Perio Classification Flashcards
How do u treat periodontal disease for a pregnant pt
Provide non surgical treatment in second trimester
Avoid traumatic procedures during pregnancy e.g. periodontal surgery
What is clinical gingival health
<10% BOP
<or equal to 4mm probing death
Absence of BOP, erythema, edema, pt.symptoms, bone loss with attachment
How do u know whether gingivitis is localised or generalised
<30% localised
>30% generalised
Potential modifying factors of plaque induced gingivitis- systemic conditions
Puberty
Menstruation
Pregnancy
Oral contraceptives
Hyperglycaemia
Leukaemia
Smoking
Malnutrition
Potential modifying factors of plaque induced gingivitis- oral factors enhancing plaque accumulation
Prominent subgingival restoration margins
Hyposalivation
Signs and symptoms of necrotising gingivitis
Pain
Severe gingival bleeding
Necrosis of ID papilla
Pseudomembrane formation
Lymphadenopathy
No bone loss
Signs and symptoms of necrotising periodontitis
Pain
Severe gingival bleeding
Necrosis of ID papilla
Pseudomembrane formation
Lymphadenopathy
With PDL and bone loss
Signs and symptoms of necrotising stomatitis
Pain
Severe gingival bleeding
Necrosis of ID papilla
Pseudomembrane formation
Lymphadenopathy
With severe soft tissue and bone destruction
Causes of necrotising periodontal disease
Aids (CD4<200 viral load)
Severe viral infection
Severe malnourishment
Stress/fatigue
Alcohol
Smoking
Tx of necrotising periodontal disease
Initial superficial debridement with ultrasonic daily (2-4 days) coupled with Chlorohexidine MW 0.2% 2xdaily- if not responsive metronidazole 400mg 3xday for 3 days
OHI and PMPR- treat systemic predisposing factors
Surgery options once disease stable: gingivectomy (superficial craters), periodontal flap surgery (deep craters)
What is this
Necrotising gingivitis
What is this
Necrotising gingivitis
What is this
Necrotising periodontitis
Periodontitis as manifestation of systemic diseases
Papillon lefevre syndrome
Leukocyte adhesion syndrome
Hypophosphatasia
Down syndrome
Ehlers-danlos syndrome
Systemic diseases affecting perio tissues independently of plaque
Squamous cell carcinoma
Langerhans cell histocytosis
Osteoporosis
Vit C deficiency
Diabetes
Non dental biofilm causes of gingivitis
Infection (herpes- candida albicans)
Congenital (hereditary gingival fibromatosis)
Immune conditions (lichen planus)
Nutritional deficiency (vit C)
What is this
Periodontitis- Papillon Lefevre Syndrome
What is this
Periodontal abscess
What is each recession type
1
2
3
What is recession type 1
Gingival recession with no loss of interproximal attachment
What is recession type 2
Gingival recession with loss of interproximal attachment- amount of interproximal attachment loss is less than or equal to buccal attachment loss
What is recession type 3
Gingival recession with loss of interproximal attachment- amount of interproximal attachment loss is more than buccal attachment loss
What does staging of disease show
Severity of disease
Interproximal bone loss at worst site
How is staging calculated
1-mild- <15% or 2mm
2- moderate- coronal third of root
3- severe- mid third of root
4- very severe- apical third of root
What does grading show
Progression of disease
How is grading calculated
%BL/age
A- slow- <0.5
B- moderate- 0.5-1
C- rapid- >1
What is the difference between a periodontitis diagnosis being currently stable, currently in remission and currently unstable?
Stable- BOP<10%, PPD<4mm, no BOP at 4mm sites
Remission- BOP>10%, PPD<4mm, no BOP at 4mm sites
Unstable- PPD >/5mm or PPD<4mm and BOP
Steps in perio tx
Step 1
Education/OHI/risk factor control/PMPR of all accessible plaque and calculus/arrange review
Step 2
Step 1 plus subgingival instrumentation of pockets>4mm, in some cases with adjunctive measures
Step 3
Step 1+2 plus repeated subgingival instrumentation, periodontal surgery in suitable patients
Step 4
Supportive periodontal care
Risk adapted interval 3-12 months
Continuous monitoring of local and systemic risk factors
PMPR
