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SET 9 ( ENDO & PERIO) > Perio doc micks > Flashcards

Perio doc micks Flashcards

1
Q

Parts of Periodontium

A
  1. Gingiva
  2. PDL
  3. Cementum
  4. Alveolar bone
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2
Q

REMEMBER‼️📌📌

PDL, Cementum, & Alveolar Bone

A

Attachment Apparatus

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3
Q

Gingival fibers & Epithelial attachment

A

Gingival Apparatus

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4
Q

composed of epithelium & conn. tissue

A

Gingiva

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5
Q 
Characteristics of Normal gingiva
Color
Shape
Tone
Texture
A 
Coral pink 
Knife edge free gingival margin
Scalloped gingival margin-follow CEJ contour
Tone: resilient & fibrous
Texture: Stippling
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6
Q

found in attached gingiva
irregularities of epithelial ridges & rete pegs
least determinant for gingivitis

A

Stippling

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7
Q

‼️📌REMEMBER

Absence of Stippling

A

Normal variation
Inflammation
Edema

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8
Q

Most important criteria for Gingivitis

A

Bleeding on Probing

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9
Q

Why bleed?

A

Microulceration in the gingiva

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10
Q

Stippling

A

Orange peel/ Peau’d orange

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11
Q

Gingival Epithelium Histologic divisions

A
  1. Oral Epithelium
  2. Sulcular Epithelium
  3. Junctional Epithelium
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12
Q

parakeratinized but both present

keratinized stratified, squamous epithelium

A

Oral Epithelium

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13
Q

non-keratinized but can keratinized

but some has parakeratinized

A

Sulcular Epithelium

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14
Q 
part of biologic width
Non-kerarinized
Collar-like band of stratified squamous epithelium
thicker near the sulcus
thinner at the apex
A

Junctional Epithelium

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15
Q

Ideal at the CEJ

A

Junctional Epithelium

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16
Q 
type of transudate that is produced in the gingival sulcus
contains cells (neutrophils) enzymes & IgA
A

Gingival Crevicular Fluid (GCF) / Sulcular Fluid

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17
Q

gingival sulcus

A

transudate

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18
Q

exudate

A

pus

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19
Q

specific gravity

A

Exudate

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20
Q

protein content

A

Transudate

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21
Q

Keratinization

A
  1. Orthokeratinize

2. Parakeratinize

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22
Q

complete keratinization

w/out nucleus

A

Orthokeratinize

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23
Q

incomplete

w/ nucleus

A

Parakeratinize

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24
Q

Prevent relapse after tx

A
  1. Supracrestal fiberotomy
  2. Retainer
  3. Overcorrection
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25
Q

Aka. Supracrestal connective tissue fibers

A

Gingival Fiber Group

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26
Q

Attaches the gingiva to the tooth & alveolar bone

Made up of Type I collagen

A

Gingival Fiber Group

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27
Q

Gingival Fiber Group

A
  1. Dentogingival Fibers
  2. Dentoperiosteal Fibers
  3. Circular Fibers
  4. Alveologingival fibers
  5. Transseptal Fibers
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28
Q

attached to the cementum to the gingiva

A

Dentogingival fibers

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29
Q

from cementum to the periosteum

A

Dentoperiosteal fibers

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30
Q

from cementum to the periosteum

A

Dentoperiosteal fibers

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31
Q

encircles the tooth , resist rotational forces

A

Circular Fiber

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32
Q

attaches gingiva to the alveolar crest

A

Alveologingival fibers

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33
Q

attaches cementum to cementum of adjacent teet ; doesn’t attach to bone
Most cause of relapse

A

Transseptal fibers

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34
Q

Principal Periodontal Ligament Fiber Group

A

Made up Type I collagen

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35
Q

from cervical cementum of tooth to alveolar crest

Mainly resists lateral movements

A

Alveolar Crest Fiber Group

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36
Q

run perpendicularly from the root of the tooth to alveolar bone
resists lateral movements & vertical movements

A

Horizontal Fiber Group

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37
Q

runs obliquely from cementum & extends occlusally towards bone found in the middle 3rd of root
📌Most numerous
📌Mosr resistant to forces along lomg axis of thd tooth / masticatory forces

A

Oblique Fiber Group

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38
Q

radiate apically from cementum to bone
primary fibers that resist tooth towards occlusal direction
Compressed during intrusion & masticatiom

