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DG1002 - FOUNDATION CK > Perio > Flashcards

Perio Flashcards

1
Q

What are the following structures commonly known as?

  • interdental papilla
  • marginal gingivae
  • attached gingivae
  • muco-gingival junction
  • oral/alveolar mucosa
A

the investing structures

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2
Q

What structure is labelled A on the photo?

A

interdental papilla

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3
Q

What structure is labelled B on the photo?

A

marginal gingivae

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4
Q

What structure is labelled C on the photo?

A

attached gingivae

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5
Q

What structure is labelled D on the photo?

A

muco-gingival junction

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6
Q

What structure is labelled E on the photo?

A

oral/alveolar mucosa

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7
Q

Which periodontal structure is important to maintain during restorative treatment in order to preserve gum health? (lowest point of the gingival sulcus to the top of the alveolar bone crest)

A

biological width

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8
Q

What are the 5 functions of the junctional epithelium of gingiva?

A
  • forms attachment to the tooth
  • provides a barrier
  • rapid turnover
  • provides antimicrobial defence
  • GCF flow
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9
Q

Which type of periodontal ligament fibre is A?

A

alveolar crest fibres

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10
Q

Which type of periodontal ligament fibre is B?

A

horizontal fibres

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11
Q

Which type of periodontal ligament fibre is C?

A

inter-radicular fibres

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12
Q

Which type of periodontal ligament fibre is D?

A

oblique fibres

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13
Q

Which type of periodontal ligament fibre is E?

A

apical fibres

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14
Q

What are the characteristics of healthy gingiva?

A
  • pale pink
  • firm
  • stippled gingiva
  • interdental papilla fills the interdental space
  • no recession, BOP or inflammation
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15
Q

What is the probing depth for healthy gingiva?

A

1-3mm

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16
Q

Which periodontal disease is the following?

  • reversible
  • inflammation of the gingival tissues mostly plaque induced
A

gingivitis

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17
Q

Which periodontal disease is the following?

  • irreversible
  • destructive chronic bacterial infection that leads to inflammation in the soft tissues and bone around the teeth
A

periodontitis

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18
Q

What are 3 putative pathogens of periodontal disease?

A
  • p gingivalis
  • tannerella forsythus
  • treponema denticola
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19
Q

How long does it take for the initial lesion to form in periodontal disease?

A

2-4 days

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20
Q

How long does it take for the early lesion to form in periodontal disease?

A

4-10 days

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21
Q

How long does it take for the established lesion to form in periodontal disease?

A

2-3 weeks

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22
Q

How long does it take for the advanced lesion to form in periodontal disease?

A

over 3 weeks

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23
Q

What are 6 signs of gingivitis?

A
  • redness
  • swelling
  • bleeding
  • loss of stippling
  • soft, spongy
  • increased probing depths (false pocketing) due to swelling
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24
Q

What are 6 signs of periodontitis?

A
  • deepened sulcus (true pocket)
  • subgingival plaque
  • alveolar bone and periodontal ligament destruction
  • loss of normal gingival contour
  • mobility of teeth and/or drifting
  • junctional epithelium receding apically
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25
Q

What is the cause of periodontal pockets? (abnormal space between tooth and supporting structures)

A

loss of connective tissue attachment (periodontal ligament and supra gingival fibre destruction)

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26
Q

What are 8 risk factors for periodontal disease?

A
  • smoking
  • systemic disease (eg. diabetes)
  • genetics
  • medication
  • pregnancy
  • stress
  • obesity
  • diet
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27
Q

What are 5 methods of managing periodontal disease?

A
  • improvements in OH
  • hygiene appointments (debridement)
  • periodontal surgery
  • adjunctive antibiotic therapy
  • tooth extraction
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28
Q

What 6 ways is periodontal health assessed?

A
  • gingival colour
  • gingival contour
  • BOP
  • pocket depth
  • radiographs
  • presence and location of plaque/calculus
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29
Q

When taking a BPE, which teeth are scored on patients RHS side?

A

7-4

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30
Q

When taking a BPE, which teeth are scored on patients anteriors?

A

3-3

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31
Q

When taking a BPE, which teeth are scored on patients LHS side?

A

4-7

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32
Q

What is the probing pressure when taking a BPE?

A

20g

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33
Q

When taking a BPE, third molars are usually not included, except from when?

A

2nd molars are missing

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34
Q

When taking a BPE, sextants with only one tooth are scored X and the remaining tooth score is included where?

A

the adjacent sextant

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35
Q

What score is given when taking a BPE when furcation is involved?

A

*

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36
Q

When taking a BPE, what does a code 4 or * indicate?

A

full 6ppc required

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37
Q

When taking a BPE, what score is given for no disease?

A

score 0

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38
Q

When taking a BPE, what score is given for bleeding on probing?

