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Clinical Handbook > Perio > Flashcards

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
Q

what is the fibrous portion of the CT made up of?

A

elastic elastin fibres

non elastic collagen fibres

26
Q

what does the PDL consist of?

A

dense network of collagen fibres arranged in oblique rows inserted in one end at bone and the other in cementum

27
Q

clinical features of gingivitis?

A

odeama
erythema
pain/tenderness in gums

28
Q

what are the pocket depths like in gingivitis?

A

no larger than normal unless swelling is so severe the gingiva has overgrown

29
Q

why is smoking a risk factor for perio?

A
  • 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
Q

what hormonal changes can predispose a patient to perio?

A

puberty
menopause
pregnancy

31
Q

why does pregnancy cause an increased severity in gingivitis?

A

increased levels of progesterone = increased permeability of vessels = increased swelling and bleeding

32
Q

why can leukaemia predispose to perio?

A

altered leukocyte function = increased incidence of perio

33
Q

what are some local risk factors of perio and why do they contribute to increased risk?

A
  • anything that makes it easier for plaque to accumulate at the gingival margins
  • calculus, enamel pearls, root grooves, malpositioned teeth, overhangs, partial dentures
34
Q

when does gingivitis become periodontitis?

A

when the junctional epithelium is damaged and migrates apically

35
Q

what are some other features associated with perio?

A 
papillae detachment
papillae swelling
hyperplasia of papillae/gingival margins
mobility
pus 
gingival recession
furcation involvement
36
Q

what is aggressive perio characterised by?

A

rapid attachment loss

destruction of PDL and supporting bone in an otherwise healthy adult usually below age of 35.

37
Q

high levels of what bacteria are associated with aggressive perio?

A

actinomyces actinobacillus

porphyromonas gingivalis

38
Q

what are some clinical features of aggressive perio?

A

not overly apparent gingival inflammation

relatively good oral hygiene

39
Q

what is prepubertal perio?

A

aggressive perio occuring before puberty

40
Q

what is LAP?

A

involves incisors and molars with onset around or soon after puberty
interproximal attachment loss on at least two permanent molars

41
Q

what is GAP?

A

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
Q

what is acute herpetic gingivostomatitis?

A

pyrexia/lymph node involvement/stomatitis/flu like symptoms

caused by herpes simplex virus

43
Q

what is a gingival abscess?

A

caused by trauma or foreign body

44
Q

what is a periodontal abscess?

A

usually arises from an established perio pocket

45
Q

what is a periocoronal abscess?

A

usually related to an operculum overlying a partially erupted third molar

46
Q

what is an antiseptic?

A

inhibit the growth of bacteria without killing them

47
Q

examples of antiseptics?

A
  • quaternary ammonium compound - cetylpyridium chlordie
  • phenols - triclosan
  • natural herb products - sanguinarine
  • bisguanide - chx
48
Q

systemic antibiotics useful for what conditions?

A

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
Q

examples of intense sweetners?

A

saccharin
acesulfame K
aspartme

50
Q

examples of intense sweetners?

A

xylitol
mannitol
sorbitol

Clinical Handbook (3 decks)

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