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Boards 2 > Perio > Flashcards

Perio Flashcards

1
Q

Miller Classifications

A

1) recession that has NOT extended to the mucogingival junction (MGJ) without bone loss
2) Recession to or BEYOUND MGJ without bone loss
3) recession to or beyond MGJ WITH bone loss and papilla recession
4) recession must be beyond MGJ with bone loss to base of recession defect

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2
Q

Bruxism may be induced by?

A
  • Medications (most notably those prescribed for attention deficit hypersactivity disorder, ADHD)
  • Stress
  • Masseter tension
  • Premature occlusion
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3
Q

pain to lateral percussion and wide sulcus indicate what?

A

lesion etiology is periodontal in origin

wide sulcus= attachment loss
lateral percussion pain= inflamed periodontal ligament, not an inflamed apical infection

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4
Q

clinical attachment level vs clinical attachment loss

A

level= distance from CEJ to sulcus depth. strictly a measurement and can indicate health/disease

loss= describes amount of attachment loss around a tooth, indicates disease, calculated by adding pocket depth and recession

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5
Q

gingival pocket depth is what?

A

the distance from the free gingival margin to the depth of the gingival sulcus

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6
Q

hardest area of the mouth to reposition a flap?

A

MX palatal due to thickness and its supporting attached gingiva

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7
Q

Necrotizing ulcerative gingivitis and periodontitis

1) associated bacteria?
2) treatment?
3) signs and symptoms?
4) risk factors

A

1) anaerobic fusobacteria and spirochetes, spirfically underneath of the gingiva
2) debridment of affected gingiva with chlorhexidine 0.12% rinse will help stop progression
3) pain, interproximal necrosis of papilla (blunting), bleeding gingiva, fetid odor, low grade fever, pseudomembrane, bone loss WITH periodontitis
4) poor oral hygeine, smoking, malnutrition, fatigue, stress, immunocompromised patients

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8
Q

Necrotizing ulcerative gingivitis vs Necrotizing ulcerative periodontitis

A

periodontitis INCLUDES BONE loss

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9
Q

indication of trauma

A

xray: funneling and widening of lamina dura, root resorption, hypercementosis
clinical: attrition, fracure, mobility, pain during function

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10
Q

How do you calculate clinical attachment loss?

A

by adding pocket depth and recession

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11
Q

tooth mobility is the most common sign of what?

A

occlusal trauma (another common sign is periodontal ligament widening)

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12
Q

define fremitus

A

tooth mobility when under function, splinting is often used as a form of treatment IF there is pain (fremitus alone isn’t enough of an indication)

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13
Q

what is the MOST common periodontal diagnosis?

A

plaque associated or marginal gingivitis

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14
Q

4 common drugs that cause gingival overgrowth?

A 
Calcium channel blockers
Phenytoin
Cyclosporin
Dilantin
Nifedipine
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15
Q

localized aggressive periodontitis is most common in what demographic? associated with what BACTERIA?

A

younger patients

*Aggregatibacter actinomycetemcomitans**

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16
Q

describe the first phase of periodontal treatment?

A

removal of causative factors, risk factors and predisposing factors that may worsen the condition of a pt (for example: any general health concerns will affect the treatment outcome -such as diabetes)

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17
Q

Hypophosphatasia

A

hereditary disease with deficiency of tissue non-specific alkaline phosphatase enzyme WHICH affects the development and mineralization of bone/teeth
* ppl have premature primary tooth loss and destruction of periodontium of permanent teeth

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18
Q

What does periodontal abscess do to bone?

A

causes the MOST rapid destruction of bone

  • when pus accumulates (neutrophils first to arrive), pressure builds up resulting in bone destruction
  • as the abscess increases in size, so does the area of bone resorption
19
Q

PMNs are first line of defense against?

A

foreign invaders, 50-60%of leukocytes circulating bloos

20
Q

IgA

A
  • most prevalent in saliva
  • ‘agglutinizing antibody’ bc its glues bacteria together
  • purpose is to prevent bacteria to oral tissues bc bound to IgA instread
21
Q

define leukocytosis

When is it observed?

A

WBC count above normal range and is a is sign of inflammatory response that is most commonly the result of infection
- observed with: acute bacterial infections, cancer, parasitic infections, strenuous exercise, emotional stress, pregnancy and anesthesia/steroid/epi administration

22
Q

materia alba

A

a soft debris on tooth surface that does NOT cause gingivitis

23
Q

Stages of pathogenesis of periodontitis

A

1) initial - presence of acute inflammatory rxn by normal healthy gingiva to plaque
2) early - lesion occurs when an infiltrate of lymphoid cells appears, T- LYMPHOCYTES
3) established - B LYMPHOCYTES and plasma cells predominate site of inflammation
4) advanced - periodontitis and irreversible loss of bone

24
Q

Does calculus cause gingivitis?

