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Perio > Module 9 exam 2 > Flashcards

Module 9 exam 2 Flashcards

1
Q

what are the 3 major categories of periodontitis?

A
  • chronic periodontitis
  • aggressive periodontitis
  • less common types of periodontitis
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2
Q

what are the two types of chronic periodontitis?

A

localized, generalized

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3
Q

what are the two types of aggressive periodontitis?

A

localized, generalized

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4
Q

what are the less common types of periodontitis?

A

periodontits as a mantifestation of systemic diseases, nectroizing perio diseases, perio associated with endodontic leisons

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5
Q

What is chronic periodontitis?

A

is a bacterial infection resulting in inflammation within the supporting tissues of the teeth, progressive destruction of the perio ligament, and loss of supporting alveolar bone

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6
Q

What does chronic perio start as?

A

plaque-induced gingivitis

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7
Q

What does chronic periodontitis involve

A

irreversible loss of attachment and bone and is the most frequently occuring form of periodontitis

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8
Q

what is chronic periodontitis also known as?

A

adult periodontitis, but is has changed because it can occur at any age

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9
Q

what are the alterations in color, texture and size of the marginal gingiva?

A
  • red or purplish tissue, in chronic it may appear bright red or purple, appears swollen, may have rolled margins, blunted or flattened papillae
  • the tissue may be pale pink and appear normal
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10
Q

is the clinical appearance of the tissues is a reiliable indicator of the presence or severity of chronic perio?

A

no

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11
Q

In chronic periodontitis is gingival bleeding, suppuration and increased crevicular fluid common?

A

yes

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12
Q

Chronic periodonitis is characterized by what kind of biofilm and calc?

A

mature

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13
Q

What does the amount of tissue destruction seen in chronic perio correspond with

A

the amount of biofilm accumulation, local contributing risk factors, smoking and systemic risk factors

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14
Q

what is clinical attachment loss

A

an estimate of the extent that the tooth supporting structures have been destroyed around a tooth

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15
Q

what are 4 things that loss of attachment in perio is characterized by?

A

1- relocation of junctional epithelium
2- destruction of the fibers of the gingiva
3- destruction of the perio ligament fibers
4- loss of alveolar bone support from around the tooth

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16
Q

Mild clinical attach loss is:
Moderate is
severe is:

A

1 to 2 mm
3 to 4 mm
loss greater or equal to 5 mm

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17
Q

What are clinical characteristics of attachement loss

A

loss of alveolar bone, perio pockets or recesssion, furcation involvement, tooth mobility

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18
Q

In localized or generalized inflammation can people have areas of health with areas of with chronic tissue destruction

A

yes

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19
Q

when is chronic perio classified as local?

A

when less than 30 % of sites are affected

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20
Q

What are contributing factors of chronic periodontitis?

A

local factors, systemic diseases, cigarette smoking

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21
Q

What are symptoms of chronic perio?

A

it is usually painless, pts start to see it when their gums bleed, progression of spaces between teeth, loose teeth, food impaction, sensitivity b/c of exposed root dull pain in jaw

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22
Q

What is peri-implantitis

A

term for chronic periodontitis in the tissues surrounding a dental implant

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23
Q

Gingivitis is a risk factor for chronic perio T/F

A

True

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24
Q

What is the age of onset for chronic perio

A

it can be at any age but is most common in adults over 35

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25
Q

at what rate does chronic periodontitis progress?

A

at a slow to moderate pace

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26
Q

Does tissue destruction in chronic perio occur in all teeth

A

no it is a site specific disease

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27
Q

does chronic perio progress at an even rate throughout the mouth?

A

no some sites may not change forever, and some may progress rapidly

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28
Q

What does initial care for chronic perio include?

A
  • consult with physicial for systemic risk factors
  • instruction, reinforcement of self care skill
  • smoking cessation
  • peiro instrumentation
  • anti microbial agents
  • removal or control of local factors
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29
Q

what goals should be included in treatment of chronic perio?