A

score 1

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39
Q

When taking a BPE, what score is given for plaque retentive factors (calculus, overhangs) pockets < 3.5mm?

A

score 2

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40
Q

When taking a BPE, what score is given for pockets > 3.5mm but < 5.5mm (black band partially disappears)?

A

score 3

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41
Q

When taking a BPE, what score is given for deep pockets > 5.5mm (black band disappears)?

A

score 4

42
Q

If periodontal tissues are too painful for the patient to take a BPE score, what should be done?

A
  • do not persist with BPE
  • disclose and take photographs
  • concentrate on OHI
  • return to BPE at a later date
43
Q

What is the difference between bleeding on probing and marginal bleeding?

A
  • Marginal bleeding reflects how well the patient is able to carry out effective plaque control daily (bleeding from swiping along gum line)
  • Bleeding on probing from the base of the pockets indicates active diseased sites (bleeding from pockets)
44
Q

During a 6ppc, what 5 measurements are taken?

A
  1. recession
  2. probing depth
  3. bleeding on probing
  4. mobility
  5. furcation involvement
45
Q

What treatment would be carried out for a BPE score of 3?

A
  • assess OH and OHI
  • assess plaque and bleeding
  • motivation
  • supra and subgingival scaling to disrupt plaque biofilm in pockets
  • periodontal pocket depth (PPD) chart of sextants scoring 3 after initial treatment
46
Q

What treatment would be carried out for a BPE score of 4 or * ?

A
  • assess OH and OHI
  • assess plaque and bleeding
  • full mouth periodontal assessment - all sextants
  • supra and subgingival scaling
  • PPD repeated after initial therapy
47
Q

What are periodontal probes used to determine?

A
  • pocket depth
  • attachment level
  • amount of gingival recession
  • presence of plaque and calculus
  • anatomical features of the root
48
Q

What is the difference between BPE and PPD scores?

A
  • BPEs are to screen for disease

- PPD are to measure the depth of pockets

49
Q

What are some factors that affect errors that can occur whilst periodontal probing?

A
  • dimensions and shape of probe
  • positioning of probe
  • measurement scale
  • probing force
  • extent of inflammation
50
Q

What probe positioning error can occur when you get an underestimated PPD?

A

probe not parallel to long axis of root

51
Q

How should a probe be positioned to get an accurate PPD?

A

keep probe parallel as possible to long axis of root

52
Q

What are 5 factors that can influence probing depth?

A
  • severity of the disease
  • thickness of probe
  • correct placement and pressure
  • tooth contours
  • calculus
53
Q

When scoring mobility, what score is given for no detectable movement/physiological mobility (classically up to 0.2mm)?

A

score 0

54
Q

When scoring mobility, what score is given for mobility of the crown of the tooth 0.2-1mm in the horizontal direction?

A

score 1

55
Q

When scoring mobility, what score is given for mobility of the crown of the tooth > 1mm in the horizontal direction?

A

score 2

56
Q

When scoring mobility, what score is given for mobility of the crown of the tooth in both the horizontal and vertical planes?

A

score 3

57
Q

What instrument is used to measure furcation involvement?

A

naber probe

58
Q

When measuring furcation, what score is given for naber probe going through 1/3?

A

grade 1

59
Q

When measuring furcation, what score is given for naber probe going through 2/3?

A

grade 2

60
Q

When measuring furcation, what score is given for naber probe going through 3/3?

A

grade 3

61
Q

What treatment implications should be explained to patients prior to periodontal treatment?

A

gums will recede, therefore roots may become visible and therefore sensitivity

62
Q

Why carry out mechanical plaque removal?

A
  • removes plaque retentive factors
  • cosmetic
  • facilitates disrupting the plaque biofilm
63
Q

What is the definition of periodontitis?

A

involves irreversible changes to, and loss of, bone, cementum and periodontal ligament which support the teeth

64
Q

When diagnosing periodontium as healthy, what are the 2 subcategories of diagnosis?

A
  • intact periodontium

- reduced periodontium

65
Q

What percentage of bleeding on probing should be expected for gingivitis for a patient with intact periodontium?

A

more than/equivalent of 10%

66
Q

What percentage of bleeding should be expected for a healthy intact periodontium?

A

less than 10%

67
Q

What is the expected pocket depths for healthy periodontium and/or gingivitis?

A

less than/equivalent to 3mm

68
Q

What is the expected probing pocket depths for a patient with reduced periodontium but (non periodontitis patient - no previous disease)?

A

less than/equivalent to 3mm

69
Q

What is the expected bleeding on probing for a patient with reduced periodontium however not due to previous disease and now has a healthy periodontium?

A

less than 10%

70
Q

What is the expected bleeding on probing for a patient with reduced periodontium however not due to previous disease and now has gingivitis?