A

Does NOT directly cause gingivitis. It is mineralized plaque that allows for non-mineralized plaque buildup… PLAQUE has a direct relation to severity of gingivitis

25
Q

What does plaque cling to?

A

tooth pellicle

26
Q

location og IgA and IgG

A

IgA = saliva
IgG = sulcular fluid
both found in large amounts in oral tissues

27
Q

1) Histiocytes
2) Neutrophiles
3) eosinophils
4) basophils
5) plasma cells
6) Monocytes
7) Lymphocytes

A

1) Histiocytes - phagocytic cells important for antigen presentation
2) Neutrophiles - most abundant WBC type. recruited immediately for phagocytosis
3) eosinophils - larger in size than neutrophils and ALLERGIC reactions
4) basophils - small amount. PARASITIC and ALLERGIC reactions
5) plasma cells - mature B-cells that make and release antibodies
6) Monocytes - large, phagocytic that increase during severe infections to remove debris/microorganisms
7) Lymphocytes - formed in lymphoid tissue and important in antibody formation

28
Q

junctional epithelium… describr reattachment

A
  • re-aataches to cementum and dentin after apically repositioned flap by re-establishing tight junctions
  • regeneration takes about 10-14 days after surgery
  • may occur even after surgical detachment as long as the root surface is completely debrided of plaque and calcular deposits
29
Q

relationship between # of walls in a defect and prognosis

A 
more walls = better prognosis (direct)
*so class 4 furcation involved has BAD prognosis*
30
Q

idiopathic chronic root resorption occurs when?

A

in pts with autogenous tooth transplantation and exhibits resorption with an unknown cause

31
Q

Furcation Classes and descriptions

A

1 - incipient bone loss; Naber’s probe can feel the depression of the furcation openingn but cannot enter
2 - partial bone loss; Nabor’s probe tip enters under the ceiling of the furcation and extends 1/3 the width of tooth
3 - TOTAL bone loss; it has a through and through opening of the furcation. The entrance to the function cannot be seen clinically
4 - basically class 3 but the entrance is clinically VISIBLE

32
Q

Class 3 compromised furcations in MN and MX

A

MN - probe passes completely through furcation of mesial and distal roots

MX - probe passes between mesiobuccal and distobuccal roots and touches palatal root

33
Q

reasons why autogenous tooth transplantations fail?

A

idiopathic chronic root resorption*, replacement resorption, resorption due to inflammation/carries/marginal periodontitis and trauma

34
Q

what is the most important determinant of the prognosis of periodontally compromised teeth?

A

the amount of attachment loss
– although alveolar bone height and clinical attachment level (CAL) are connected, there are sometimes cases where the alveolar bone heigth and CAL differ, so CAL is more important when determining prognosis

35
Q

what is prognosis of a tooth with sever attachment loss and vertical mobility?

A

hopeless prognosis. MUST be extracted to avoid infection that may compromise other teeth

36
Q

What is mineral trioxide aggregate used for?

A

filling material for endodontic txt

37
Q

How do you address/manage postsurgical root sensitivity?

A

By addressing main etiology which is plaque. So plaque control and removal is best treatment. Desensitizing dentrifrice works but it is only temporary and takes 2 weeks to kick in

38
Q

3 types of gingival embrasures

A

type 1: no loss of dental papilla

type 2: partial loss of interdental papilla

type 3: complete loss of interdental papilla

39
Q

What type of embrasure does MX first PM have?

A

type 2 or type 3, creates a mesial concavity that is hard to clean

40
Q

What is the most recommended oral hygiene method for proximal plaque removal? what is its limitation?

A

dental floss! But it is not capable of reaching deep into the pocket

41
Q

oral water irrigation devices pro and con?

**home water irrigation systems main goal is

A

Pro- help remove plaque in shallow periodontal pockets by propelling pulsating high pressure water to flush subgingival plaque… they are INEFFECTIVE if the pocket is deep
** designed to reduce amount of bacteria on the gingiva, not the tooth surface

42
Q

describe ‘new attachment’

A

reunion of C.T. with a root surface deprived of its periodontal ligament. It occurs when newly formed periodontal ligament fibers embed themselves into the cementum of a previously debrided root surface

43
Q

G- or G+ adhere better to the tooth or soft tissue?

A

G+ = tooth (produce dextrans, levans, glucans)

G- = soft tissues (produce alginates that help them adhere)… G- also adhere to G+

Boards 2 (15 decks)

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