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AU17: Perio > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

How is periodontal disease identified?

A

Inflammation and loss of periodontal tissue support

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2
Q

How do we assess loss of periodontal tissue support?

A
  1. Probing depths
  2. Clinical attachment levels
  3. Radiographic evaluation
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3
Q

T/F: The OHI-S evaluates all of the teeth in the mouth.

A

FALSE

Only certain teeth

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4
Q

What is the scoring scale for the OHI?

A

0-6
0 is excellent
Anywhere from 3.1-6.0 is poor

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5
Q

The plaque index is specific in assessing the amount of plaque at which part of the tooth?

A

Gingival margin

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6
Q

What is the O’Leary Plaque index?

A

Calculates percentage of tooth surfaces positive for plaque.

Used in pre-doc clinics

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7
Q

T/F: The OHI-S is an index for both plaque and calculus.

A

True

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8
Q

T/F: The NIDR is a good simple way to evaluate calculus in thousands of patients.

A

True

SImple 0-2 scale

0 = no calculus
1 = supragingival
2 = supra and subgingival calculus
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9
Q

What surfaces of which teeth are used in the Volpe-Manhold Index?

A

Lingual surfaces of lower anterior teeth

Very detailed

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10
Q

Which index for inflammation uses simply a 0 or 1 for presence or absence of inflammation in 3 different areas of each facial surface?

A

Papillary-Marginal-Attachment Index (PMA)

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11
Q

Which inflammation index is related to the plaque index?

A

Gingival Index (GI)

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12
Q

In the ________ index bleeding with gentle touch gives an automatic score of 2.

A

Gingival index

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13
Q

If you wanted to know the severity of inflammation in a patient would you use GI or PMA?

A

GI

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14
Q

BoP is a valid indicator for periodontal __________. However, it is a poor indicator of periodontal ___________.

A

stability; breakdown

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15
Q

What is the difference between the extent and the severity of periodontal destruction?

A

Extent = proportion of tooth sites in the mouth showing periodontitis

Severity = Amount of attachment loss at diseased sites

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16
Q

The ESI defines disease at what amount of attachment loss?

A

> 1mm

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17
Q

Which periodontal destruction index is scored from 0-8, and involves the VISUAL examination of the circumference of each tooth?

A

Periodontal Index System (PI)

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18
Q

T/F: The PI looks at the progression from gingivitis to attachment loss.

A

True

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19
Q

What are two key components of the Periodontal Disease Index System?

A

Crevicular measurements and periodontal disease index

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20
Q

How does the Periodontal Disease Index System differ from the PI?

A

The PI is done with visual evaluation, while the PDI is more detailed and uses probing measurements.

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21
Q

T/F: In the CPITN, only the worst finding is recorded per sextant.

A

True

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22
Q

For PSR, what score correlates to a visible colored area but BoP?

A

1

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23
Q

In PSR, what score correlates to a partially visible colored area?

A

3

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24
Q

In the clinic, what do you do if you get a score of 3?

A

Do full probing for that sextant

25
Q

What do you do if a patient has a PSR score of 3 on teeth in three different sextants?

A

Do full mouth perio probe charting

26
Q

T/F: For PSR, you score a sextant with the score that correlates to the worst score recorded in that sextant.

A

True

27
Q

What are the benefits to PSR?

A
  1. Early detection
  2. Speed
  3. Simplicity
  4. Cost-effective
  5. Ease of recording
  6. Risk management
28
Q

T/F: PSR can replace comprehensive periodontal examinations.

A

FALSE

Only designed to detect perio disease. When indicated full perio exam must be completed

29
Q

T/F: Patients who have been treated for periodontal disease and are in the maintenance phase should have PSR done at dental visits.

A

FALSE

Comprehensive perio exams

30
Q

T/F: PSR is a good screening tool for children and adolescents.

A

FALSE

Meant for adults

31
Q

What are some problems with the evaluation indices?

A
  1. Halo effect
  2. Leniency/severity error
  3. Central tendency error
32
Q

What is the difference between sensitivity and specificity?

A

Sensitivity = when patient has disease the test will be positive

Specificity = when patient is disease free, test will be negative

33
Q

The _____ is the probability that a positive test is correct. While the _____ is the probability that a negative test is correct.

A

PVP; PVN

34
Q

Periodontal disease is currently diagnoses almost entirely on the basis of its _____________.

A

Clinical manifestations

35
Q

T/F: Microbiological testing is often used in clinical practice.

A

FALSE

Not chairside available

36
Q

Testing the GCF, saliva, and blood of a patient is using what method of diagnosing periodontal disease?

A

Assessment of host response

37
Q

What three things are needed for a diagnoses?

A

X-rays, charting, and clinical findings

38
Q

What is a problem with probe penetration in diagnosis?

A

Lack of sensitivity and reproducability

39
Q

T/F: CAL is usually done in private practice?

A

False

40
Q

What is a problem with radiographic examinations in diagnosis?

A

Limited sensitivity in small bone change

41
Q

_________ radiography is better in diagnoses because it can detect bone change as low as 5%.

A

Subtraction

42
Q

T/F: Bacterial culturing has a low sensitivity.

A

True

43
Q

Why is it difficult to identify most of the main putative perio pathogens?

A

They are non-motile

44
Q

What two bacteria are most often identified using antibodies?

A

Aa and Pg

45
Q

T/F: Bacterial cells must be living to be detected with antibodies.

A

FALSE

Does not require viable cells

46
Q

Several pathogens such as Pg, Tf, and Aa possess in common a _____________ enzyme that hydrolyzes ________.

A

Trypsin-like; BANA

47
Q

What is the problem with using chairside enzyme kits to diagnose disease?

A

Inability to distinguish between individual bacteria

48
Q

T/F: PCR has a high sensitivity and specificity for the identification of target pathogens.

A

True

49
Q

T/F: Probing for 16S rRNA has a high sensitivity and specificity.

A

True

50
Q

What is the most common source of a sample to test for the host response in diagnosis?

A

GCF

51
Q

What are intracellular destruction enzymes?

A

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

52
Q

Extracellular destruction enzymes are associated with the activity of ___________.

A

MMPs

53
Q

Which intracellular destruction enzyme is a good predictor for future perio breakdown and has high sensitivity and specificity for clinical attachment loss?

A

Beta-glucuronidase

54
Q

What makes up the extracellular matrix of the periodontium?

A

Collagen, proteoglycan, non-collagen proteins

55
Q

What is the breakdown product of collagen that can be detected in the GCF from sites with periodontitis?

A

Hydroxyproline

56
Q

T/F: IR spectra to measure GCF contents has a high sensitivity and specificity for detecting disease.

A

True

57
Q

How does NIR spectroscopy detect disease?

A

Measures oxygen saturation in the tissue

Tissue with periodontitis will have significantly less oxygen than gingivitis and healthy sites

58
Q

What is a negative of most salivary diagnostic tests?

A

Test for general risk factors but cannot predict when disease activity will occur

59
Q

T/F: SOBT is a good substitute for a periodontal exam.

A

FALSE

Offers simple screening only if thorough periodontal exam is not possible

AU17: Perio (15 decks)

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