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Hygiene Sem 1 > perio > Flashcards

perio Flashcards

1
Q

tissues of the periodontium

A

gingiva
cementum
PDL
alveolar bone

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2
Q

the gingiva is located ___ to CEJ of each tooth

A

coronal

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3
Q

Function of the gingiva

A

protects underlying tooth- supporting structures from oral environment

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4
Q

demacrations of gingiva include

A

free gingival groove
mucogingival junction

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5
Q

4 anatomical areas of gingiva

A

free gingiva
attached gingiva
interdental gingiva
gingival sulcus

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6
Q

free gingiva is also refered to as

A

unattached gingiva or marginal gingiva

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7
Q

surround tooth like a turtleneck- located coronal to CEJ

A

free gingiva

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8
Q

the free gingiva meets the tooth in a thin rounded edge called

A

gingival margin

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9
Q

attached gingiva is located ____ free gingiva and alveolar mucosa

A

between

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10
Q

attached gingiva is widest where?

A

incisor and molar regions

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11
Q

narrowest attached gingiva in what region

A

premolar

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12
Q

in health what may have a stippled appearance (like an orange peel) and may be pigmented dependant upon individials skin color

A

attached gingiva

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13
Q

purpose of attached gingiva

A

to withstand forces during chewing, speaking and toothbrushing

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14
Q

the interdental gingiva prevents

A

food from becoming packed between teeth during chewing

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15
Q

gingival col is a valley like depression that is

A

apical to the contact area of 2 adjacent teeth that connects facial and lingual papillae

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16
Q

will the col be present if there is a large space between 2 teeth or if there is notable ging recession

A

no

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17
Q

healthy sulcus measurment

A

1-3mm

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18
Q

base of gingival sulcus is formed by what

A

junctional epithelium

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19
Q

gingival crevicular fluid (GCF) seeps from underlying ___ into ___

A

connective tissue, into sulcular space

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20
Q

how much GCF is in a healthy sulcus?

A

little to none

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21
Q

5 functions of the periodontal ligament

A

Supportive
Sensory
Nutritive (provides nutrients to cementum and bone)
Formative (provides cementoblasts and osteoblasts)
Remodeling

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22
Q

root cementum primary function

A

periodontal ligament attachment

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23
Q

what are sharpeys fiber in relation or cementum and PDL

A

sharpeys fibers are terminal endings of PDL attached to cementum

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24
Q

what is alveolar bone

A

mineralized connective tissue that forms bones of upper and lower jaw

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25
Q

what does alveolar bone form that provides support to roots of the teeth

A

bony sockets

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26
Q

the existence of alveolar bone is dependant upon

A

the presence of teeth

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27
Q

alveolar bone proper is aka

A

cribriform plate

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28
Q

cortical bone is aka

A

compact bone

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29
Q

cancellous bone is aka ?
and it fills the interior protion of?

A

spongy bone
alveolar process (mostly in interproximal areas)

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30
Q

what is the periosteum of alveolar bone

A

layer of connective tissue that covers outer surface of bone

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31
Q

gel like substance (mesh-like) containing interwoven protein fibers surrounding most cells

A

extracellular matrix

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32
Q

epithelial cells secrete a thin mat of extracellular matrix called

A

basal lamina

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33
Q

is keratinized tissue very flexible?

A

no

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34
Q

the heaviest keratinized epithelium of the body is found on the

A

palms of hands and soles of feet

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35
Q

examples of non-keratinized tissue in the oral cavity

A

lining of cheeks

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36
Q

connective tissue is composed of

A

fibroblasts
macrophages
neutrophils
lymphocytes

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37
Q

enamel is derived from

A

epithelial tissue

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38
Q

which type of cell junction allows the cell to attach to the basal lamina

A

hemidesmosome

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39
Q

how would you describe the basal layers of the squamous stratified epithelium

A

cube shaped cells

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40
Q

the epithelial lining of the gingival sulcus is

A

thin and non keratinized

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41
Q

in health the junctional epithelium attaches to the tooth?

A

slightly coronal/above CEJ

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42
Q

known collectively as dentogingival unit

A

Junctional epithelium and gingival fibers

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43
Q

what supragingival fibers encircle the tooth in a collar like fashion?

