Perio Flashcards
Steps in pellicle formation (3)
Pellice forms (happens quickly)
adhesion and attachment of bacteria
colonization and plaque maturation
How does the type of bacteria in plaque change as it matures?
facultative gram + to anaerobic gram -
Red complex bacteria
P. gingivalis
T. Forsythus
T. denticola
What bacteria is implicated in Aggressive Periodontitis?
AA
What bacteria is implicated in root caries?
Actinomyces viscosus
What bacteria is implicated in coronal caries?
Strep Mutans
The primary colonizers of dental plaque are what kind of bacteria?
Gram + facultative
The predominant inflammatory cells in the periodontal pocket are?
Neutrophils
What destroys collagen?
MMPs
Defective neutrophils lead to?
Aggressive periodontitis
Pathogenesis of Periodontal lesion:
Stage 1: ____ lesion, ____ infiltrate, ___ days
Stage 2: ____ lesion, ____ infiltrate, ___ days
Stage 3: _____ lesion, ____ infiltrate, ___ days
Stage 4: _____ lesion
Stage 1: initial lesion, neutrophils, 2-4 days
Stage 2: early lesion, T-cells, 4-7 days
Stage 3: established lesion, B-cells, 14-21 days
Stage 4: advanced lesion, transition to irreversible damage
Define scaling:
remove supra gingival & sub gingival plaque & calculus
Define root planing:
removal of calculus and cementum
Scalers are used?
supragingival
Curettes are used?
subgingival
1/2 and 3/4 curettes are used where?
anterior
5/6 curette is used where?
Anterior and premolar
7/8 and 9/10 curettes are used where?
posterior F/L
11/12 curette is used where?
posterior, medial
13/14 curette is used where?
posterior, distal
What are the 2 types of curettes?
Universal and Gracey
When inserting a curette into a period pocket, what angulation should be used?
0 degrees
When performing scaling and root planing, what angulation should be used?
45-90 degree angulation
Steps of a Modified Widman flap:
- internal/revers bevel
- sulcular incision
- interdental (removes the piece of gingiva)
A long junctional epithelial attachment is considered?
repair
A perio pack is made from what material?
ZOE
When is a free gingival graft used?
When we want to increase height of keratinized gingiva
When is a connective tissue graft used?
when we want to achieve root coverage
Ostectomy is the removal of ____ bone.
supporting
Osteotomy is the removal of ____ bone.
non-supporting
What is the only way to regenerate attachment?
bone graft
New attachment refers to:
embedding of new PDL fibers into new cementum
Reattachment occurs when?
reunion of epithelium and CT after injury or incision
The new classification of periodontitis uses?
Stages and grades
Amount of CAL in stage 1, 2, 3, 4 periodontitis?
1: 1-2 mm
2: 3-4 mm
3: >5 mm
4: >5 mm
Amount of RBL is stage 1, 2, 3, 4 periodontitis?
1: 15% (coronal 1/3)
2: 15-33% (middle 1/3)
3: middle 1/3 +
4: middle 1/3 +
What what stages of periodontitis has tooth loss occurred and how many teeth have been lost?
Stage 3: 4 or less teeth
Stage 4: 5 or more teeth
Each stage of periodontitis also gets a “location”:
Localized (<30% of sites)
Generalized
Molar incisor
Amount of RBL/CAL in grades A, B, C of periodontitis?
A: none
B: <2mm in 5 years
C: >2 mm in 5 years
% bone loss/age in grades A, B, C of periodontitis?
A: <0.25
B: 0.25-1
C: >1
Phenotype of grades A, B, C of periodontitis?
A: Plaque exceeds amount of destruction
B: Plaque and destruction coincide
C: Plaque levels do not match amount of destruction
How does smoking impact Grade?
A: non-smoker
B: <10 cigs/day
C: >10 cigs/day
How does diabetes impact Grade?
A: non-diabetic
B: HbA1c <7%
C: HbAic >7%