A

Apical Fiber Group

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39
Q

from cementum in the fircarion towards bone in the furcation area
Found only in multirooted teeth

A

Interradicular Fiber Group

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40
Q

‼️📌REMEMBER📌‼️

Periodontal fibers embedded in cementum & bone are called

A

Sharpey’s Fibers (mineralized)

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41
Q

Other name of Alveolar Bone Proper

A

Bundle bone / Cribriform plate

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42
Q

Most numerous cells found in PDL

A

Fibroblast

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43
Q

Anatomic Parts of the Gingiva

A
  1. Free Gingiva / Marginal Gingiva
  2. Gingival Margin
  3. Free gingival groove
  4. Attached ginigva
  5. Gingival sulcus
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44
Q

tissue not attached to the tooth or bone

measured from free gingival crest (gingival margin) to the free gingival groove

A

Free Gingiv or Marginal Gingiva

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45
Q

most coronal portion of gingiva

A

Gingival Margin

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46
Q

line between marginal gingiva & attached gingiva

coincides with apical border of junctional epithelium

A

Free Gingival groove

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47
Q

Measured from the free gingival groove to the mucogingival junction
Stipplings are found here
Tightly bound to underlying periosteum & cementum

A

Attached Gingiva

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48
Q

between marginal gingiva & attached gingiva

coincides with apical border of junctional epithelium

A

Free Gingival Groove

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49
Q

measured from free gingival groove to the mucogingival junction
stippling are found here
tightly bound to underlying periosteum & cementum

A

Attached Gingiva

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50
Q

between marginal gingiva & tooth surface; GCF is found here
bounded by
Sulcular epithelium- laterally
JE- apically

A

Gingival sulcus

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51
Q

‼️📌BE
Thinnest Attached gingiva
Thickest

A

Posterior portion of the mandible

Anterior (maxilla) - labial surface of lateral incisors

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52
Q

valley like structure between the lingual papilla & facial papilla

A

Interdental Col / Inter papillary Saddle

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53
Q

Occupies the gingival embrasure of the interdental space above the alveolar crest
Pyramidal shape

A

Interdental or Interproximal gingiva (papilla)

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54
Q

A line betweem attached gingiva & alveolar mucosa

A

Mucogingival Junction

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55
Q

loosely attached mucosa covering the base of the alveolar process continuing towards the vestibule & floor of the mouth

A

Alveolar mucosa

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56
Q

Probing force

A

10gm- 25gm

  1. 010 kg - 0.025 kg
  2. 022 lbs - 0.055 lbs
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57
Q

normally in CEJ or above CEJ (in enamel)

A

Level of Free Gingival Margin in Relation to CEJ

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58
Q

Probing must be gentle- Walking Technique

A

BOP

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59
Q

measured from Gingival margin to base of sulcus

A

Pocket Depth or Probing Depth

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60
Q

Position , angulation & orientation of probe

A

Ideally: Parallel to the tooth surface
Maximum: Angle 0-10*
xray angle
bitewing radiograph

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61
Q

readily combines with mercury to form gamma 2 phase weakest ohase & contributes to failure of amalgam restoration

A

Tin

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62
Q

scazenger

A

zinc

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63
Q

‼️📌 Calcular deposits are composed of

A

Calcium & Phosphate

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64
Q

Sticky deposits in oral cavity where microorganisms accumulate are called?

A

Plaque

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65
Q

Immediately after cleansing a tooth a thin film of saliva covers the tooth .,It is called

A

Pellicle

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66
Q

measured from CEJ towards Base of Sulcus

A

CAL

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67
Q

measured from CEJ to Gingival margin

Gingival recessiom = CAL- Pocket depth

A

Gingival recession

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68
Q

📌‼️‼️REMEMBER

can be tx by Free Gingival graft

A

Recessions

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69
Q

obtained from Edentulous region or palatal area

A

Graft

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70
Q

Most common failure of autographs

A

Loss of Blood supply

infection

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71
Q

source of Blood supply of Autografts

A

Bed of recipient tissue

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72
Q

important to evaluate prognosis of tooth

A

Mobility

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73
Q

due to coronal migration of gingival margin
gingival hyperplasia
gingival hypertrophy

A

Pseudopocket

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74
Q

apical migration of the junctional epithelium
(loss of attachment)
related to bone loss

