Perio Disease

Question 0

Initial Lesion

Answer 0

Inflammatory response to biofilm

Occurs 2-4 days within bacterial irritation

Clinical appearance:
Early breakdown of collagen
Looks normal from outside, ulcerations in pocket

Question 1

4 stages of development of gingival and PD

Answer 1

Initial Lesion
Early Lesion
Established Lesion
Advanced Lesion

Question 2

Early Lesion

Answer 2

Increased inflammatory response

Biofilm becomes older/thicker
7-14 days

Infiltration of fluids - lymphocytes, plasma cells

Breakdown of collagen cells supporting ging.

Epithelium of sulcus migrates

Question 3

Established Lesion

Answer 3

Progression from early lesion

Formation of pocket epithelium

Collagen destruction

Clinical appearance:
JE proliferates
Loss of connective tissue

Question 4

Advanced Lesion

Answer 4

Extension of inflammation thru to underlying bone

Connective tissue destruction

Long appearance of teeth

Root exposure

Question 5

Intrabony pocket

Gingival pocket

PD pocket

Suprabony pocket

Answer 5

IP - Pocket depth below bone

GP - Affects gingiva

PDP - affects bone

SP - pocket depth above bone

Question 6

Contents found in a pocket

Answer 6

Microbes and their products

Ging sulcus fluid

Desquamated epithelial cells

Leukocytes

Purulent exudate (living/dead microbes)

Question 7

Pocket development factors

Answer 7

Deepens due to continuos action of irritants and biofilm

PDL fibers detach

JE migrates apically

Exposes cementum to fluids - can alter cementum

Question 8

Normal Tooth surface irregularities

Answer 8

Enamel surface - sometimes will have cracks and grooves

CEJ - determine bt this and calculus. Can feel similar

Root surface - can be rough.

Question 9

Types of furcation NEED ANSWER

Answer 9

Class I

Class II

Class III

Class IV

Question 10

Function of attached gingiva

NEED ANSWER

Answer 10

.

Question 11

Contributing factors to Disease Development

Answer 11

Etiologic - actual cause of a dz / condition

Predisposing - susceptible to a dz / condition

Contributing - lends assistance to / supplements a dz / condition

Risk - exposure that increases probability that dz will occur.

Question 12

Dental factors to Disease Development

Tooth surface irregularities

Answer 12

Pits, grooves, cracks

Calculus

Exposed altered cementum

Demineralization and cavitated caries

Rough and groove surfaces left after scaling

In adequately contoured and polished restorations

Question 13

Dental factors to Disease Development

Tooth contour

Answer 13

Congenital abnormalities

Extra / missing cusps

Flattened proximal surfaces

Occlusal surfaces affected by attrition

Areas of erosion / abrasion

Question 14

Dental factors to Disease Development

Tooth position

Answer 14

Crowded
Rotated
Anterior overbite
Open contact
Open bite 
Food impaction
Overhang of restoration 
Embrasures
Tipped tooth

Question 15

Dental factors to Disease Development

Dental prosthesis

Answer 15

Ortho appliances
Denture with deficient margin
Dental with bad clasp

Question 16

Ging position

Answer 16

Receded - gums below CEJ
Enlarged - height extended coronally
Reduced height of interdental papilla - food trapped
Tissue flap over occlusal
PD pocket - deep, hard to clean

Question 17

Ging contour

Answer 17

Sharp - healthy
Rolled
Bulbous
Cratered
McCalls Festoon
Clefted

Question 18

Effect of mouth breathing

Answer 18

Red gums

Dehydration -> bacterial proliferation -> inflammation -> red

Question 19

Other factors affecting PD

Answer 19

Personal OH:
Neglect
Biofilm control
Awareness

Diet:
Soft food - adhere to teeth
Cariogenic
Masticatory deficiencies

Question 20

Self cleaning mechanisms of mouth

Answer 20

Food enters mouth

Teeth together for chewing

Food forced out by pressure of bite

Food particles brought to occlusals

Food particles remaining on teeth can be removed by tongue, lips, teeth

Question 21

Risk factors for PD

Answer 21

Drugs - cause ging enlargement (phenotocin, cyclosporine)
Tobacco
Diabetes
Systemic conditions - osteoporosis, psychosocial pressures (stress)

Question 22

Factors to teach pt about PD

Answer 22

What is a pocket
How does a pocket form
Sig of pocket measurement
Personal and prof care