Perio Flashcards

1
Q

Perio: how classify disease in examination

A
  1. Disease - chronic periodontitis
  2. generalised / localised
  3. stage and grade
  4. stability
  5. modifying factors
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2
Q

Perio classification: Generalised or localised? (3)

A
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3
Q

Perio classification: staging?

A

measures severity

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4
Q

Perio classification: Grading?

A

Measures progression of disease

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5
Q

Perio classification: Stability?

A

measures activity of disease

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6
Q

Perio classification: Modifying factors? (4)

A
  1. immune system impairment
    • Disease (leukaemia, HIV, PREGNANCY)
    • Genetic conditions (downs syndrome)
  2. Local Risk factors
    • acquired (plaque, calc, overhang, trauma, ortho)
    • Anatomical (malposition, concavities, root grooves)
  3. systemic risk factors
    • non modifiable (ageing, genetics/disorders, gender)
    • modifiable
      • Smoking (<BF & >immune action)
      • osteoporosis (<bone density)
      • stress (>chemicals = >immune system)
      • obesity / nutrition (see image)
      • drugs (see image)
      • poor controlled diabetes mellitus
      • HIV
      • Hormones
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7
Q

Perio: stages of treatment?

A
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8
Q

What are the first two stages of perio treatment?

A
  1. immediate, acute symptoms
    • pain
  2. systemic phase
    • systemic risk factors addressed
    • quit smoking / control diabetes / contact their specialist
    • Antibiotics if systemic effect
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9
Q

what are the 3rd (5) and 4th stages of perio treatment?

3 outcomes of stage 4?

A

re-evaluation 3 months after original treatment

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10
Q

What are the 5th and 6th stages of perio treatment?

for the 6th stage - what is carried out at each visit? (3)

A

recall 3-12 months (tailored to patient) - normally 3 months

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11
Q

Perio: what is done before treatment begins with a patient to optimise the outcome of perio treatment?

A

Explain disease

explain risks

explain risk factors

explain treatments/alternatives and benefits / risks of doing nothing

explain importance of OH

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12
Q

Perio: difference between engaging and non-engaging patients

A

engaging
1. >=50% improvement BOP and Plaque scores OR
2. <=20% plaque AND <=30% bleeding OR
3. met target for personal plan

non-engaging
1. opposite (<50% improvement on both)
2. opposite
3. opposite - patient prefers palliative care (dentist reduces symptoms and they’re happy with that so don’t do own care)

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13
Q

What are the 10 types of periodontal tissue conditions?

A
  1. health
  2. plaque induced gingivitis
  3. non-plaque induced gingival diseases/conditions
  4. Periodontitis
  5. PerioDONTITIS as manifestation of systemic condition/disease
  6. PerioDONTAL tissues effected by systemic disease/condition (non plaque induced)
  7. periodontal abscess
  8. periodontal-endodontic abscesses
  9. necrotic periodontal diseases
  10. mucogingival deformities/conditions
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14
Q

Perio: what are the conditions for periodontal tissues being at health when:

  1. intact periodontium
  2. Reduced periodontium
A
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15
Q

Perio: causes of:

  1. plaque induced gingivitis (3) / localised measurement?
  2. non-plaque induced gingival diseases/conditions (4)
A
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16
Q

perio: What? and examples? for:

  1. Issues that are exaggerating factors of perio and make get worse quicker
  2. periodontal tissue issue due to systemic disease/condition (non-plaque induced)
A
17
Q

Perio: Mucogingival deformities / conditions: (recession not caused by plaque)

  • causes (2)
  • types (3)
A
18
Q

Necrotising oral disease:

  1. Cause
  2. Features (4)
  3. types (3)
    - causes of 3rd type
A

Dark triangular ulceration inter-proximally

19
Q

necrotising oral disease:

  1. diagnosis (how cant diagnose and common bacterias causing)
  2. risk factors (developing / developed countries)
A
20
Q

necrotising oral disease:

  1. two main stages of treatment
  2. treatment process stages (6)
A

.