A

Tru Pocket

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75
Q

Miller Classification of Tooth Mobility

A

Grade I
Grade II
Grade III

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76
Q

horizontal mobililtyn<1mm, normal

A

Grade I

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77
Q

Horizontal mobility > 1mm - 2mm

A

Grade II

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78
Q

Horizontal Mobility >2mm or vertical mobility; Poorest prognosis

A

Grade III

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79
Q

Joint between a tooth & alveolaf bone

A

Gomphosis

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80
Q

use Naber’s Probe

A

Furcation Evaluation

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81
Q

Furcation Classification by Glickman

A

Grade I
Grade II
Grade III
Grade IV

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82
Q

Incipient furcation involvement
Pocket primarily affects soft tissue & coronal to alveolar bone
Depression due to furcation opening can be felt using probe

83
Q

Furcation bone loss
Not through & through
Probe enters under the roof of furcation

84
Q

Total furcation bone loss

Through & through Not seen clinically

85
Q

Total furcation bone loss , through & through seen clinically

86
Q

📌‼️REMEMBER
What is the most Critical factor in determining if a tooth is candidate for Extraction or can be saved with surgical periodontal therapy

87
Q

evaluated by Digital pressure on buccal & lingual of each tooth

88
Q

Radiographic Evidence of Bone Loss

A

Periodontitis

89
Q

Periodontitis Diagnosis

A

Multiple Periapical
Bitewing
Panoramic

90
Q

Change in tissue tome
Gingivitis
Periodontal Disease

A

Erythema

Cyanosis

91
Q

📌‼️REMEMBER

Most effective way to determine presence of plaque?

A

Disclosing Solution

92
Q

What is the best indicator to evaluate success of scaling & root planing

A

Reduction of Bleeding Index & Plaque Index

93
Q

Scaling & Root Planing removes

A

Cementum
Dentin
Plaque

94
Q

removal of calcular deposits in root surface

95
Q

smoothing of root to remove infected tooth substances

96
Q

scraping gingival wall

97
Q

Gold standard of all curettes

A

Gracey Curettes

98
Q
  • Most common complication after root planing
A

Sensitivity

99
Q

Anterior Teeth

A

1,2, 3, , 4

100
Q

5, 6

A

ant.teeth & PM

101
Q

7,8,9,10

A

Posterior buccal & Lingual

102
Q

11, 12, 15, 16

A

Post. teeth mesial

103
Q

13, 14,,17, 18

A

Post. teeth distal

104
Q

Masticatory Mucosa

A

KSSE
Dorsum tongue
hard palate
attached gingiva

105
Q

NKSSE

found almost everywhere in the oral cavity

106
Q

Lining Mucosa
inside lining of cheeks
inside lining of the lips
lining between buccal & labial mucosa

A

Buccal mucosa
Labial mucosa
Alveolar mucosa

107
Q

found in taste buds responsible for sensory perception of the tongue

A

Specialized Mucosa

108
Q

most common involves Canines & Premolars (Abrasion)

Due to hard bristle brush

A

Toothbrush trauma

109
Q

chemical action

110
Q

Mechanical wear

111
Q

physiologic action

112
Q

loading resulting to tooth flexure & microfractures

A

Abfraction

113
Q

Toothbrushing Techniques

A
  1. Bass Method
  2. Stillman
  3. Charters
  4. Circular Force
  5. Horizontal
114
Q

bristles at 45* in relation to tooth towards sulcus, cleans gingival sulcus
Best toothbrush technique

A

Bass Method

115
Q

bristles at degrees in relation to tooth towards sulcus, half of bristles in gingiva, half in sulcus

116
Q

45* in relation to tooth but towards occlusal

117
Q

least effective toothbrushing techniques

A

Circular Force

118
Q

Most common used by the px.