A
  • control bacterial biofilm
  • alter or eliminate local or systemic risk factors
  • arrest disease progression
  • prevent recurrence of perio
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30
Q

what are the desired outcomes in tx of chronic perio?

A
  • reduction in gingival inflammation
  • reduction of dental biofilm
  • reduction of probing depths
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31
Q

what is going to determine long term outcome of perio therapy?

A

patient compliance with self care

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32
Q

what is a refractory disease?

A

destructive perio in a patient who when monitored over time exhibits additional attachment loss at one or more sites despite repeated prof. perio therapy and a patient who practices good self care

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33
Q

What are primary features of aggressive periodontitis?

A
  • rapid destruction of attachment and rapid loss of supporting bone
  • no obvious signs of systemic disease
  • other family members with aggressive perio
34
Q

What are secondary features of aggressive perio?

A
  • small amounts of biofilm
  • elevated a. actinomycetemcomitans
  • phagocyte abnormalities
  • lack of clinical signs of a disease
  • poor response of perio therapy
  • episodic disease progression
35
Q

what is episodic disease progression?

A

occuring in succession of acute destructive phases with intermittent inactive phases

36
Q

When is the onset of localized aggrestive periodontitis?

A

around the time of puberty

37
Q

Where is localized aggressive perio seen?

A

first molars and or incisor and involving no more than 2 teeth other than first molars and incisors

38
Q

What should you look for in LAP?

A

vertical bone loss around the first molars and incisors beginning around puberty

39
Q

What is the onset of generalized aggressive periodontitis

A

occurs in persons younger than 30, but they can be older

40
Q

What is Generalized Aggressive Periodontitis? (gap)

A

generalized interproximal attachment loss affecting at least 3 permanent teeth other than the first molars and incisors, Destruction of the attachment and alveolar bone is very episodic occuring in a succession of acute phases

41
Q

what are clinical manifestations of GAP?

A

tissues may be acutely inflammed, ulcerated and fiery red, the y may also appear pink and free of inflammation although they have deep pockets

42
Q

What are some examples of periodontitis as a manifestation of systemic disease?

A
  • associated with hematological disorders

- associated with genetic disorders

43
Q

what are some examples of perio associated with hematological factors?

A
  • aquired neutropenia
  • leukemias
  • other
44
Q

what are some examples of perio associated with genetic disorders?

A
  • familial and cyclic neutropenia
  • down syndrome
  • leukocyte adhesion deficency syndrome
  • papillon-lefevre syndrome
  • chediak-higashi sydrome
  • histiocytosis syndromes
  • glycogen storage disease
  • infantile genetic agranulocytosis
  • cohen syndrome
  • hypophosphatasia
45
Q

What is a hematologic disorder?

A

abnormalities in the structure or function of the blood and blood forming tissues

46
Q

what is aquired neutropenia?

A

blood disorder characterized by abnormally low level of neutrophils which can be seeen with chemo, radiotherapy, viral infections

47
Q

what is important for us to know about neutropenia

A

lowers the immunologic barrier to bacterial and fungal infections, affects PMNS which may result in severe perio destruction

48
Q

What are periodontal manifestations of leukemia?

A

gingival enlargement, bleeding and infections

49
Q

what are the most common HIV assicated perio diseases?

A

LGE and necrotizing perio diseases

50
Q

What should we remember about perio disease in HIV infected individuals

A

perio attach loss and alveolar bone destruction may be extremely rapid

51
Q

What is important to know about familial and cyclic neutropenia?

A

they may experiencce severe periodontal destruction, appear at a young age

52
Q

What is important to know about down syndrome?

A

they develop severe, agressive perio, substantial plaque formation, deep pockets, gingival inflamation

53
Q

what is important to know about Leukocyte adhesion deficency syndrome?

A
  • perio attributed to this is rare

- begins upon eruption of the primary teeth with rapid attachment and tooth loss

54
Q

what is important to know about papillon lefevre syndrome?

