local periodontal risk factor - semester 1

Question 1

risk factors

Answer 1

• An attribute or exposure that increases the probability of disease
• Periodontal risk factors
• local
• systemic
• Modifiable
• Non-modifiable
• Essential for development of periodontal disease
• host response
• bacteria (plaque biofilm)

Question 2

local risk factors

Answer 2

• Increase biofilm retention
• Increase biofilm pathogenicity
• Cause direct damage to the periodontium
• Factors that increase plaque retention
• dental calculus
• tooth morphology
• Local factors include the following:
• malpositioning of teeth
• dental restorations & appliances
• oral hygiene habits
• occlusal forces

Question 3

dental calculus

Answer 3

• The surface of the calculus deposit is irregular and covered with
  disease-causing bacteria
• How does calculus attach to tooth surface?
   Acquired pellicle
   Irregular tooth surface
   Direct contact
  As calculus builds up, it becomes irregular, forming ledges on the teeth
   Plaque control becomes difficult
   Plaque retention on irregular calculus increases risk for disease
   Controlling disease in the presence of biofilm and calculus is difficult

Question 4

tooth morphology

Answer 4

• Developmental defects- grooves
• Tooth and root concavities
• Poorly contoured restorations
• Carious lesions
• Calculus deposits in cracks
  in the tooth surface, tiny
  openings from PDL
  detachment, or grooves in
  the cementum from over
  instrumentation
• Deposit removal is difficult
  because deposits lie
  sheltered in tooth defects

Question 5

malposition teeth

Answer 5

• Hinder proper plaque
  removal

Question 6

open contact and plunger cusp

Answer 6

• Trapped food between teeth
• OHI can be a challenge
• Alteration on gingival contour
• May lead to periodontal breakdown

Question 7

dental restoration and appliances

Answer 7

• Crowns - margins below the gingival margins
• Crown 2mm from alveolar crest initiates bone resorption
• Inadequate embrasure space to accommodate the dental papilla
• Partial dentures, fixed bridges
• Poorly contoured restorations
• Poorly constructed prosthesis
  *overhangs
• Difficult or even impossible to remove biofilm effectively from the
  tooth surface adjacent to an overhang
• Difficulties in cleaning the tooth surface results in biofilm retention
  and can lead to increased severity of disease

Question 8

occlusal forces

Answer 8

• Functional occlusal forces – normal forces produced during the
  act of chewing food
• Parafunctional occlusal forces – result from tooth-to-tooth
  contact when not in the act of eating
• Signs of Trauma from occlusion
• tooth mobility
• sensitivity to pressure
• migration of teeth
• Enlarged, funnel-shaped PDL space
• alveolar bone resorption

Question 9

primary occlusal trauma

Answer 9

Primary Trauma from Occlusion* Excessive forces on healthy periodontium
* Excessive forces on the abutment teeth
* Widening of the periodontal ligament space
* High restorations
* Sensitivity
* Mobility
* Pain
* No apical migration of JE
* Adjustment reverses trauma

Question 10

secondary occlusal trauma

Answer 10

Secondary Trauma from Occlusion
* Excessive forces on unhealthy periodontium
* JE apical migration, loss of connective tissue
* Unhealthy periodontium with secondary occlusal forces will result in rapid bone loss, pocket formation
* Parafunctional Occlusal Forces
 tooth to tooth wear when not masticating
 clenching- continuous intermittent force on upper and
lower arch
 bruxing- grinding of teeth

Question 11

oral hygiene habits

Answer 11

• Tongue thrusting- force
  against anterior teeth
  causing lateral pressure
  to the periodontium
• Mouth breathing-
  dehydration of gingival
  tissue
• Improper use of interdental aids- loss
  of contour of tissue
• Ineffective and/or traumatic
  toothbrushing (‘quality’ inadequate or
  damaging)
• Alternatively, patient does not brush
  regularly (‘quantity’ inadequate)
  Floss will not dislodge the biofilm from the base of a root concavity
  Interdental brushes can effectively remove the biofilm from a root
  concavity