Midterm 2 Flashcards
How is periodontal disease identified?
Inflammation and loss of periodontal tissue support
How do we assess loss of periodontal tissue support?
- Probing depths
- Clinical attachment levels
- Radiographic evaluation
T/F: The OHI-S evaluates all of the teeth in the mouth.
FALSE
Only certain teeth
What is the scoring scale for the OHI?
0-6
0 is excellent
Anywhere from 3.1-6.0 is poor
The plaque index is specific in assessing the amount of plaque at which part of the tooth?
Gingival margin
What is the O’Leary Plaque index?
Calculates percentage of tooth surfaces positive for plaque.
Used in pre-doc clinics
T/F: The OHI-S is an index for both plaque and calculus.
True
T/F: The NIDR is a good simple way to evaluate calculus in thousands of patients.
True
SImple 0-2 scale
0 = no calculus 1 = supragingival 2 = supra and subgingival calculus
What surfaces of which teeth are used in the Volpe-Manhold Index?
Lingual surfaces of lower anterior teeth
Very detailed
Which index for inflammation uses simply a 0 or 1 for presence or absence of inflammation in 3 different areas of each facial surface?
Papillary-Marginal-Attachment Index (PMA)
Which inflammation index is related to the plaque index?
Gingival Index (GI)
In the ________ index bleeding with gentle touch gives an automatic score of 2.
Gingival index
If you wanted to know the severity of inflammation in a patient would you use GI or PMA?
GI
BoP is a valid indicator for periodontal __________. However, it is a poor indicator of periodontal ___________.
stability; breakdown
What is the difference between the extent and the severity of periodontal destruction?
Extent = proportion of tooth sites in the mouth showing periodontitis
Severity = Amount of attachment loss at diseased sites
The ESI defines disease at what amount of attachment loss?
> 1mm
Which periodontal destruction index is scored from 0-8, and involves the VISUAL examination of the circumference of each tooth?
Periodontal Index System (PI)
T/F: The PI looks at the progression from gingivitis to attachment loss.
True
What are two key components of the Periodontal Disease Index System?
Crevicular measurements and periodontal disease index
How does the Periodontal Disease Index System differ from the PI?
The PI is done with visual evaluation, while the PDI is more detailed and uses probing measurements.
T/F: In the CPITN, only the worst finding is recorded per sextant.
True
For PSR, what score correlates to a visible colored area but BoP?
1
In PSR, what score correlates to a partially visible colored area?
3
In the clinic, what do you do if you get a score of 3?
Do full probing for that sextant
What do you do if a patient has a PSR score of 3 on teeth in three different sextants?
Do full mouth perio probe charting
T/F: For PSR, you score a sextant with the score that correlates to the worst score recorded in that sextant.
True
What are the benefits to PSR?
- Early detection
- Speed
- Simplicity
- Cost-effective
- Ease of recording
- Risk management
T/F: PSR can replace comprehensive periodontal examinations.
FALSE
Only designed to detect perio disease. When indicated full perio exam must be completed
T/F: Patients who have been treated for periodontal disease and are in the maintenance phase should have PSR done at dental visits.
FALSE
Comprehensive perio exams
T/F: PSR is a good screening tool for children and adolescents.
FALSE
Meant for adults
What are some problems with the evaluation indices?
- Halo effect
- Leniency/severity error
- Central tendency error
What is the difference between sensitivity and specificity?
Sensitivity = when patient has disease the test will be positive
Specificity = when patient is disease free, test will be negative
The _____ is the probability that a positive test is correct. While the _____ is the probability that a negative test is correct.
PVP; PVN
Periodontal disease is currently diagnoses almost entirely on the basis of its _____________.
Clinical manifestations
T/F: Microbiological testing is often used in clinical practice.
FALSE
Not chairside available
Testing the GCF, saliva, and blood of a patient is using what method of diagnosing periodontal disease?
Assessment of host response
What three things are needed for a diagnoses?
X-rays, charting, and clinical findings
What is a problem with probe penetration in diagnosis?
Lack of sensitivity and reproducability
T/F: CAL is usually done in private practice?
False
What is a problem with radiographic examinations in diagnosis?
Limited sensitivity in small bone change
_________ radiography is better in diagnoses because it can detect bone change as low as 5%.
Subtraction
T/F: Bacterial culturing has a low sensitivity.
True
Why is it difficult to identify most of the main putative perio pathogens?
They are non-motile
What two bacteria are most often identified using antibodies?
Aa and Pg
T/F: Bacterial cells must be living to be detected with antibodies.
FALSE
Does not require viable cells
Several pathogens such as Pg, Tf, and Aa possess in common a _____________ enzyme that hydrolyzes ________.
Trypsin-like; BANA
What is the problem with using chairside enzyme kits to diagnose disease?
Inability to distinguish between individual bacteria
T/F: PCR has a high sensitivity and specificity for the identification of target pathogens.
True
T/F: Probing for 16S rRNA has a high sensitivity and specificity.
True
What is the most common source of a sample to test for the host response in diagnosis?
GCF
What are intracellular destruction enzymes?
Can be detected in host GCF as markers of active perio destruction.
Released from dead neutrophils
Ex. Aspartate amino-transferase, alkaline phosphatase, elastase, beta-glucuronidase
Extracellular destruction enzymes are associated with the activity of ___________.
MMPs
Which intracellular destruction enzyme is a good predictor for future perio breakdown and has high sensitivity and specificity for clinical attachment loss?
Beta-glucuronidase
What makes up the extracellular matrix of the periodontium?
Collagen, proteoglycan, non-collagen proteins
What is the breakdown product of collagen that can be detected in the GCF from sites with periodontitis?
Hydroxyproline
T/F: IR spectra to measure GCF contents has a high sensitivity and specificity for detecting disease.
True
How does NIR spectroscopy detect disease?
Measures oxygen saturation in the tissue
Tissue with periodontitis will have significantly less oxygen than gingivitis and healthy sites
What is a negative of most salivary diagnostic tests?
Test for general risk factors but cannot predict when disease activity will occur
T/F: SOBT is a good substitute for a periodontal exam.
FALSE
Offers simple screening only if thorough periodontal exam is not possible