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Peds 2 (Exam 3) > Perio > Flashcards

Perio Flashcards

1
Q

how common is gingivitis in the primary dentition?

A
  • uncommon

- -young children have less plaque than aldults

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2
Q

what is the prevalence of gingivitis at age 4-5?

A

50%

*almost 100% at puberty (declines after then stays constant)

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3
Q

what is the peak age of gingivitis at puberty for boys? girls?

A 
boys = 10 yrs
girls = 13 yrs
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4
Q

what does gingivitis associated with puberty resemble/

A

pregnancy gingivitis

*related to inc in steroid hormones

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5
Q

what are some local factors for gingivitis?

A
  • crowded teeth
  • ortho appliances
  • mouthbreathing
  • erupting primary and perm teeth
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6
Q

to treat gingivitis, kids under what age should be assisted by their parents when brushing?

A

8-10

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7
Q

what can longstanding gingivitis lead to?

A

chronic inflammaroty gingival enlargement (localized/generalized)

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8
Q

what are the common sites for chronic gingival enlargemnt?

A
  • around ortho appliances

- areas dried by mouth breathing

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9
Q

what drugs often cause drug-induced gingival overgrowth/

A
  • phenytoin (anti convulsant)
  • cyclosporine (transplant pts)
  • Ca++ channel blockers (hypertension)
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10
Q

how is drug-induced gingival overgrowth different from chronic inflammatory?

A

fibrous, firm, pale pink, often with LITTLE TENDENCY TO BLEED

  • starts at interdental papilla and gradually spreads to margin
  • can become extreme enough to cover crowns
  • happens slowly
  • appears to be genetic
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11
Q

what happens if the medications that cause drug-induced gingival overgrowth cannot be discontinued?

A

may be surgically removed but will recur.
surgery indecated when:
-appearance is unacceptable
-interferes with comfortable function
-produces perio pocket that cannot be maintained

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12
Q

the most severe cases of drug-induced gingival overgrowth are seen in what types of patients/

A

those with intellectual disabilities

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13
Q

where is the most common place for defects of the attached gingiva to arise?

A

mandib incisors when they erupt labial to the alveolar ridge

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14
Q

what problems do defects of the attached gingiva cause for the pts?

A

makes labially erupted teeth difficult to clean, particularly once recession has occured, leaving them even more vulnerable to periodontitis and attachment loss

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15
Q

loss of attachment and recession that occurs with labially malpositioned tooth is sometimes termed what?

A

stipping

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16
Q

what is the tx for defects of the alveolar ridge?

A

gingival graft and ortho movement of teeth

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17
Q

what is a max frenum penetratin the incisive papilla accomplanied by

A

large midline diastema

*common finding in children

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18
Q

when should you tx a max frenum prenetrating incisive papilla?

A
  • can be delayed until perm teeth present to allow natural close of diastema
  • older children = better cooperation
  • if ortho tx is planned, postpone surgical tx until diastema has been closed
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19
Q

commonly called “tongue-tied”

A

ankyloglossia

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20
Q

what is the indication for tx for ankyloglossia

A
  • normal mobility is limited (speech, feeding)

- if tongue cannot be protruded or touch upper alveolar process

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21
Q

what is the tx for ankyloglossia?

A

simple frenectomy

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22
Q

20% of 14-17 year olds have attachment loss of greater than ____mm at more than ____ sites

A
  • 2mm
  • 1 sites

*number and severity of affected sites inc with age

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23
Q

when is chronic perio most easily stopped?

A

in adolescnesce when attachment loss is minimal and deep pockets have not formed

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24
Q

how many kids younger than 18 try their first cig every day?

A

3,900

*over 950 of them will become regular smokers

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25
Q

type of perio problem that most commonly affects younger ppl

A

aggresive perio

  • localized affects young pts
  • generalized affects young adults
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26
Q

how is the localized form of aggresive perio characterized?

A

loss of attachment and bone around perm incisors and 1rst perm molars

*attachment loss is rapid, occuring at 3X rate of adult onset disease

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27
Q

when is LAP usually found?

A

early adolescence

*may first be noticed after mild trauma luxates tooth

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28
Q

in LAP, do pts usually have more plaque and inflammation than other kids?

A

yes

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29
Q

what is the prevalence of LAP?

A

1% in the US

*most commonly seen in the AA pop

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30
Q

does LAP have an genetic component?

A

yes, at least some cases appear to be inherited as an autosomal dominant trait

*linked to neutrophil chemotactic defect

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31
Q

what is the tx of LAP?

A

SRP combined with systemic antibiotic therapy and monitoring systemic antibiotic choice

  • some reattachment can be seen after antibiotic therapy
  • localized surgical intervention often necessary for residual effects
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32
Q

early onset of periodontitis characterized by localized loss of attachment in the PRIMARY dentition

*occurs in kids without evidence of systemic disease

A

prepubertal localized aggressive perio

33
Q

where does LPP most often occur in the mouth

A

molar area, localized, bilateral symmetrical loss of attachment occurs

34
Q

which pop is most often affected by LPP?

A

AA

35
Q

when is LPP most often dx?

A

late primary dentition or early transitional dentition

*may progress to LAP in perm

36
Q

what is LPP believed to be the result of?

A

bacterial infection combined with specific, but minor host immunological defecits

37
Q

what is the tx of LPP?

