflicted injuries can cause?

A
  1. Gouging or scratching gingiva with fingernails
  2. Fingernail fragment
  3. Toothpicks
  4. Often results in extensive exposure of root surface
66
Q

What are chemical injury?

A
  • Topically applied products that causes ulcerations
  • interferes with biofilm control and contribute to periodontal inflammation: alcohol burn and aspirin burn
67
Q

What is rubbing alcohol burn?

A
  • local anesthetic
  • mild burn
  • heals 2-4 days

Periodontics (9 decks)

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