mock exam Flashcards
Secondary occlusal trauma
- normal/excessive occlusal forces
- Bone Loss
- occurs in presence of insertion loss
- tissue injury due to normal/excessive occlusal forces on reduced periodontal support
Surgical techniques for pocket therapy
Zone 1: Soft tissue pocket wall
zone 2: tooth surface
zone 3: underlying bone
zone 4: attached gingiva
Appointment calendar for patients with implants
- every 6-9 months
- patients with improved Oral hygiene, chronic periodontal disease, regular smoker.
- probing depth 4-6 mm with bleeding
- suppuration when pressing or probing
- masticatory mucosa 2-3 mm
- irregular controlled diabetes
Mombelli (1999) general principles
- Bone regeneration/ tissue recovery
- Removal of biofilm from peri-implant pocket
- Reduction or elimination of locations that are difficult to clean
Decontamination/conditioning of the surface
NOT - reduction of bleeding sites
Maintenance protocol for patient with dental implants
- submucosal irrigation of the peri-implant sulcus with disinfectants and oral antiseptics
- another appointment 2-4 weeks to ealuate results of mechanical therapy
- evaluation of the use of topical antibiotic in the peri-implant sulcus
- CHX / 10% providine-iodine can be used
localised papillary gingivitis
it is attached to one or more interproximal spaces in a limited area
generalised papillary gingivitis
Affects most interproximal spaces
localised marginal gingivitis
it is limited to the free gum of a tooth or some
generalised marginal gingivitis
affects the entire free gum of an arch or both
localised diffuse gingivitis
inflammation extends from the gingival margin to the mucogingival line in a single tooth or in some teeth
generalised diffuse gingivitis
it affects the entire gum. The alveolar mucosa and the inserted gum show inflammation, so the anatomical separation between them, the mucogingival line, is erased.
Advanced flap procedures
- Coronally repositioned flap
- Semilunar coronally repositioned flap
Rotational flap procedures
- Laterally sliding flap
- double papilla flap
- oblique rotated flap
X-ray must be individualised depending on the initial severity of the case and findings at the recall visit. On a patient with periodontal disease without good periodontal control, we will take:
- vertical/periapical bitewing x-ray of problematic areas one every 12-14 months, whole mouth x-ray series every 3-5 years.
Selecting root cover procedure, several factors must be taken into account:
- Aesthetics of the area and availability of donor tissue
- Presence of muscle inserts and recession form (width and depth)
- Recession form (width and depth) and Presence of muscle inserts
- Presence of muscle inserts and availability of donor tissue
On papilla bleeding index, probing is done in all 4 quadrants. which ones?
Facially (in quadrants 2 and 4) and orally (in quadrants 1 and 3).
From an epidemiological point of view, when can we determine that patient has gingival health?
When it has less than 10% of locations that bleed with drilling depths of 3mm or less.
Measurements of CT attachement, Junctional epi attachment, gingival sulcus and the biological width?
CT attachement = 1.07mm
Junctional epi attachment = 0.97mm
Gingival sulcus = 0.69mm
Biological width = 2.04 mm
Factors that determine the pattern in which this bone destruction develops?
- way of propagation
- food impaction
- normal variation in alveolar bone
- radius of action
Depending on a periodontal patient characteristics in fixed prostheses.
Connective attachment: more constant structure.
Many cells repopulate the curetted root surface, however only two of them would achieve complete periodontal regeneration, which 2 cells are they?
- Cells derived from the periodontal ligament and bone perivascular cells.
What “requires the removal of very small amounts of supporting interproximal bone and it is indicated when interproximal bone levels vary horizontally”?
Flattening of the interdental bone
“usually progress without producing clinical symptoms and may therefore go undetected unless observed radiographically” responds to
Root surface resoption
How do we calculate the percentage of hygiene index (HI) (O’leary et al, lindhe)
(number of plaque free areas) / (number of examined areas) x 100
Ramfjord teeth. which ones?
Teeth 16, 21, 24, 36, 41 and 44
Grade of disease progression
Grade A : Slow rate of progression where there is evidence of no loss over 5 years.
Grade B: moderate progression in which there has been less than 2mm of loss in a period of 5 years.
Grade C: Rapid rate of progression in which there has been more or equal to 2mm of loss in over 5 years.
In a publication a surgical procedure was described to be used in the treatment of “periodontal pus pockets”. Who described the technique for the first time?
Kirkland
Modified windman flap
- The initial incision should be parallel to the long axis of the tooth and plaed approximately 1mm from the buccal gingival margin.
- if the pockets on the buccal aspects of the teeth are <2mm deep, an intracrevicular incision may be made.
- a third incision made in a horizontal direction and in a position close to the surface of the alveolar bone crest separates the soft tissue collar of the root surfaces from the bone.
- The pocket epithelium and the granulation tissues are removed by means of curettes.
Not -The dressing, as well as the sutures, is removed after 4 weeks.
Objectives of bone graft procedures
- Regeneration of a functional insertion apparatus
- Elimination or reduction of the pocket
- Restoration of the alveolar process
Not - Elimination of dental plaque
Which parameter is a sign of non-reversible bone loss?
Mobility
Which flap design pointed out the importance of removing the soft tissue pockets, that is replacing the flap at the crest of the alveolar bone?
Windman flap.
Pulp vitality
- Teeth with periodontal infection are generally vital on thermal tests
- Provocation of sharp pain sensation indicates a vital pulp
-Teeth with a peri-radicular infection and a periodontal abscess are generally non-vital in the test
NOT - the vitality of the pulp is tested rather than its sensitivity
During pregnancy the subgingival microbiota undergo changes including an increase in…
prevotella intermedia
A failing case can be recognised by
gradual increases in tooth mobility
Radiographic implantitis
a standardised parallel technique is required using position devices
Changes in the forces exerted on the teeth. The pattern of changes that may follow failure to replace missing first molars is characteristic. In extreme cases it consist of the following
- The maxillary incisors are pushed labially and laterally
- the second and third molars tilt, resulting in a decrease in vertical dimension
- anterior overbite is increased. the mandibular incisors strike the maxillary incisors near the gingiva or traumatise the gingiva.
Not - the premolars move mesially, and the mandibular incisors tilt or drift labially.
Necrotising ulcerative gingivitis (NUG)
There is a “metallic” foul taste, and the patient is conscious of an excessive amount of “pasty” saliva.
Vitamin C deficiency does not cause
-Edema
-Bleeding
-Edema of the gingival connective tissue
- Collagen degeneration
Not - Gingival inflammation
Radiographic signs of trauma from occlusion may include
- Radiolucency and condensation of the alveolar bone
-Increased width of the periodontal space
-Root resoption, these areas are usually insufficient in magnitude to be detected on radiographs.
Not - A horizontal rather than vertical destruction of the interdental septum.
Which is the most common clincial sign of trauma to the periodontium?
- increased tooth mobility
What is the distinguished feature of necrotising ulcerative periodontitis (NUP)?
Bone destruction