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MCQ 1.1 > Perio > Flashcards

Perio Flashcards

1
Q

What does a BPE score 0 mean

A

No pockets
No calculus/overhangs
No BOP

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2
Q

What does a BPE score 1 mean

A

No pockets
No calculus/overhangs
BOP

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3
Q

What does a BPE score 2 mean

A

No pockets
Supra or subgingival calculus/overhangs

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4
Q

What does a BPE score 3 mean

A

Probing depth 3.5-5.5 mm

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5
Q

What does a BPE score 4 mean

A

Probing depth above 5.5 mm

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6
Q

What does * mean for perio

A

Furcation involvement meaning you can see where the roots diverge

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7
Q

Which teeth are assessed in sillness and loe

A

UR6, UR2, UL4, LR4, LL2, LL6

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8
Q

How does sillness and Loe score the teeth examined

A

They are added and divided by 4 then divided by 6 (the number of teeth’s examined)

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9
Q

What does a score of 0 in sillness and loe mean

A

No plaque

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10
Q

What does a score of 1 mean in sillness and loe

A

Film visible only by removal with probe

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11
Q

What does a score of 2 mean in sillness and loe

A

Moderate accumulation of plaque at the gingival margin visible to the naked eye

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12
Q

What does a score 3 mean in sillness and loe

A

Heavy accumulations of plaque easily visible in the gingival crevice and interdentally

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13
Q

How does the modified turesky technique measure perio

A

0 to 5 is assigned to buccal and lingual non restored surface of all the teeth expect third molars

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14
Q

How is an index determined for the modified turesky technique

A

By dividing the total score by the number of surfaces (max 56)

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15
Q

How do you calculate the index with the O’Leary technique

A

Total number of tooth surfaces with stained plaque recorded DIVIDED BY the total number of surfaces present TIMES 100 = %

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16
Q

What does a mobility score 0 mean

A

No detectable movement above 0.2mm

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17
Q

What does a mobility score 1 mean

A

Horizontal mobility between 0.2 and 0.5 mm

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18
Q

What does a mobility score 2 mean

A

Movement 0.5 - 1 mm

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19
Q

What does a mobility score 3 mean

A

Above 1 mm or vertical displacement

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20
Q

What does furcation grading 1 mean

A

Less than 3mm horizontal probing

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21
Q

What does furcation grading 2 mean

A

Grater than 3mm but not through

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22
Q

What does furcation grading 3 mean

A

Through and through involvement

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23
Q

What is gingivitis

A

Reversible inflammation of gingival with no accompanying destruction of periodontal tissues

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24
Q

Why does gingivitis occur

A

Most commonly develops in response to plaque adherent to tooth surfaces or adjacent restorations
May occur in relation to hormonal disturbances

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25
Q

How long can it take for gingivitis to occur

A

21 days

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26
Q

What is periodontitis

A

Bacterially induced, immune mediated inflammatory diseases of tissues supporting teeth

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27
Q

What does periodontitis destroy

A

PDL and alveolar bone

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28
Q

How many bacterial species are there in the human oral microbiome

A

Nearly 800

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29
Q

What make up the 60% pioneer bacteria

A

Streptococcus species

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30
Q

What are 3 other pioneer bacteria

A

Actinomyces
Veillonella
Neisseria

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31
Q

List 5 examples of host susceptibility to perio

A

Gene polymorphism
PMN defects
Smoking
Diabetes
Immunosuppression

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32
Q

What does plaque consist of

A

Diverse population of micro organisms embedded in extracellular matrix polymers

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33
Q

What is calculus

A

Calcified deposit found on surfaces of teeth covered by biofilm of plaque calcium and phosphate crystals appear

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34
Q

What are the 4 different types of calcium phosphate crystal

A

Octacalcium phosphate
Hydroxyapatite
Whitlockite
Brushite

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35
Q

How long does it take for supragingival calculus to form

A

Within 12 days

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36
Q

What is supragingival calculus

A

About gingavae
Builds in creamy amorphous layers particularly lingually around lower incisors and buccal on maxillary molars near salivary duct openings

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37
Q

Where is the mineral content derived from in supragingival calculus

A

Saliva

38
Q

Where is mineral content derived from in subgingival calculus

A

GCF

39
Q

Which calculus build up is commonly anaerobic

A

Subgingival

40
Q

What is non specific plaque hypothesis

A

Disease due to volume of plaque not type of microbes
Microbes produce virulence factors that lead to inflammation and tissue destruction

41
Q

What is specific plaque hypothesis

A

Microbial analysis revealed bacteria that are more often associated with disease than with health
Focuses on periodontal disease that have specific microflora associated

42
Q

What is ecological plaque theory

A

Accumulation of plaque results in inflammation which changes local environment
Facilitates shift in microflora causing more inflammation

43
Q

What is polymicrobial synergy and dysbiosis

A

All plaque biofilms have potential to stimulate disease and although toxic and proinflammatory usually tolerated