A

Horizontal

119
Q

Classification types of Toothbrushing techniques according to movement

A 
Roll
Vibratory
Circular
Vertical
Horizontal
120
Q

roll method or modified stillman technique

121
Q

stillman, charters & bass techniques

122
Q

Fones techniquee

123
Q

Leonard technique

124
Q

scrub technique

A

Horizontal

125
Q

Induced by Nifedipine. phenytoin, & cyclosporine, genes

Prevented by good oral hygiene

A

Gingival Overgrowth

126
Q

Tx. Gingival overgrowth

A

Gingivectomy

127
Q

After gingivectomy

dressing

A
  1. Reduce pain/ bleeding
  2. Mechanical protection
  3. ⬆️ Healing
  4. Debris- free environment (plaque- free)
128
Q

Gingival margin moving CORONALLY due to GINGIVAL OVERGROWTH

A

Pseudopockets

129
Q

Degree of Gingival Enlargement

A

Grade 0
Grade I
Grade II
Grade III

130
Q

no signs of gingival enlargement

131
Q

enlargement confined to interdental papillae

132
Q

enlargement involves papilla & marginal gingiva

133
Q

enlargement covers 3 quarter or more of the crown

134
Q

GINGIVAL ENLARGEMENT BASED ON LOCATION

limited to the gingiva adjacent to a single tooth or group of teeth

135
Q

involving the gingiva throughout the mouth

A

Generalized

136
Q

confined to the marginal gingival

A

Marginal Gingiva

137
Q

Confined to the Interdental Papilla

138
Q

involving the marginal & attached gingvae & papillae

139
Q

isolated sessile or pedunculated, tumor- like enlargement

140
Q

Most common Periodontal disease

Most common cause is Poor Oral Hygiene

A

Gingivitis

141
Q

Characteristics of Gingivitis

A 
Inflammation of Gingiva
Bleeding on probing
Absence of pockets
Absence of radiographic finding
Absence of stippling
142
Q

Scurvy

A

Scrobutic Gingivitis

143
Q

Pregnancy Gingivitis

A

⬆️⬆️Progesterone more

⬆️ estrogen

144
Q

Red glazed, atrophic, or eroded gingiva
Desquamting gingiva/ sloughing gingiva
atrophic stratified squamous epithelium
short or absent rete pegs

A

Desquamative Gingivitis

145
Q

Desquamative Gingivitis

Associated with

A

Pemphigus Vulgaris
Pemphigoid
Lichen planus
Chronic ulcerative stomatitis

146
Q

desmosomes

A

Pemphigus Vulgaris

147
Q

Hemidemosomes

A

Pemphigoid

148
Q

anbsence of rete pegs or saw toothing- White patches (wickham’s striae)

A

Lichen Planus

149
Q

punched out grayish pseudomembrane of interdental papilla
pain & bleeding
fetid odor, fever & malaise
absence of pocket

A

NUG/ Trench Mouth / Vincents Ds.

Old: ANUG

150
Q 
NUG/ Trench mouth/ Vincents
Causative Agent (FuPS)
A

Fusobacterium
Prevotella Intermedia
Spirochetes (Treponema Pallidum)

151
Q

📌‼️Elevated Prevotella Intermedia

A

Down Syndrome

152
Q

Tx. of NUG

A

Debridement- removal of damage tissue
Irrigation w/ chlorhexidine gluconate
Antibiotic (penicillins)

153
Q

Same as NUG
with CAL & Bone Loss
Presence of Pockets

154
Q

Causative agent of NUG

155
Q

rapid progression of attachment loss
Absence of plaque- usually
<30 yrs

A

Aggressive Periodontitis / Juvenile Periodontitis

156
Q

Ex. Of Aggressive / Juvenile Periodontitis

157
Q

‼️📌Teeth involved in LAP/LJP

A

Incisors & 1st molars

158
Q

Causative agent of LAP/LJP

A

Actinobacillus (old term)
Aggregatibacter Actinomycetemcomitans
Capnocytophagea Ochracea

159
Q

Most common cause of Localized Aggressive Periodontitis

A

Aa

Aggregatibacter Actinomycetemcomitans📌📌

160
Q

Causative Agent of Generalized Aggressive Periodontitis (Generalized Juvenile Periodontitis)
Causative Agent

A

Prevotella Intermedia

Eikenella Corrodens

161
Q

slow to moderate progressiom, with periods of rapid progressiom of attachment loss
“burst of destruction”
Presencec of subgingival calculus- frequent finding

A

Chronic Periodontitis

162
Q

causative agents- multiple microorganisms

A

Chronic Periodontitis

163
Q

Other Syndromes Associated with Severe Periodontitis

A
  1. Chediak- Higashi Syndrome
  2. Papillon Lefevre Syndrome
  3. Down Syndrome
  4. Lazy Leukocyte Syndrome
  5. Leukocyte Adhesion Deficiency
164
Q

severe periodontitis

cafe- au-lait spots (brownish spot in skin)