A

more than/equivalent to 10%

71
Q

Would there be any expected probing attachment loss for a patient with a reduced peridontium however not due to previous disease?

A

yes

72
Q

Would there be any expected probing attachment loss for a patient with successfully treated periodontitis?

A

yes

73
Q

What is the expected probing pocket depths for a patient with successfully treated periodontitis?

A

less than/equivalent to 4mm (no site 4mm with BOP)

74
Q

What is the expected bleeding on probing for a patient with successfully treated periodontitis and now stable?

A

less than 10%

75
Q

What is the expected bleeding on probing for a patient with gingivitis and has a history of periodontitis but is now in remission?

A

more than/equivalent to 10%

76
Q

What is the expected bleeding on probing percentage for localised gingivitis (1/3 or less of the mouth)?

A

between 10-30%

77
Q

What is the expected bleeding on probing percentage for generalised gingivitis?

A

more than 30%

78
Q

What BPE score is given for the following?

  • no pockets > 3.5mm, no calculus/overhangs
  • no bleeding after probing
  • black band completely visible
A

score 0

79
Q

What BPE score is given for the following?

  • no pockets > 3.5mm
  • no calculus/overhangs
  • bleeding after probing
  • black band completely visible
A

score 1

80
Q

What BPE score is given for the following?

  • no pockets > 3.5mm
  • supra or subgingival calculus/overhangs
  • black band completely visible
A

score 1

81
Q

What is the treatment for a BPE score of 0?

A

encouragement to continue as they are, no need for periodontal treatment

82
Q

What is the treatment for BPE score of 1?

A

OHI

83
Q

What is the treatment for BPE score of 2?

A
  • OHI

- removal of plaque retentive factors and calculus

84
Q

What are the 3 subcategories of periodontitis diagnosis?

A
  • localised (less than/equivalent to 30% teeth)
  • generalised (more than 30% teeth)
  • molar incisor pattern
85
Q

What is the treatment for a BPE score of 3?

A
  • initial period treatment (OHI, removal of PRFs including supra and subgingival scaling)
  • appropriate radiographs of affected teeth (PAs)
  • after 3 months - review and localised 6ppc
86
Q

Code 3

What is the final diagnosis for less than/equal to 4mm PPD and no radiographic bone loss?

A

health or gingivitis

87
Q

Code 3

What is the final diagnosis for more than/equal to 4mm PPD and radiographic bone loss?

A
  • localised perio <30%
  • generalised perio >30%
  • molar incisor pattern perio
88
Q

What is the assessments/treatment for BPE score of 4?

A
  • full perio assessment
  • appropriate radiographic assessment (PAs or OPG)
  • 6ppc of all teeth, not just the areas scoring 4s
89
Q

When staging periodontitis, what stage is given for

  • interproximal bone loss of <15% (or 2mm attachment loss from CEJ)
  • 1-2mm clinical attachment loss
  • PPD 4mm or less
A

stage 1 (early/mild)

90
Q

When staging periodontitis, what stage is given for

  • interproximal bone loss of coronal third of root
  • 3-4mm clinical attachment loss
  • tooth loss
  • PPD 5mm or less
A

stage 2 (moderate)

91
Q

When staging periodontitis, what stage is given for

  • interproximal bone loss of mid third of root
  • 5mm or more clinical attachment loss
  • bone loss beyond 33%
  • tooth loss of 4 teeth or more
  • class 2-3 furcations
A

stage 3 (severe)

92
Q

When staging periodontitis, what stage is given for

  • interproximal bone loss of apical third of root
  • encompasses all of stage 3 but with masticatory dysfunction, secondary occlusal trauma etc
A

stage 4 (very severe)

93
Q

How is the grading of periodontitis calculated?

A

% bone loss divided by patient age

94
Q

When grading periodontitis, what grade is given for < 0.5?

A

grade a (slow rate of progression)

95
Q

When grading periodontitis, what grade is given for 0.5-1.0?

A

grade b (moderate rate of progression)

96
Q

When grading periodontitis, what grade is given for >1.0?

A

grade c (rapid rate of progression)

97
Q

What current status is given for the following?

  • BOP < 10%
  • PPD equal to/less than 4mm
  • no BOP at 4mm sites
A

currently stable

98
Q

What current status is given for the following?

  • BOP equal to/more than 10%
  • PPD less than/equal to 4mm
  • no BOP at 4mm sites
A

currently in remission

99
Q

What current status is given for the following?

- PPD more than/equal to 5mm or PPD more than/equal to 4mm and BOP

A

currently unstable

100
Q

Which 6 factors are considered when diagnosing periodontal condition?

A
  • extent of disease
  • type of disease
  • stage
  • grade
  • current periodontal status
  • risk factor profile

DG1002 - FOUNDATION CK (11 decks)

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