A

circular

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44
Q

which fibers of the periodontal ligament are located around the tip of the root

A

apical fibers

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45
Q

Root cementum description

A

Thin layer of CT that covers the surface of the root
Attached to dentin
More resistant to resorption so can do ortho

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46
Q

Root cementum functions

A

PDL attachment
Seals open tubules
Compensates for attrition to maintain length

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47
Q

Keratinized epithelial cells are

A

Waterproof

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48
Q

Wavy boundary (epi/ct) describe deep extensions of

A

Epithelial ridges of epithelium that reach down into CT
(Rete ridges/rete pegs)

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49
Q

Wavy boundary (epi/ct) enhances adhesion of

A

Epi to ct by increasing surface area

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50
Q

The oral epithelium joins CT

A

Wavy interface with epithelial ridges

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51
Q

Oral epithelium consists of what 4 stratified squamous epithelial layers

A

Basal
Prickle
Granular
Keratinized

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52
Q

Dulcimer epithelium joins CT with

A

Smooth interface (no ridges)

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53
Q

Sulcular epithelium 3 layers

A

Basal
Prickle
Superficial

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54
Q

2 epithelium layers of Junctional epithelium

A

Basal
Prickle

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55
Q

Microscopic anatomy of the JE is smooth or wavy interface

A

Smooth

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56
Q

4 Supragingival fiber bundles function

A

Strengthens attachment of JE to tooth by bracing gingival margin against tooth
Provides rigidity to withstand chewing
Connects adjacent teeth together
Connects free ging with cementum and alveolar bone

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57
Q

Supragingival fibers bundles: alevogingival

A

Attach gingiva to bone

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58
Q

Supragingival fiber bundles: periosteogingival

A

Attach gingiva to bone

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59
Q

5 periodontal ligament fibers

A

Alveolar crest
Horizontal
Apical
Oblique
Interradicular

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60
Q

Periodontal ligament fibers main function

A

To provide support and sensing of pain and tactile pressure

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61
Q

Biologic component of mature cementum:

A

Growth factor molecules are produced during formation then stored in matrix to assist with PDL regeneration

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62
Q

3 types of cementum

A

Intermediate (located at CEJ)
Acellular (mainly sharpey fibers)
Cellular (apical and interradicular portions of root )

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63
Q

Three arrangements of cementum to enamel (OMG)

A

Cementum overlaps enamel for a short distance
Cementum meets enamel
Cementum leaves a gap between itself and enamel

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64
Q

Constantly undergoes periods of bone remodeling when teeth are subject to mechanical forces

A

Alveolar bone

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65
Q

Osteoblasts

A

Bone forming

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66
Q

Osteoclasts

A

Bone resorbing

67
Q

Alveolar bone consists of

A

Alveolar bone proper
Travecular (spongy) bone
Cortical (compact) bone

68
Q

Pathogenesis refers to

A

Sequence of events that occur during the development of a disease

69
Q

2 types of periodontal disease

A

Gingivitis
Periodontitis

70
Q

Bacterial infection confined to the gingiva and can be reversible

A

Gingivitis

71
Q

A bacterial infection including all parts of periodontium (bone, cementum, gingiva and PDL) IRREVERSIBLE

A

periodontitis

72
Q

What is the difference between perio disease and periodontitis

A

Perio disease- bacterial infection of periodontium
Periodontitis is a type of perio disease

73
Q

Periodontium in health appears

A

Pink
Firm
No bleeding

74
Q

Sulcus in health the Junctional epithelium will be ___ to CEJ

A

Coronal

75
Q

Gingivitis is a type of perio disease characterized by changes in

A

Colour, contour and consistency of gingival tissues

76
Q

Gingivitis is observed clinically how many days after plaque biofilm accumulates

A

4-14 days

77
Q

In gingivitis is the Junctional epithelium still coronal to CEJ

A

Yes

78
Q

Acute gingivitis lasts for
Tissues appear

A

A short period of time
Swollen

79
Q

Chronic gingivitis lasts for
New collagen fibers are formed resulting in a more

A

Months/years
Fibrotic tissue

80
Q

Gingivitis may persist for years without

A

Progressing to periodontitis

81
Q

Periodontitis is characterized by the apical

A

Migration of the JE

82
Q

With periodontitis widespread destruction of Supragingival fiber bundles occur but what continues to regenerate

