Perio Flashcards
Perio: how classify disease in examination
- Disease - chronic periodontitis
- generalised / localised
- stage and grade
- stability
- modifying factors
Perio classification: Generalised or localised? (3)
Perio classification: staging?
measures severity
Perio classification: Grading?
Measures progression of disease
Perio classification: Stability?
measures activity of disease
Perio classification: Modifying factors? (4)
- immune system impairment
- Disease (leukaemia, HIV, PREGNANCY)
- Genetic conditions (downs syndrome)
- Local Risk factors
- acquired (plaque, calc, overhang, trauma, ortho)
- Anatomical (malposition, concavities, root grooves)
- 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
Perio: stages of treatment?
What are the first two stages of perio treatment?
- immediate, acute symptoms
- pain
- systemic phase
- systemic risk factors addressed
- quit smoking / control diabetes / contact their specialist
- Antibiotics if systemic effect
what are the 3rd (5) and 4th stages of perio treatment?
3 outcomes of stage 4?
re-evaluation 3 months after original treatment
What are the 5th and 6th stages of perio treatment?
for the 6th stage - what is carried out at each visit? (3)
recall 3-12 months (tailored to patient) - normally 3 months
Perio: what is done before treatment begins with a patient to optimise the outcome of perio treatment?
Explain disease
explain risks
explain risk factors
explain treatments/alternatives and benefits / risks of doing nothing
explain importance of OH
Perio: difference between engaging and non-engaging patients
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)
What are the 10 types of periodontal tissue conditions?
- health
- plaque induced gingivitis
- non-plaque induced gingival diseases/conditions
- Periodontitis
- PerioDONTITIS as manifestation of systemic condition/disease
- PerioDONTAL tissues effected by systemic disease/condition (non plaque induced)
- periodontal abscess
- periodontal-endodontic abscesses
- necrotic periodontal diseases
- mucogingival deformities/conditions
Perio: what are the conditions for periodontal tissues being at health when:
- intact periodontium
- Reduced periodontium
Perio: causes of:
- plaque induced gingivitis (3) / localised measurement?
- non-plaque induced gingival diseases/conditions (4)
perio: What? and examples? for:
- Issues that are exaggerating factors of perio and make get worse quicker
- periodontal tissue issue due to systemic disease/condition (non-plaque induced)
Perio: Mucogingival deformities / conditions: (recession not caused by plaque)
- causes (2)
- types (3)
Necrotising oral disease:
- Cause
- Features (4)
- types (3)
- causes of 3rd type
Dark triangular ulceration inter-proximally
necrotising oral disease:
- diagnosis (how cant diagnose and common bacterias causing)
- risk factors (developing / developed countries)
necrotising oral disease:
- two main stages of treatment
- treatment process stages (6)
.
4 types of periodontal tissue lesions?
- gingival abscess
- pericoronal abscess
- Periodontal lesion/abscess?
- endodontic-periodontal lesion
Perio: what are gingival and pericoronal abscesses?
- gingival = forms between tooth and gingiva, closer to crown than periapical but not as close as periodontal one
- pericoronal abscess = forms in gingiva surrounding partially erupted / impacted tooth
Periodontal lesions
- General types (2)
- cause
- signs/symptoms (8)
- treatment (4)
endodontic-periodontal lesion
what and link?
classifications/causes?
types (2)
signs/symptoms?
treatment?
endodontic-periodontal lesion:
anatomy causing link? (5)
what disease does periodontits increase the risk factor of? (6)
why?
As causes systemic immune system heightening so can effect the following:
Perio: general patient process from stage 1 to 4
- 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
- Maintenance
- 3 month intervals (OHI as required / sub/supra scaling)
- annual pocket charts
when is it okay to carry out subgingival scaling?
ONLY when pocket >4mm
less = risks further loss of attachment
BPE information
- rules?
- how?
- scores?
- treatment for each score?
- sextant must have 2 or more teeth, worst score each sextant, 8s not counted unless missing molar
- CPITN probe (3.5 -5.5 band +ball tip 0.5mm), pressure = 20-25g
- 0,1,2,3,4,*
- image
6PPC information
- how?
- process?
- types
- what both types record
- 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
- complete and abbreviated/review chart
- 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
what are ramfjord’s teeth
what if not present
16
21
24
36
41
44
use similar alternative or note as N
modified plaque and bleeding scores
- how
- when both recorded
- why
- 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)
- recorded at every visit apart from clinical assessment first visit
- identifies engaging patients as can assess OH
what growth / tumour can affect the gingiva when a women is pregnant?
Pregnancy epulis
what should be done if a patient has necrotising oral disease, yet they have no predisposing factors?
Get a HIV test as could be the only probable cause
difference in meaning between marginal bleeding and bleeding from the base of a pocket?
margin = how well patient brushing and OH
pocket = how much inflammation currently there