A
  • characerized by hyperkeratosis of palms of hands and soles of feet and severe destruction of periodontium
  • primary teeth are lost by 5 or 6, permanent teeth are lost due to bone destructon by 15
55
Q

What is important to know about chediak-higashi syndrome?

A
  • pale colored hair, eyes and skin,
  • imparment of neutrophil chemotaxis
  • aggressive perio
56
Q

What is glycogen storage disease?

A
  • characterized by neutropenia

- perio manifestations appear at a young age with potential for early tooth loss

57
Q

What is infantile genetic agranulocytosis?

A
  • severe chronic neutropenia usually detected soon after birth
  • experience severe perio
58
Q

What is Cohen syndrome?

A
  • neutropenia, developmental delay, mental retardation, small head, weak muscle tone
  • increase susceptibility to early perio breakdown, assicated with neutropenia
59
Q

what is ehlers danlos syndrome types IV and VIII

A
  • connective tissue disorder associated with bruising, joint hypermobility skin laxity, weakness of tissues
  • early onset of generalized periodontitis, premature loss of deciduous and permanent teeth
60
Q

what is hypophosphatasia?

A
  • deficency in alkaline phosphate, skeletal defects resembling rickets
  • severe loss of alveolar bone and premature loss of primary and permanent teeth in absence of inflammatory response
  • early exfoliation of anterior teeth
61
Q

What is necrotizing periodontal disease?

A

-inflammatory destructive infection of periodontal tissues that involve tissue necrosis

62
Q

What is NUG?

A

tissue necrosis limited to the gingival tissues

63
Q

What is NUP?

A

tissues necrosis of the gingival tissues combined with loss of attachment and alveolar bone loss

64
Q

NUP is a painful infection characterized by

A

necrosis of gingival tissues, perio ligament, and alveolar bone

65
Q

How quickly can loss of attachment happen in NUP

A

within days

66
Q

Necrotizing perio disease primarily involves what area of the mouth

A

interdental and marginal gingiva

67
Q

what is necrotizing perio disease characterized by

A

ulcerated and necrotic papillae and gingivall margings, appear punched out or cratered

68
Q

the necrotic arease in necrotizing perio disease are covered by what

A

a yellowish white or grayish tissue slough called a pseudomembrane

69
Q

Where are the first leisons seen in npd?

A

interproximally in the mandibular anterior sexant

70
Q

Is an odor present in NPD

A

yes there can be

71
Q

what may NPD be associated with

A

excessive salivation

72
Q

what is an interdental crater in NPD?

A

central tissue destruction between facial and lingual portions of papilla

73
Q

what happens to the bone in NPD?

A

deep craters in the interdental alveolar bone

74
Q

what are the systemic signs and symptoms of NPD?

A

-swelling of lymph nodes especially the submandibular and cervical nodes

75
Q

What are some predisposing factors for NPD?

A

-systemic diseases which impair immunity
-poor self care
emotional stress
inadequate sleep, fatiuge
alcohol use
caucasian
cigarette smokers
poor nutrition
prexisting gingivitis or tissue trauma

76
Q

what is the goal of the acute phase of tx of NPD

A

eliminate disease activity and relieve pain and discomfort

77
Q

what is done in treatment of NPD

A
  • perio instrumentation
  • self care instruction
  • oxygen therapy with hydrogen peroxide
  • pain control
  • antibiotic therapy
  • seen daily, appropriate tx should releive symptoms in a few days
78
Q

what should education of the patient of NPD involve?

A

-nutrition, intake of fluids, smoking cessation

79
Q

What are the 4 subgroups of developmental or aquired deformities and conditions?

A
  • localized tooth related factors that modify or predispose to plaque induced gingival diseases or perio
  • mucogingival deformities and conditions around teeth
  • mucogingival deformities and conditions on edentulous ridges
  • occlusal trauma
80
Q

WHat are some tooth related factors that predispose to perio disease?

A

-enamel pearls, cervical enamel projections, palatolingual grooves, malalignment

81
Q

what is the most common mucogingival deformity related to perio disease

A

recession of the gingival margin

Perio (11 decks)

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