A

Transseptal fiber bundles

83
Q

In health the crest of the bone is located approximately how many mm apical to CEJ

A

2mm

84
Q

Bone loss must be recorded in client record according to

A

Pattern
Distribution
Severity

85
Q

Horizontal bone loss is described as

A

Bone loss occurring in a plane parallel to CEJ of adjacent teeth

86
Q

Localized bone loss occurs in

A

Isolated areas

87
Q

Generalized bone loss occurs evenly throughout

A

Dental arches

88
Q

Mild bone loss %

A

20-30%

89
Q

Moderate bone loss

A

30-50%

90
Q

Severe bone loss

A

Greater than 50%

91
Q

What is the most common pattern of bone loss

A

Horizontal

92
Q

What pattern of bone loss results in more rapid progression of bone loss to next root surface

A

Vertical (trench like)

93
Q

Pathway in horizontal bone loss

A

Into gingival tissue
Into alveolar bone
Into PDL

94
Q

Pathway in vertical bone loss

A

Into gingival CT
Directly into PDL space
Into alveolar bone

95
Q

Infrabony defect result when

A

Bone loss occurs in an uneven oblique direction

96
Q

There is NO apical migration of JE describes what kind of pocket

A

Gingival pocket

97
Q

Gingival pockets are also called

A

Pseudopockets

98
Q

Periodontal pocket is characterized by apical

A

Migration of the JE

99
Q

2 types of perio pockets

A

Suprabony
Infrabony

100
Q

Suprabony pocket occurs when there is what kind of bone loss

A

Horizontal

101
Q

Infrabony pockets occur when there is vertical bone loss and the JE is located?

A

Apical to crest of alveolar bone

102
Q

Attachment loss describes destruction of

A

Fibers and alveolar bone that supports the teeth

103
Q

A disease site is an area of

A

Tissue destruction

104
Q

An active disease site is

A

A disease sure that shows continued apical migration of JE over time

105
Q

Periodontal disease is characterized by periods of

A

Disease activity and inactivity

106
Q

Disease prevalence describes the number of both old and new cases of a disease that are identified in a

A

Specific population at a given point in time

107
Q

Prevalence vs incidence

A

Prevalence all cases at given time
Incidence number of new disease cases over a period of time

108
Q

Variables associated with prevalence of disease

A

Gender
Age
Education level
Socioeconomic status
Access to dental care

109
Q

Tobacco has been identified as a

A

Behavioural risk factor

110
Q

Staging classifies

A

Severity and extent of disease
to assess specific factors

111
Q

Grading of perio disease aims to indicate

A

Rate of perio progression
Responsiveness to standard therapy
Potential impact on systemic health

112
Q

3 steps of staging and grading pt

A

Initial case overview
Establish stage
Establish grade

113
Q

Healthy tissue does not

A

Bleed

114
Q

In health gingival margin is evenly

A

Scalloped and smooth

115
Q

In health margin is slightly

A

Coronal to CEJ

116
Q

Papilla changes in gingivitis can manifest as

A

Bulbous
Blunted
Cratered

117
Q

Tissue becomes what 3 things in gingivitis

A

Soft spongy and nonelastic

118
Q

If distribution of inflammation is diffuse this means

A

It is throughout gingival margin papilla and attached gingiva

119
Q

Reduced periodontium means

A

Pre existing loss of periodontal tissue but no current activity

120
Q

Plaque induced gingivitis on a reduced periodontium in a non periodontitis patient may result from

A

Orthodontically induced movement of teeth

121
Q

Intact periodontium refers to no loss of

A

Periodontal tissue past or present

122
Q

What type of periodontal disease is most common

A

Plaque induced gingivitis

123
Q

Erythema aka

A

Redness

124
Q

A patient exhibits a bacterial infection of all parts of the periodontium what is the state of pts periodontium

A

Periodontitis

125
Q

Potential modifying factors of plaque induced gingivitis

A

Systemic (pregnancy, period, hyperglycaemia, smoking)
Oral factors (hyposalivation)
Drug induced

126
Q

Pyogenic granuloma aka

A

Pregnancy tumour (non cancerous)

