Perio/DMS Flashcards
What is periodontology?
The study of the periodontal tissues (gingiva, periodontal ligament, root cementum and alveolar bone) in health and disease, including causes prevention and treatment of diseases
What are the periodontal tissues?
Gingiva
Periodontal ligament
Root cementum
Alveolar bone
What causes stippling of the gingiva?
Connective tissue projections within the tissue.
What is the cementoenamel junction?
AKA amelocemental junction
Place where cementum covering the root and enamel covering the anatomical crown meet.
What is the free gingiva?
The free gingiva forms one of the walls of the gingival sulcus and is separated from the attached gingival by a groove called free gingival groove
What is attached gingiva?
It is the continuation of the free gingival and extends up to the alveolar mucosa.
Attached gingival is separated from the alveolar mucosa by a muco-gingival sulcus
What are the three types of gingival fibres?
Dentogingival
Alveologingival
Circular - fibres are unique in that they exist entirely within gingiva and don’t contact tooth
What is periodontal disease?
A group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent microbial plaque
What are possible plaque retention factors?
Calculus Dental restorations Carious cavities Partial dentures Orthodontic appliances Mal-positioned teeth
What is inflammation?
The response of living tissue to injury
Dilation of blood vessels
Increased permeability of vessel walls
Inflammatory exudate
Emigration of white blood cells from blood vessels into connective tissue (diapedesis)
What are they symptoms of gingivitis?
Erythema (redness)
Swelling
Bleeding on gentle probing
What is the difference between gingivitis and periodontitis?
For gingivitis inflammation confined to the gingiva involving no loss of connective tissue attachment
In periodontitis, apical extension of the gingival inflammation resulting in destruction of the connective tissue attachment, apical migration of the junctional epithelium, bone loss and true pocket formation
What is false and true pockets?
False pocket - gingival swelling
True pocket - loss of attachment
What are the signs of periodontitis?
True pocket formation
Bone loss
Tooth mobility (looseness)
Peridontitis may progress at different rates at different sites in the mouth and in different people, why?
Peridontitis is caused by microbial plaque but may be more or less destructive depending upon the susceptibility of the host
What are the risk factors for periodontitis?
Smoking
Diabetes
Stress
Genetic
What treatment can be used to treat periodontal disease?
Plaque control
Removal of plaque retention factors
What is subgingival debridement?
Subgingival debridement is the part of nonsurgical therapy which aims to remove the biofilm without intentionally removing the cementum or subgingival calculus
What are the different ways of plaque control?
- Oral hygeine (tooth brushing technique)
- Supragingival plaque control (scraping)
- Subgingival debridement
What do the material characteristics of dental materials determine?
Selection - most suitable
Preparation/placement method
Dentists/patients expectation
Performance (longevity)
What are the different material types?
Restorative
Impression
Dentures
Metals and alloys
What are the different types of restorative materials?
Amalgam
Composite resin
Glass ionomer cement
What is creep?
The deformation of a material over time
Amalgam creep may result in cuspal fracture as it protrudes around the margins and is thought to be a cause of failure of marginal ridges
How does composite resin bind to a tooth?
Acid etch technique
30% phosphoric acid for 20 seconds
Acid etching is the use of an acidic substance to prepare the tooth’s natural enamel for the application of an adhesive. The acid roughens the surface microscopically, increasing retention of resin sealant.
What is shear strength?
Amount of stress a material is able to withstand when subjected to a tangential force or twisting motion
Properties of glass ionomer cement
Bonds to enamel Fluoride released (1ppm per day)
How do you test the robustness of composite resins?
Shear strength
How is composite resin applied?
Mechanical interlocking between adhesive resin and etched enamel
Composite resin bonds to the unfilled resin
What is an alternative strength test other than shear strength?
Compressive strength
Amalgam beats composite resin
What is thermal expansion?
Restorative material should expand and contract as the tooth does otherwise microleakage occurs
What is microleakage?
The seepage of MOs, debris, fluid and breakdown products along the junction of restorations and the cavity preparation.
What is viscosity?
Ability to flow
In impression taking what is the low viscosity/high viscosity materials used for?
Low - most accurate detail of tooth surface e.g.
High - most dimensionally stable after setting and removing e.g Polyether
What does it mean if a material is elastic?
Full recovery of shape
If non-elastic there is permanent deformation
Elastic recovery should occur in impression material
What type of denture bases are available?
Acrylic resin
Metals and alloys
What are metals and alloys used for?
Partial denture frameworks
Orthodontic wires
Denture bases
What are different type of interventive treatment for dental caries?
Ranges from
- Simple restoration
- Replacement restoration
- Root canal therapy
- Extraction
What does interventive treatment depend on for caries?
Signs/symptoms Cost Time Patient preference Damage done
What 4 causes induce caries?
Susceptible tooth surface
Bacteria
Substrate
Time
Where does plaque form?
- Pits and fissures
- Interproximal
- Smooth surfaces
- Root surface
What can we do to combat caries?
Reduce intake of sugar
Remove plaque, regularly
Increase exposure to fluoride
Tip balance towards remineralisation
What are primary caries?
Unrestored tooth
What are secondary caries?
Previous restoration
How can caries be detected?
Visual detection of coronal caries - enamel discolouration +/- surface destruction
Radiographs - conventional or digital