Oral exam Flashcards
Primary factors
(2)
Bacterial plaque in a susceptible host
Calculus is a contributing factor or SECONDARY etiologic factor
A plaque biofilm is essential
Contributing factors
Systemic
(3)
Local
(5)
Diabetes
HIV/AIDS
smoking
Trauma from occlusion
Root proximity
Overhangs
Calculus
Smoking
Socio economic factors
Others
Primary periodontal pathogens
(5)
Aggregatiabacter actinomyces
Porphyromonas gingivalis
Tannerella forsythia
Treponema denticola
Prevotella intermedia
Definition of biofilm ???
inorganic components of biofilm are calcium, phosphorus, and trace amounts of sodium, potassium, and fluoride
A biofilm is defined as a community of microorganisms attached to an inert or living surface by a self-produced polymeric matrix or an assemblage of microbial cells associated with a surface and enclosed in a matrix of primarily polysaccharide material.
Difference between supra/subgingival calculus
(2)
Supragingival: gram (+) cocci and short rods, aerobic environment, slight diversity, calculus formation and root caries
Subgingival: both tooth-attached and unattached, epithelium association, gram (-) rods and spirochetes, anaerobic environment, great diversity, tissue destruction
Name any muco-cutaneous diseases affecting the periodontium
Lichen planus, erythema multiforme, pemphigoid? (this one says it’s cutaneous, not specifically mucocutaneous)
Main periodontal manifestations with:
Pregnancy/diabetes/leukemia/HIV/AIDS/transplant pts/epilepsy/hypertension
?
Genetic diseases affecting the periodontium
Associated with immunologic disorders: (5)
Affecting oral mucosa and gingival tissue: (1)
Affecting CT: (1)
Metabolic and endocrine disorders: (4)
Down’s syndrome, leukocyte adhesion deficiency, Papillon-Lefevre syndrome, Chediak-Higashi Syndrome, congenital neutropenia
epidermolysis bullosa
Ehlers-Danlos syndrome
hypophosphatasia, osteoporosis, diabetes mellitus, obesity
Predominant cells of early lesion, established lesion
Early: (2)
Established: (5)
PMNs*, macrophages
PMNs, macrophages, T lymphocytes, B lymphocytes, plasma cells*
Does age make a difference? Same attachment loss in different ages?
(2)
Prevalence, extent, and severity of recession increases with age
Prevalence of non-severe and total periodontitis increased with age
How are the periodontal tissues destroyed in periodontal disease
What does bleeding on probing mean? What is happening in the pocket with BOP?
(2)
Indicates ulceration of the JE → indicating inflammation; bleeding index is a standardized way to interpret bleeding present with probing that would put patients at risk for oral health disease like gingivitis and periodontitis
Dilation and engorgement of the capillaries and thinning or ulceration of the sulcular epithelium; vasculitis of the blood vessels adjacent to the JE; progressive destruction of the collagen fiber network
Gingivitis vs periodontitis
Gingivitis:
Periodontitis:
“the inflammation of the gingival tissues without loss of CT attachment”
“the inflammation of the gingival tissues with apical migration of junctional epithelium with concomitant loss of CT attachment and bone”
Staging and Grading
Staging:
Based upon severity of the case and complexity of the case management. Consider CAL, amount and % of bone loss, PD, presence and extent of ridge defects, furcation involvement, tooth mobility, tooth loss due to periodontitis
Grading:
consider biologic features like the rate of disease progression, risk of further advancement, potential threats to general health
Grade A = low risk of progression
Grade B = moderate risk
Grade C = high risk
Trauma from occlusion (TFO) (primary vs secondary and controlled orthodontics now included)
Primary:
Secondary:
traumatic occlusal forces applied to a tooth or teeth with normal periodontal support; clinically may see adaptive mobility but does not progress (ex: “high” restoration with mobility resolving following reduction)
injury resulting in tissue changes from normal or traumatic occlusal forces applied to a tooth or teeth with reduced periodontal support
Mobility (I, II, III)
(4)
I: first distinguishable sign of movement greater than normal (physiologic)
II: movement which allows crown to move 1 mm from its normal position in any direction
III: tooth may be rotated or depressed in alveoli
Must use 2 rigid instruments, one on either side (like mirror handles, NOT fingers)
Furcation classifications (I-IV)
Grade I:
control of inflammation through plaque control and root preparation; adjustment of occlusion if indicated at reevaluation; odontoplasty if indicated
Grade II (shallow):
all of the above plus flap debridement/osseous surgery or potential regeneration
Grade II (deep):
control of inflammation (difficult), adjustment of occlusion, flap debridement/osseous surgery, root resection, osseous regeneration, tunnel preparation, extraction
Grade III:
all of the above except osseous regeneration
Goldman-incipient/Glickman Grade I:
pocket formation into the flute (beginning) of the furca, but interradicular bone is intact
Goldman cul-de-sac/Glickman Grade II:
loss of interradicular bone with pocket formation of varying depths into the furca, but not completely through to the other side (can be shallow or deep)
Goldman through-and-through/Glickman Grade III:
complete loss of interradicular bone with pocket formation allowing probe to pass completely to the other side
