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BDS 2: Periodontology > Management of Patients with Gingivitis & Periodontitis > Flashcards

Management of Patients with Gingivitis & Periodontitis Flashcards

1
Q

What is the pathogenesis of periodontitis?

A

It is mediated by the inflammatory-immune response to bacteria in the dental biofilm

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2
Q

What genetic factors can increases susceptibility to periodontitis? (2)

A
  • Congenital defects of immune system

- Age

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3
Q

What environmental factors can increases susceptibility to periodontitis? (3)

A
  • Smoking
  • Diet
  • Stress
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4
Q

What systemic diseases can increases susceptibility to periodontitis? (4)

A
  • Diabetes
  • Obesity
  • Cardiovascular diseases
  • Immunodeficiency
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5
Q

How do we define a healthy periodontium? (2)

A
  • <10% bleeding sites

- With probing depths ≤3 mm

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6
Q

What are the 4 levels of healthy paeriodontium?

A

1) Pristine periodontal health, with a structurally sound and uninflammed periodontium (ideal)
2) Well-maintained clinical periodontal health with a structurally and clinically sound (intact) periodontium
3) Periodontal disease stability with a reduced periodontium
4) Periodontal disease remission/control, with a reduced periodontium

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7
Q

Which levels of health periodontium have attachment loss

A

1 = No attachment loss

2 = No attachment loss

3 = Attachment loss

4 = Attachment loss

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8
Q

How can bleeding sites help us define cases of gingivitis?

A
  • Localised is 10%≤BOP%≤30%

- Generalised BOP%≥30%

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9
Q

What is gingivitis

A
  • Inflammation of the gums due to plaque accumulation
  • No bone loss
  • Reversible
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10
Q

What are some clinical characteristics of gingivitis?(8)

A
  • Erythema
  • Oedema
  • Tenderness
  • Enlargement
  • Swelling
  • Redness
  • Halitosis
  • Altered taste
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11
Q

How do we define a case of periodontitis? (2)

A
  • Interdental attachment loss is detectable at ≥2 non- adjacent teeth

OR

  • Buccal or oral attachment loss ≥3 mm with pocketing ≥3mm is detectable at ≥2 teeth
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12
Q

What is periodontitis?

A
  • Supra and sub gingival plaque/calculus accumulation
  • Loss of periodontal attachment
  • Irreversible
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13
Q

What are some clinical characteristics of periodontitis? (10)

A
  • Erythema
  • Oedema
  • Tenderness
  • Enlargement
  • Swelling
  • Redness
  • Suppuration
  • Tooth mobility
  • Gum recession
  • Halitosis
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14
Q

What are periodontal probes used to assess?

A

The presence of pockets and attachment loss, as well as the presence of inflammation

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15
Q

What will you see when probing healthy periodontium?

A

The depth of the sulcus is 1-3 mm

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16
Q

What will you see when probing healthy periodontium?

Why does this occur?

A
  • Probing depth is > 3mm

- A periodontal pocket is a gingivalsulcus that has been deepened by disease

17
Q

Define Probing pocket depth (PPD)

A

Distance from the gingival margin to the tip of the probe

18
Q

Define Probing attachment level (PAL)

A
  • Distance from the CEJ to the tip of the probe
  • Requires the measurement of the distance between free gingival margin (FGM) and CEJ
  • Formula: PPD-distance CEJ-FGM
19
Q

Define Gingival recession (REC)

A

Distance from gingival margin to the CEJ

20
Q

What are the therapeutic objectives of gingivitis? (4)

A
  • Control risk factors
  • Improvement in patient’s compliance and life-style
  • Improve the effectiveness of oral hygiene and motivate the patient
  • Reduce/eliminate gingival inflammation
21
Q

What are the therapeutic objectives of periodontitis? (5)

A
  • Control risk factors
  • Improvement in patient’s compliance and life-style
  • Improve the effectiveness of oral hygiene and motivate the patient
  • Reduce/eliminate gingival inflammation
  • Stop periodontitis and reduce PPD
22
Q

What are the casual therapies fro treatment of periodontitis

A
  • To guide behaviour change by motivating the patient to undertake successful removal of supra gingival dental biofilm and risk factor control
  • To control the sub gingival biofilm and calculus
23
Q

How can you mechanically control supragingival dental biofilm? (2)

A
  • Toothbrush

- Interdental aids

24
Q

How can you chemically control supragingival dental biofilm (4)

A
  • Dentifrices
  • Mouth rinses
  • Gels
  • Sprays
25
Q

What are some situations where chemical plaque control might be useful? (5)

A
  • Prevention of biofilm after surgery
  • After/during SRP
  • Acute gingival inflammation
  • Disabled patients
  • Necrotising lesions
26
Q

What are the 2 most proven risk factors of periodontitis?

A
  • Smoking

- Diabetes

27
Q

What are some local plaque retentive factors? (4)

A
  • Overhanging restorations
  • Tooth malposition
  • Incongruent prosthesis
  • Tooth crowding
28
Q

What is debridement?

A

Removal of soft (plaque) sub gingival deposits

29
Q

What is scaling?

A

Removal of hard calcified (tartan) deposits

30
Q

What is root planing?

A

Removal of pathological cement through the reshaping of the root surface

31
Q

What do you use in debridement? (2)

A
  • Laser

- Air polishing

32
Q

What do you use in scaling?

A

Ultrasonics

33
Q

What do you use in scaling?

A

Curette

34
Q

What do we except from sub gingival instrumentation? (4)

A
  • Decrease in plaque levels
  • Decrease in inflammation levels
  • Decrease in PPD
  • Gain in attachment level

BDS 2: Periodontology (9 decks)

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