A

Chediak- Higashi Syndrome

165
Q

AKA Palmoplantar Keratoderma Periodontitis
Severe Periodontitis
Palmoplantar keratoderma- hyperkeratosis of palms & soles

A

Papillon -Lefevre Syndrome

166
Q

severe periodontitis due to increase P. intermedia

Less prone to caries

A

Down Syndrome

167
Q

poor response of leukocytes to infections
Prone to infection
kulang ang px
⬇️ signaling hormone in the body

A

Lazy Leukocyte Syndrome

168
Q

inability of leukocyte to adhere in sites of infection

⬇️ adhesion proteins

A

Leukocyte Adhesion Deficiency

169
Q

sensitive heat & cold

A

Reversible

170
Q

relieved by cold

A

Irreversible Pulpitis

171
Q

Pulp Necrosis

A

Irreversible Pulpitis

172
Q

‼️📌REMEMBER

Does true periodontitis always begins with gingivitis ?

173
Q

Radiographic findings of Periodontitis

A

Loss of Lamina dura
Widening of Periodontal space
Horizontal / Vertical bone loss

174
Q

What cell produce by Lymphokines?

A

T- Lympocytes

175
Q

📌‼️‼️ Mediators of Tissue Destruction

A
  1. MMP
  2. Cytokines
  3. Prostaglandins
176
Q

primart proteinase that destroy periodontal tissue

A

MMP - Matrix Metalloproteinase (MMP)

177
Q

signaling molecules like interleukins & tumor necrosis fx

178
Q

Microprganisms appear

A

10-12hrs after birth

179
Q

1st microogranism to appear after birth , most numerous

A

S. Salivarius

180
Q

only appear after a tooth has erupted

A

Strep.mutans & sanguis

181
Q

1st colonizee

182
Q

way of communicatim of microorganisks

A

Quorum Sensing

183
Q

Probing Age

A

13-14 y/ o

184
Q

oral microflora is same to adults

A

By the age 4-5

185
Q

Healthy Oral Cavity

A

Gm (+) facultative (cocci) anerobes
Streptococcus & Actinomyces
Fermenting microorganism - sugar as source of energy
Non-motile

186
Q

Unhealthy Oral Cavity

A

Gm (-) obligate anaerobes (rods)
Proteolytic Microorganisms
Motile

187
Q

Most common primary colonizer of plaque

yellow complex microorganisms

A

Rods & Cocci

188
Q

Purple Complex

A

Actinomyces

189
Q 
Late / Secondary Colonizers
Green Complex (GrEAC)
A

Eikenella Corrodens
Actinobacillus Actinotherapeutics
Capnocytophaga

190
Q

Orange Complex (FPC)

A

Fusobacterium
Prevotella
Campylobacter

191
Q

Red complex - causes bleeding

PTT

A

Porphyromonas
Treponema Denticola
Tannerella Forsythia

192
Q

One wall

A

Hemiseptum

193
Q

two wall

A

Osseous crater

194
Q

Lowest success after grafting procedure

A

One wall- hemiseptum

195
Q

Most common type of Osseous Defect or Vertical Bone Loss

A

Two wall- Osseous crater

196
Q

highest success rate after grafting procedure

A

3 wall- intrabony defect

197
Q

📌‼️‼️ Most commom pattern of bone loss

reduction in height

A

Horizontal

198
Q

reduction in width

A

Vertical Bone Loss

199
Q

Horizontal Bone Loss

A

Probing- True Pocket- Suprabony Pocket

200
Q

Vertical Bone Loss

A

Pocket- Infrabony Pocket (Intrabony Pocket)

201
Q

provide ACCESS & VISIBILITY to root surfaces of debridement

although it may result to REDUCTION OF POCKET DEPTH

A

Primary Goal of All Flaps

202
Q

include epithelium , C.TT & periosteum
most common type of flap
alveolar bone is exposed

A

Full thickness flap/ Mucoperiosteal Flap

203
Q

includes epithelium & conn. tissue only
periosteum remains attached to alveolar bone
alveolar bone is not exposed

A

Partial Thickness Flap/ Split Thickness Flap

204
Q

takes 1month

A

Complete Healing of Tissue After a flap surgery

SET 9 ( ENDO & PERIO) (4 decks)

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