Overview Of Local Contributing Factors

Question 1

What is a local contributing factor? (LCF)

Answer 1

Anything that influences PD health status at a particular site or sites w/ no systemic effects
-May included anatomic anomalies or iatrogenic features

Question 2

Do LCFs cause periodontitis?

Answer 2

NO

-Accelerate the progression of the disease

Question 3

T/F - LCFs can change the prognosis from favorable to unfavorable.

Answer 3

TRUE

Question 4

T/F - Modifiable LCF may improve prognosis or tx.

Answer 4

TRUE

Question 5

What are 4 sites associated with anatomic LCFs?

Answer 5

Proximal contact relation

Cervical enamel projections

Enamel pearls

Bifurcation ridges

Question 6

Open contacts = ?

Answer 6

Food impaction
-Forceful wedging of food interproximally by occlusal forces
—Lateral food impaction = due to tongue pressure in open embrasures

Question 7

What is a cervical enamel projection?

Answer 7

Narrow wedge-shape extension of enamel pointing toward the furcation

• 30% of mand molars
• 17% of max molars
• Buccal surfaces
• 2nd molar>1st molar

Question 8

Grade I CEP?

Answer 8

Distinct change in CEJ pointing toward the furcation

Question 9

Grade II CEP?

Answer 9

Cervical enamel projection approaches, but does not enter, the furcation

Question 10

Grade III CEP?

Answer 10

Cervical enamel projection extends into the furcation

Question 11

T/F - CEP are plaque retentive, predispose to furcation involvement.

Answer 11

TRUE

Question 12

Tx of CEPs?

Answer 12

No tx If Grade 1 or 2

• No CT won’t form on enamel
• Remove carefully to avoid pulp exposure

Question 13

Where are enamel pearls found?

Answer 13

Furcations

Frequent on 3rds

Question 14

What is the intermediate bifurcation ridge?

Answer 14

Excess cementum on mand molars runs longitudinally b/t mesial and distal roots

• Medially or laterally placed
• Plaque and calculus removal difficult

Question 15

Palatogingival grooves?

Answer 15

Extends from cingulum apically

Extends onto root 50% of time = attachment loss

Question 16

Tx of palatogingival grooves?

Answer 16

Odontoplasty

Minimalize groove to reduce plaque retention

Question 17

Root Trunk?

Answer 17

Distance of CEJ to coronal aspect of the furcation

Question 18

Root trunk classifications?

Answer 18

A - very short root trunk
-1/3 or less of the cervical area of the root

B - Medium root trunk
—Half of the length of the root

C - Long root trunk
—furcation entrance is in cervical 2/3rds

Question 19

Which is better for attachment? Short or long root trunks?

Answer 19

The more area for attachment, the better, however the furcation involvement in teeth w/ long root trunks is very unfavorable

Question 20

T/F - Root fusion decreases the amount of attachment area

Answer 20

TRUE

Question 21

T/F - Long contacts and minimal embrasures inhibit plaque removal

Answer 21

TRUE

Question 22

T/F - Healthy teeth unaffected if you treat the compromised tooth, however, healthy teeth affected if the compromised tooth untreated.

Answer 22

TRUE

Question 23

Prevalence of accessory canals?

Answer 23

25-50% molars

1st molar>2nd molar

Always tx non-vital teeth with RCT very first

Question 24

How to tx cemental tears?

Answer 24

Debridement and regen

Question 25

T/F - Overhangs promote plaque retention which equals inflammation and attachment loss.

Answer 25

TRUE

Question 26

T/F - More attachment loss with larger overhangs.

Answer 26

TRUE

Question 27

Do overhangs cause periodontitis?

Answer 27

NO

-They can contribute, but they do not cause periodontitis

Question 28

Impingement of a margin = ??

Answer 28

Inflammation, bleeding, discomfort

Question 29

What is the biologic width?

Answer 29

2 mm

~1 mm - junctional epi
~1 mm - CT

Question 30

What are factitial injuries?

Answer 30

Pts pick at gingival tissue