Orthodontic Perio, Endo & Restorative Treatment 18% 12Q Flashcards
which organism must be present in periodontal disease?
Porphyromonas Gingivalis
during orthodontic Tx, which organism is present in higher numbers?
Bacteroides Gingivalis
which organism has an association with juvenile periodontitis?
AA - Actinobacillus actinomycetemcomitans
Match the condition and associated organisms: Strep M, AA, Strep A, BG, Staph A, PG
- Perio:
- Ortho Perio:
- Juvenile Perio:
- Caries:
- Rheum Fever:
- Osteomyelitis:
- Perio: PG
- Ortho Perio: BG
- Juvenile Perio: AA
- Caries: Strep M
- Rheum Fever: Strep A
- Osteomyelitis: Staph A
In peril, a Class II furcation involvement means what? What is the Tx?
halfway through
Graft and Guided Tissue Regeration
In perio, a Class III furcation involvement means what? What is the appropriate Tx?
through and through
Hemisection, Extraction, or open flap curettage
what effect does intrusion have on peril pockets and furcations
Intrusion does not change furcation or pocket
what kind of defect has the best prognosis? how many walls?
3 walled
with 3 walled peril defects, you can get Pocket reduction with regenerative perio therapy. What therapy?
debridement, graft and Guided Tissue Regeneration
it is safe to initiate orthodontic treatment when peril has been stable for ___ - ___ months
3 - 6 mo
a 2 walled perio defect is aka
osseous crater / interdental crater
a 2 Walled perio defect is a concavity confined to ________ and _________ walls
facial and lingual
what is the appropriate treatment for a 2 walled perio defect?
osseous recontouring or resection
where are 1-2 Walled hemiseptal defects commonly found?
mesially tipped or supraerupted teeth.
can 1-2 wall hemiseptal perio defects be eliminated with orthodontic treatment?
YES, uprighting and eruption will level the bony defect
If bone level is flat between adjacent teeth and the marginal ridges are at different levels, correcting marginal ridge discrepancy will create a:
hemiseptal defect
which two systemic conditions put patients at an increased risk for periodontal disease?
uncontrolled diabetes
rheumatoid arthritis
A free Gingival Graft is performed ( pre / post )-ortho when less than ___mm of gingiva for cosmetic reasons post-ortho
pre - ortho
2mm
what is the appropriate/ideal gingival display upon smiling?
1-2mm
what are the potential causes of excessive gingival display?
VME
short upper lip
increased max eruption (altered active)
Delayed apical migration of gingival margin (altered passive)
Gingival margin should be ___mm coronal to CEJ
1mm
Biologic width, or the distance form bone to gingival sulcus should be ___mm
2mm
what Tx is appropriate for a vertical root fracture?
extraction
is a horizontal root fracture occurs, can you continue ortho?
yes
with gingival inflammation, there will be a greater breakdown of bone because of higher _______________ levels
prostaglandin levels
can ortho cause perio involvement?
yes
Frenectomy procedures should be done ( before / after ) space closure and
( before / after ) debonding
after space closure
before debond
Compared to 1960 the prevalence and severity of perio disease are both ( higher / lower )
higher
A ________________ fiberotomy severs gingival and transseptal fibers which run between two adjacent teeth in the same arch, and is used to reduce ____________ relapse
supracrestal
rotational
Contraindications to supracrestal fibrotomy Tx include: Poor OH, excessive ( lingual / labial ) root prominence, active Perio
labial
Supracrestal fibrotomy Tx is more successful in (maxillary / mandibular ) teeth
maxillary
Supracrestal fibrotomy Tx heals is ___ - ___ days
7-10 days
which canine exposure technique preserves the attachment and mimics natural tooth eruption by allowing the canine to be brought down through attached gingiva
Closed eruption technique
after extraction of a tooth, the maxillary ridge will 25% in ___ months and 33% in ___ years
6 mo
5 yrs
gingival recession happens 68% of the time, mores in (maxillary / mandibular ) teeth and occurs ( symmetrically / asymmetrically )
mandibular
symmetrically
When considering root proximity, ___ - ___mm of root separation will provide adequate bone and embrasure space for perio healing
2 - 3mm
after band removal, the total amount of time needed for adequate bone remodeling, cessation of mobility and narrowing of the periodontal ligaments is:
6 months
ankylosed teeth should be removed as soon as the alveolar height is changes because ankylosis has what effect on the development of the alveolar ridge?
arrested developemnt
Which systemic antibiotic is least effective for perio disease?