21
Q

4 types of periodontal tissue lesions?

A
  1. gingival abscess
  2. pericoronal abscess
  3. Periodontal lesion/abscess?
  4. endodontic-periodontal lesion
22
Q

Perio: what are gingival and pericoronal abscesses?

A
  1. gingival = forms between tooth and gingiva, closer to crown than periapical but not as close as periodontal one
  2. pericoronal abscess = forms in gingiva surrounding partially erupted / impacted tooth
23
Q

Periodontal lesions

  1. General types (2)
  2. cause
  3. signs/symptoms (8)
  4. treatment (4)
A
24
Q

endodontic-periodontal lesion

what and link?
classifications/causes?
types (2)
signs/symptoms?
treatment?

A
25
Q

endodontic-periodontal lesion:

anatomy causing link? (5)

A
26
Q

what disease does periodontits increase the risk factor of? (6)

why?

A

As causes systemic immune system heightening so can effect the following:

27
Q

Perio: general patient process from stage 1 to 4

A
    • education
    • OHI
    • risk factor control
    • PMPR

6-8 weeks - gums heal

    • step 1 again
    • re-evaluation (image)
      !!! - pocket chart (RSD >4mm pockets)!!!!!!
    • repeat 1 &2
    • > 6mm pockets = perio surgery
  1. Maintenance
    • 3 month intervals (OHI as required / sub/supra scaling)
    • annual pocket charts
28
Q

when is it okay to carry out subgingival scaling?

A

ONLY when pocket >4mm

less = risks further loss of attachment

29
Q

BPE information

  1. rules?
  2. how?
  3. scores?
  4. treatment for each score?
A
  1. sextant must have 2 or more teeth, worst score each sextant, 8s not counted unless missing molar
  2. CPITN probe (3.5 -5.5 band +ball tip 0.5mm), pressure = 20-25g
  3. 0,1,2,3,4,*
  4. image
30
Q

6PPC information

  1. how?
  2. process?
  3. types
  4. what both types record
A
  1. PCP12 probe (two bands 3-6, 9-12mm), 6 points of each tooth, go from middle of page where teeth diagrams are, dot for bleeding, higher gingival margin compared to ECJ = negative score
    • record missing teeth
    • quadrant 1 buccal each 3 points from posterior to midline, gingiva compared to ECJ and pocket depths until midline
    • check for bleeding
    • same but from midline to posterior on palatal
    • then buccal of second quadrant from midline then posterior palatally
    • repeat for lowers starting on left
  • measure MOBILITY - see image
  1. complete and abbreviated/review chart
  2. complete
    = gingival margin relative to ECJ, then Pockets, then add together to get loss of attachment
    = BOP, Furcations, MOBILITY

abbreviated
= pockets >4mm, BOP, furcation, mobility
= good as fast and shows area for attention but bad as doesn’t show progression of attachment losss
= used when localised perio

31
Q

what are ramfjord’s teeth

what if not present

A

16
21
24
36
41
44

use similar alternative or note as N

32
Q

modified plaque and bleeding scores

  1. how
  2. when both recorded
  3. why
A
  1. Ramfjord’s teeth
    plaque
    • scoring = 2 for visible plaque, 1 for on probe, 0 for none - across 3 areas of each tooth - P, B and IP. score = score divided by max score (37)

bleeding
- scoring = 4 surfaces, 1 for bleeding, 0 for non, then divided by max (24)

  1. recorded at every visit apart from clinical assessment first visit
  2. identifies engaging patients as can assess OH
33
Q

what growth / tumour can affect the gingiva when a women is pregnant?

A

Pregnancy epulis

34
Q

what should be done if a patient has necrotising oral disease, yet they have no predisposing factors?

A

Get a HIV test as could be the only probable cause

35
Q

difference in meaning between marginal bleeding and bleeding from the base of a pocket?

A

margin = how well patient brushing and OH

pocket = how much inflammation currently there