A
  • antibiotic therapy with local therapies

- tertracylines, metronidazole, amox, azith

38
Q

who does GAP affect most?

A

young adults

39
Q

where does GAP affect most?

A

may affect the entire dentition and is not self limiting

*heavy amounts of plaque and calculus and inflammation

40
Q

is GAP associated with A. actino?

A

no

41
Q

how should GAP be tx?

A

aggressively with local therapy and systemic antibiotics

42
Q

rapid onset of PAINFUL gingivitis with interproximal marginal necrosis and ulceration

A

NUG/P

43
Q

what is the peak incidence for NUG/P?

A

late teens adn early twenties in North america and europe

-younger in less developed countries

44
Q

what are the predisposing factors for NUG/P?

A
  • malnutrition
  • viral infections
  • stress
  • lack of sleep

*associated with high levels of spirochetes and P. intermedia

45
Q

what is the tx for NUG/P

A
  • local debridement

- antibiotic therapy with penicillin or metro indicated when temp change

46
Q

early loss of attachment in kids may often be associated with what?

A

systemic disease

*defects in immune system

47
Q

is there a correlation between perio problems and diabetes pts?

A

yes, probably due to impaired immune fuctions

48
Q

what % of teens with diabetes have perio disease?

A

10-15%

49
Q

is there a correlation btw down syndrome and perio problems?

A

yes, may be first seen in primary dentition and most develop by 30 yrs old

*minor immune function may be responsible

50
Q

what is a common perio finding for down syndrome?

A

severe recession in the mandib ant region associated with a high frenum attachment and shallow vestibule also a common finding

51
Q

genetic disorder in which the enzyme BONE ALKALINE PHOSPHATASE is deficient or defective

A

hypophosphatasia

*dx by finding of low alkaline phosphatase levels in serum sample

52
Q

what are the symptoms of hypophosphatasia?

A
  • premature loss of deciduous teeth
  • sever bone abnormalities leading to neonatal teeth
  • the earlier the symptoms the more severe the disease
  • in the more comon mild forms, the early loss of primary teeth may be the only symptom (odonto-hypophosphatasia)
53
Q

how does early tooth loss occur in hypophosphatasia?

A

result of defective cementum formation that results in weakened attachment of tooth to bone

54
Q

how are the teeth affected in hypophosphatasia?

A

in the order of formation

  • typically primary incisors are exfoliated before the age of 4
  • perm dentition is normal
55
Q

what is the tx for hypophosphatasia?

A

-strensiq (replacement therapy approved less than 2 weeks ago)

56
Q

what is the dx for hypophasphatasia?

A

good for perm dentition

57
Q

rare, recessive genetic disease that involves the surface glycoproteins on leukocytes to be defective, resulting in poor migration to infection sites and impaired phagocytic function.

A

leukocyte adhesion deficiency (LAD)

58
Q

when does LAD appear?

A

early primary dentition

59
Q

what are the symptoms of LAD?

A

bone loss rapid around nearly all teeth and inflammation

*requires scrupulous oral hygiene measures

60
Q

reduced numbers or the disappearance of neutrophils form the blood and bone marrow

A

neutropenia

61
Q

how is neutropenia dx?

A

finding depressed neutrophils on a differential blood count

62
Q

what oral issues are associated with neutropenia?

A

severe gingivitis and pronounced alveolar bone loss

63
Q

what is the tx of neutropenia?

A
  • rigorous local measures to control plaque

- pts may not be able to maintain level of oral hygiene necessary to prevent disease

64
Q

rare genetic disorder that has onset of severe perio or transitional dentition along with severe inflammaiton and rapid bone loss
*easily identified hyperkeratosis of the palms and soles of feet

A

papillon leFevre syndrome

65
Q

what is the tx of papillon-LeFevre syndrome?

A
  • aggressive local measures to control plaque

- antibiotic therapy has worked in kids

66
Q

previously known as histocytosis X, this rare disorder of childhood has a typical presentation of infiltration of bones, skin, liver, and other organs with histocytes

A

histocytosis

*teeth may be left “floating in air” and eventually exfoliated

67
Q

what % of histocytosis pts have intitial infiltrates seen in the oral cavity,

A

10-20% usually in the mandible

68
Q

what is the tx for histocytosis?

A

-local measures such as radiation, surgery, and chemotherapy

69
Q

what is the px for histocytosis?

A

disseminated = poor with mortality rates exceeding 60%

mild = excellent

70
Q

most common form of childhood cancer

A

leukemia

71
Q

type of leukemia that is the most common and has the best px

A

ALL

72
Q

accounts for about 20% of childhood leukemias and has a poorer long term survival

A

AML

73
Q

which type of leukemia may be associated with gingival enlargements, bluish leasions, and systemic fever?

A

AML

74
Q

what is the incidence for calculus for kids and teens?

A

kids = 10%

teens = 1/3 of teens

75
Q

where is calculus most often seen in kids?

A

lingual side of mandib incisors followed by buccal of max molars

76
Q

probing where provides screening for LJP?

A

incisors and perm molars

77
Q

what are a normal finding of probing kids teeth?

A

transient deep pockets

*can be distinguished from true attachment loss by locating the cemneto enamel jx

78
Q

what are the normal crestal height of bone in relation to CEJ in kids?

A

in 1-2 mm

Peds 2 (Exam 3) (9 decks)

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