127
Q

Oral changes are often first clinical signs of leukemia resulting in

A

Enlarged tissue and increased bleeding
Tissues tear easily
Usually begins in papilla

128
Q

What vitamin helps to maintain healthy sulcular epithelium

A

Vitamin a

129
Q

Vitamin c deficient pt tissue characteristics

A

Bright red
Swollen
Ulcerated
Bleed easily

130
Q

Medications commonly associated with gingival enlargement

A

Anticonvulsants (seizure; Dilantin)
Calcium channel blockers (amlodipine)
Immunosuppressant (cyclosporine)

131
Q

Onset of gingival enlargement by medications usually occurs

A

3 months of taking meds

132
Q

Non plaque induced gingival diseases are not resolved after

A

Plaque removal

133
Q

Non plaque induced gingival diseases may include

A

Hereditary/ genetic development
Infection
Immune conditions
Neoplasms
Traumatic lesions

134
Q

Is there loss of periodontal attachment in necrotizing gingivitis

A

No

135
Q

Primary herpetic gingivostomatitis- initial oral infection with

A

Herpes simplex 1 virus

136
Q

Primary herpetic gingivostomatitis is characterized by

A

Fiery red tiny fluid filled blisters that easily rupture to form painful ulcers

137
Q

Erythema multiforme is a hypersensitivity reaction or allergic reaction which includes

A

Swollen lips and excessive crust formation

138
Q

Lichen planus is an

A

Autoimmune disease

139
Q

Granulomatous inflammatory conditions include

A

Crohns disease

140
Q

Allergic reaction to toothpaste characterized by

A

Tissue sloughing

141
Q

Oral lichen planus is characterized by?
Can last how long
May be what kind of reaction?

A

Lacy white patches
Can last for many years
May be allergic or immune reaction

142
Q

Number 1 cause of tooth loss in adults

A

Periodontitis

143
Q

What is not a reliable indicator of the presence or severity of chronic periodontitis

A

Clinical appearance

144
Q

Signs/ symptoms of periodontitis

A

Abundance of mature plaque/calc
Reddish or purplish tissue (tissues may be pale pink)
Gingival bleeding
Loss of attachment mobility
Swelling
Suppuration(pus)

145
Q

Clinical attachment loss or CAL means

A

Loss of alveolar bone support from around tooth

146
Q

What is not usually a symptom with periodontitis

A

Pain

147
Q

Once a perio client

A

Always a perio client

148
Q

Determine pathogenesis and rate of progression of the disease

A

Contributing factors

149
Q

Necrotizing gingivitis examples

A

HIV
AIDS
Stress
Smoking

150
Q

Necrotizing periodontitis affects ?
Examples?

A

Personal attachment and bone
HIV aids stress smoking

151
Q

Necrotizing stomatitis affects

A

Oral mucosa

152
Q

Two categories which are starting points of a periodontitis case

A

Full perio assessment to determine CAL
radiographs to determine RBL

153
Q

Stage 1 periodontitis pertains to what third of the tooth

A

Cervical third (less than 15%)

154
Q

Apical third of the tooth is involved in what stage of periodontitis

A

Stage 3/4

155
Q

Grade A refers to

A

Slow rate periodontitis

156
Q

No loss over 5 years in regards to RBL/CAL refers to what grade of perio

A

Grade A

157
Q

Grade B: moderate rate periodontitis

A

RBL or CAL less than 2mm over 5 years
Destruction equivalent with biofilm deposits

158
Q

Grade C: rapid rate periodontitis

A

RBL OR CAL Greater or = 2mm over 5 years
destruction exceeds expectations given biofilm deposits

159
Q

When it comes to staging early and moderate periodontitis will be stage

A

1 and 2

160
Q

When grading, the consensus is to assume it is grade?

A

B

161
Q

Our #1 indicator of gingival inflammation

A

Bleeding

162
Q

Someone can have inflammation up to __% of the oral cavity and still be considered?

A

10%
Healthy

163
Q

If there is a __mm interdental pocket with bleeding (open pocket) we still?

A

4mm
Still grade and stage

164
Q

Necrotizing periodontal disease rapidly escalates and can produce loss of periodontal attachment within

A

Days

Hygiene Sem 1 (22 decks)

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