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Perio Flashcards

1
Q

early changes within pulp instigated by the advancing carious lesion lead to the production of what? and what forms it?

A

tertiary dentine

odontoblasts

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2
Q

tertiary may present in what two forms?

A

reactionary - in response to mild stimulus

reparative - laid down by secondary odontoblasts if the primary odontoblasts are irriversibly damaged by rapid stimulus

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3
Q

inflammation of the pulp leads to what symptoms?

A
  • constant throb
  • lack of pain on biting unless the inflammation has spread beyond the confines of the pulp
  • the inability to obtain pain relief
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4
Q

chronic pulpitis may be the result of what?

A

persistent mild to moderate irritation of the pulp or it may follow on from acute pulpitis

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5
Q

symptoms of chronic pulpitis?

A

mild intermittent pain over an extended period of time
pain of varying intensity
pain which is difficult to localise
pain induced by thermal change or sweet solids and liquids

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6
Q

what is apical periodontitis?/periradicular periodontitis?

A

the leaching of bacteria and inflammatory exudate causing an inflammatory response in the apical tissues = experienced as pain on biting or TTP

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7
Q

how is pus formed?

A

accumulation of bacteria/inflammatory cells in an enclosed space

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8
Q

pus may spread into the soft tissues and cause?

A

cellultitis

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9
Q

signs of an abscess?

A

severe throbbing pain
obvious clinical swelling
sensitive to biting/percussion
b/c increased pressure - tooth can be elevated in socket = increased mobility / more pain because premature contact on biting

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10
Q

what is the initial tx of an abscess?

A

drainage/local measures

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11
Q

how deep is the ginigval crevice generally in health?

A

1-3mm

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12
Q

what are the two components of the gingival tissues?

A

attached gingiva

alveolar mucosa

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13
Q

what is the juncitonal epithelium?

A

wide layer of epithelial cells at the base of a pocket attached to the cementum in the same way they are attached to each other.

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14
Q

what are dentogingival fibres?

A

embeded in cementum and fan out in a coronal direction towards the free gingival margin

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15
Q

what are dentoperiosteal fibres?

A

embedded in same area as dentoginigval but fan out in apical direction towards root

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16
Q

what are circular fibres?

A

encircle the tooth like a ring

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17
Q

what are transeptal fibres?

A

embedded in cementum of adjacent teeth and run above bone crest

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18
Q

what is responsible for stippling?

A

gingival collagen fibres

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19
Q

gingival collagen fibres are damaged/destroyed in perio conditions which explains what changes?

A
  • gingivae become glazed = smooth texture

- teeth become looser

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20
Q

what type of bone is present between the tooth sockets?

A

spongy cancellous bone

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21
Q

what fibres are embedded into the cementum and the alveolar bone of the socket of the walls?

A

sharpeys fibres

22
Q

cementum has a similar structure to bone but differs how?

A

no blood supply
no nerves
does not remodel
more resistant to resorption

23
Q

cementum does not remodel but thickens with age , this is known as?

A

hypercementosis

24
Q

what cells are present int he connective tissue?

A

lymphocytes
neutrophils
fibroblasts
macrophages

25
what is the fibrous portion of the CT made up of?
elastic elastin fibres | non elastic collagen fibres
26
what does the PDL consist of?
dense network of collagen fibres arranged in oblique rows inserted in one end at bone and the other in cementum
27
clinical features of gingivitis?
odeama erythema pain/tenderness in gums
28
what are the pocket depths like in gingivitis?
no larger than normal unless swelling is so severe the gingiva has overgrown
29
why is smoking a risk factor for perio?
- reduced gingival blood supply - up to 50% impairment of chemotaxis and phagocytosis of PMN's - impaired wound healing - increased production of inflammatory substances e.g cytokines = increased collagenase produciton
30
what hormonal changes can predispose a patient to perio?
puberty menopause pregnancy
31
why does pregnancy cause an increased severity in gingivitis?
increased levels of progesterone = increased permeability of vessels = increased swelling and bleeding
32
why can leukaemia predispose to perio?
altered leukocyte function = increased incidence of perio
33
what are some local risk factors of perio and why do they contribute to increased risk?
- anything that makes it easier for plaque to accumulate at the gingival margins - calculus, enamel pearls, root grooves, malpositioned teeth, overhangs, partial dentures
34
when does gingivitis become periodontitis?
when the junctional epithelium is damaged and migrates apically
35
what are some other features associated with perio?
``` papillae detachment papillae swelling hyperplasia of papillae/gingival margins mobility pus gingival recession furcation involvement ```
36
what is aggressive perio characterised by?
rapid attachment loss | destruction of PDL and supporting bone in an otherwise healthy adult usually below age of 35.
37
high levels of what bacteria are associated with aggressive perio?
actinomyces actinobacillus | porphyromonas gingivalis
38
what are some clinical features of aggressive perio?
not overly apparent gingival inflammation | relatively good oral hygiene
39
what is prepubertal perio?
aggressive perio occuring before puberty
40
what is LAP?
involves incisors and molars with onset around or soon after puberty interproximal attachment loss on at least two permanent molars
41
what is GAP?
generally has a later onset, before age of 30 | generalised attachment loss involving at least 3 permanent teeth other than first molars and incisors
42
what is acute herpetic gingivostomatitis?
pyrexia/lymph node involvement/stomatitis/flu like symptoms | caused by herpes simplex virus
43
what is a gingival abscess?
caused by trauma or foreign body
44
what is a periodontal abscess?
usually arises from an established perio pocket
45
what is a periocoronal abscess?
usually related to an operculum overlying a partially erupted third molar
46
what is an antiseptic?
inhibit the growth of bacteria without killing them
47
examples of antiseptics?
- quaternary ammonium compound - cetylpyridium chlordie - phenols - triclosan - natural herb products - sanguinarine - bisguanide - chx
48
systemic antibiotics useful for what conditions?
aggressive periodontitis chronic perio resistant to mechanical therapy multiple perio abscesses/full mouth disinfection approach acute infections pts showing systemic symtpoms such as pyrexia and glandular involvement
49
examples of intense sweetners?
saccharin acesulfame K aspartme
50
examples of intense sweetners?
xylitol mannitol sorbitol

Clinical Handbook (3 decks)

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