Metronidazole
the incisogingival position is determined by the position of the gingival margin. In some young patients, labial gingival level has not migrated to its adult level , so they either need _______________ or ______________ depending on bone level.
gingivectomy
osseous surgery (crown lengthening)
black triangles can be addressed with:
IRP
ARS (air rotor stripping)
black triangles are caused by:
crown shape, bone loss, root position
improper root positioning ( can / cannot ) lead to reduced bone levels
can
name 4 conditions/characteristics which can predispose someone to root resorption
hypothyroidism
previous RR
long, thin roots
long duration of Tx
which type of fibers are most associated with relapse?
transseptal fibers
Profit says suprecrestal
___ - ___% of children and ___ - ___ % of adults need pre-ortho perio
5-10%
20-25%
___% of perio patients in ortho will see rapid progression
10%
perio patients in ortho should have scaling ___x as often as normal
2x (twice)
Bone breakdown is higher for perio patients because of higher prostaglandin levels which leads to increased ___________ activity
osteoclast
_______________ is released during the breakdown of periodontal fibers
Interleukin - I
T/F: ortho can be done concurrently or immediately after an specification procedure
True
This procedure should be performed on a tooth with necrotic pulp and unfinished root tip formation
apexification
What is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end? performed to encourage the continuation of this process.
Apexogenesis
with horizontal root fractures, a ___ year observation period is needed before initiation of orthodontic treatment
2 year
If a tooth with a horizontal root fracture undergoes orthodontic Tx, the root fragment may separate, and/but there ( is / is not) worsening of prognosis of that tooth.
is NOT
Orthodontic treatment for teeth with prior RCT ( do / do not ) have more root resorption than non-endo treated teeth
no NOT
What is the diagnosis when a radiolucency inside the canal is observed? What should be done?
Internal RR
Immediate Endo
The peak incidence of incisor trauma is at ___ - ___ years old
8 - 10 years old
The ump ( does / does not ) have proprioceptors
does not
If placing porcelain crown, the minimum overjet needed is ___ - ___mm to avoid additional tooth preparation on lingual surface
0.5-0.75mm
If placing conventional porcelain bridge, the minimum overjet needed is ___ - ___mm to avoid additional preparation on the lingual surface
0.5-0.75mm
T/F: If placing porcelain veneers, an edge-to-edge overate to allows sufficient space on labial for both temporary composite build up and eventual porcelain laminate
True
if placing a bonded bridge, the appropriate overate and minimal OB is ___mm. Additionally, ______ incisor angulation permits better retention due to vertically oriented occlusal forces.
0.5mm
upright
When veneering the U2-2, place the lateral ___/___ away from the central and ___/___ away from the canine
⅓ from central
⅔ from canine
The width-to-length ratio of the centrals should be ___ - ___ %
65-75%
The space needed for an implant restoration of a lateral incisor is roughly ___mm, ⅔ the width of the central
7mm
When lateralizing canines (substitution), ST esthetics, the size and _____ of the canines, and the need for ____________ in the lower arch are more important factors than doing restorations on the centrals
shape
extractions
You need ___ months of retention before restoration after extrusion is done.
6 months
in the Gorlick foundation study, they found that ___% of patients have decalcification and that you should (prescribe / avoid ) fluoride
50%
avoid - allow the tooth to remineralize
In the Guzman-Armstrong technique for treating calcification, the steps include:
- Allow natural remineralization for ___ months – no Fl-, it arrests remineralization and leads to staining
- _____________ to camouflage white spots, then do Fl- treatment
- acid _____________ (loses 250μm) followed be Recaldent or MI paste plus
- Restoration
- 6 months
- external bleach
- acid microabrasion
- restoration
over the counter fluoride is 0.____%
0.05%
the maxillary lateral is ____% of the size of central incisor
75%
If the laterals are congenitally missing and you have Bs and Cs, what can be done?
extract Bs to encourage 3s to erupt into the lateral position