44
Q

Where are red complex bacteria most frequently found

A

In deep periodontal pockets

45
Q

What are 3 red complex’s

A

P gingivalis
T forsythia
T denticola

46
Q

What are 4 orange complex’s

A

P intermedia
P nigrescens
P micros
F nucleatum

47
Q

What are 3 yellow complex’s

A

S oralis
S mitis
E corrodens

48
Q

What type of bacteria is periodontitis largely associated with

A

Gram negative bacteria

49
Q

What are 3 species of designated periodontal pathogens

A

Aggregatibacter actinomycetemcomitans
Porphyromonas gingivalis
Tannerella forsythia

50
Q

What does aggregatibacter actinomycetemcomitans do

A

Multiple adhesion molecules allow strong binding to various surfaces
Invades epithelial cells and fibroblasts
Blocks T cell proliferation and has immunosuppressive functions

51
Q

What does porphyromonas gingivalis do

A

Inhibits neutrophil function - cannot phagocytose
Uses gingipains to produce inflammatory state in neutrophils and release pro inflammatory cytokines
Suppresses antigen presenting function of epithelial cells

52
Q

What are 5 virulence factors

A

Fimbriae from adherence
Proteases
Bone resorbing factors
Toxins - leukotoxin, cytotoxic metabolites
Capsule

53
Q

What effect does interlukin 1 have

A

Osteoclast activation
Margination of neutrophils
TNF production/release
Prostaglandin IL 6 release from fibroblasts

54
Q

What effect does interleukin 6 have

A

Increase bone resorption
Activates T cells and differentiation of B cells
B cells and IG production

55
Q

What effect does interlukin 8 have

A

Chemotaxis (strong) of neutrophils

56
Q

What effect does interleukin 10 have

A

Anti inflammatory suppression

57
Q

When does an initial lesion occur

A

2-4 days

58
Q

When do early lesions occur

A

4-7 days

59
Q

When do established lesions occur

A

2-3 weeks

60
Q

When do advanced lesions occur

A

More than 3 weeks

61
Q

What is the shape of bacilli

A

Rods

62
Q

What are 3 bacilli

A

Bacillus
Fusiform
Vibrio

63
Q

What shape are cocci

A

Round

64
Q

What are 3 cocci species

A

Diplococci
Streptococci
Staphylococci

65
Q

What shape are spirochetes

A

Spiral

66
Q

What are the 2 types of spirochetes

A

Loosely spiralled
Tightly spiralled

67
Q

What are oxygen loving bacteria called

A

Obligate aerobes

68
Q

What are oxygen hating bacteria called

A

Obligate anaerobes

69
Q

What are the 2 neither loving or hating bacteria called

A

Facultative anaerobes
Aerotolerant anaerobes

70
Q

What are 5 gram positive bacteria

A

Streptococcus sanguinis
Streptococcus oralis
Actinomyces naesludii
Actinomyces viscosus
Veilonella species

71
Q

What type of bacteria are present in healthy gingival sulcus

A

Gram positive cocci

72
Q

What 2 adhesions attach to bacteria on the tooth

A

Fimbri
Pilli

73
Q

What does inflammation increase the flow of

A

GCF

74
Q

List 3 bacteria present in periodontitis

A

Porphyromonas gingivalis
Tanerella forsythia
Treponema denticola

75
Q

What is the main bridging species

A

Fusobacterium nucleatum

76
Q

What happens during the initial lesion stage

A

Increased GCF flow
Neutrophil accumulation
Early loss of perivascular collagen
Increased permeability

77
Q

What activates the complement during the initial lesion stage

A

Lipopolysaccharides and peptidoglycans in bacterial cell walls via alternative pathway
Enter tissue causing mast cells to release vasoactive amines - vasodilation

78
Q

During the initial lesion stage how much of connective tissue does the lesion occupy

A

5-10%

79
Q

At what stage does plaque biofilm begin to extend subgingivally

A

Early lesion stage 4-7 days

80
Q

What is the vascular change during the early lesion stage

A

Opening of dormant capillary beds increasing permeability

81
Q

What is the change in GCF at the early lesion stage

A

Increased GCF and changes from interstitial fluid to inflammatory exudate escalation of inflammation

82
Q

What percentage of lymphocytes infiltrate around 21 days

A

70%

83
Q

At the early lesion stage what mainly infiltrates

A

T cells along with antigen presenting cells and macrophages

84
Q

At what stage does a false pocket begin

A

Established lesion stage

85
Q

What is a false pocket

A

Deepened gingival sulcus but stable and attached

86
Q

At what stage can gingivitis progress to periodontitis

A

Established lesion stage due to deepening of gingival sulcus

87
Q

What is the defining feature of the established lesion stage

A

Predominance of plasma cells in connective tissues

88
Q

What causes the periodontal pocket to form

A

B cell lesion progression
Connective tissue breakdown leads to loss of attachment
Early proliferation apical migration and lateral extension of junctional epithelium

89
Q

What happens during the established lesion stage

A

Increased permeability and ulceration of pocket epithelium
Ingress bacterial products - continued production of inflammatory cytokines - perpetuation of pro inflammatory process

90
Q

At what stage does early bone loss occur

A

Established lesion stage

91
Q

What is the main difference in the advanced lesion stage

A

Overt loss of attachment

MCQ 1.1 (43 decks)

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