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RADIO INTERPRETATION > perio dx interpretation > Flashcards

perio dx interpretation Flashcards

1
Q

Periodontal Disease def

A

Destructive inflammatory disease affecting supporting structures of the teeth

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2
Q

forms of perio dx

A

❑Gingivitis: only the soft tissues are involved
❑Periodontitis: soft tissues and supporting bone affected

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3
Q

progression of perio dx

A
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4
Q

Major cause of tooth loss in
patients > 35 years

A

perio dx

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5
Q

Severity of perio disease increases with

A

*Age
*Amount of plaque
*Amount of bacterial micro-flora

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6
Q

Periodontal Disease
Predisposing Factors

A

A) Plaque retention
B) Salivary Immune Factors
C) Cell mediated hypersensitivity in crevicular plaque
D) Local dental factors
- poor restorations, Calculus (tartar), Tilted/rotated tooth= plaque traps
- Thin bone more sus to destruction

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7
Q

Periodontal disease
Clinical Signs

A
  • Edema, erythema of the tissues
  • Loss of epithelial attachment to
    tooth surface and pocket formation
  • Bleeding on probing
  • Purulence
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8
Q

Radiographic Examination of perio dx bone

A

–quantity; relative to root length
- quantity; crestal evaluation
- quality
- furcation involvment as plaque trap
- PDL space

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9
Q

forms of alveolar bone loss

A
  • GENERALIZED
  • LOCALIZED
  • HORIZONTAL
  • VERTICAL
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10
Q

generalized vs localized bone loss

A

Generalized: > 75 % of existing dentition
Localized: Specify locations i.e. #7-D,
#30-M,D

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11
Q

Radiographic Examination aspects of Roots in perio dx

A
  • length
  • shape –conical, diverging, curves,
    dilaceration, etc…
  • crown:root ratio
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12
Q

if roots are in close proximity what is the effect?

A

thinner bone btwn them: more sus to destruction

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13
Q

coverging/diverging roots and effects

A

converging roots are nt as supported whereas the diverging roots are more supported

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14
Q

Radiographic examination of
ROOT ANATOMY factors

A
  • Length
  • Atypical multiple roots
  • Proximity to adjacent roots
  • Shape (Conical, Curves (accentuated or “S”), Dilaceration, Diverging vs. converging, Hypercementosis)
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15
Q

Dilaceration
causes?

A
  • Abnormal angulation or bend in the root (and occasionally the crown) of a tooth
  • Some related to trauma during odontogenesis
  • idiopathic
  • can increase perio support of tooth
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16
Q

root?

A

dilaceration

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17
Q
A

dilaceration

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18
Q

local predisposing factors of perio dx

A
  • restorations
  • calculus
  • tilted rotated teeth: ie, uneven marginal
    ridges
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19
Q
A

calculus

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20
Q

how can we best demonstrate calculus

A

demonstrate best with “bright” densities (lighten the image)

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21
Q

Radiographic Changes in
Periodontal Disease

A
    1. Horizontal Bone Loss
    1. Vertical Bone Loss
    1. Furcation Involvement
    1. Large crown:root Ratio
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22
Q

Definition of Horizontal Bone Loss:

A

Even/uniform apical movement of the alveolar crestal bone height along adjacent root surfaces between affected tooth/teeth
SLOW ADVANCING FRONT

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23
Q

around tooth?

A

follicular space

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24
Q

what is the follicular space significance

A

this is where the bone will attatch to the tooth establishing horizontal level
always apical to the CEJ (1.3-1.5mm)

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25
Q

around teeth

A

follicular space

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26
Q

Posterior Dentition in
Health
- shape/crest?
- physiologic bone height?

A
  • flat (plateau), corticated crest
  • physiologic bone height is
    <2.0mm from CEJs
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27
Q

Anterior Dentition in
Health
shape/crest?
bone height?

A
  • pointed, corticated crest
  • physiologic height is <2.0mm from CEJs
28
Q

health?

A

healthy?

29
Q

healthy?

A

yes

30
Q

Radiographic Description of
Periodontal Bone Loss classes

A
    1. Incipient bone loss –slight crestal bone loss of < 1.0 –2.0mm, but less than 20%
    1. Moderate bone loss –evidence of ~20% up to 50% bone loss
    1. Advanced bone loss –evidence of 50% or more of bone loss; evidence of vertical defects
31
Q

Incipient bone loss
- shape/crest?
- bone level to physiologic height?
- mm?, but less than %?

A
  • blunted, non-corticated crest
  • bone level is apical to
    physiologic height
  • < 1.0 – 2.0mm, but less than
    20%
32
Q

bone loss?

A

incipient bone loss

33
Q

Moderate Bone Loss
- shape of crest
- prominent loss of?

A

blunted, non-corticated crest
- prominent loss of alveolar bone height

34
Q

bone loss?

A

moderate bone loss

35
Q

Moderate vs. Advanced Bone Loss
-shape of crest
- prominent loss of?

A
  • blunted, non-corticated crest
  • prominent loss of alveolar bone height
36
Q

Advanced (severe)Bone Loss
-shape of crest
- prominent loss of? %? evidence of what defects?
- crown:root ratio ?

A
  • prominent loss of alveolar bone height; evidence of 50% or more of bone loss; evidence of vertical defects
  • crown:root ratio > 1:2
37
Q

bone?

A

advanced bone loss

38
Q

bone loss

A

advanced

39
Q

is this bone loss?

A

no WNL

40
Q

initial changes of perio dx in posterior

A

Loss of cortication but minimal loss of height

41
Q

what is happening?

A

loss of cortication and height of bone

42
Q

Definition of Vertical Bone Loss:

A

Angular bone loss along a root that more severely involves the affected tooth/teeth than the adjacent teeth

43
Q

what is happening at the mesial

A

vertical bone loss

44
Q

what bony defect is this?

A

vertical bone defect

45
Q

RADIOGRAPHIC EXAMINATION OF FURCATIONS
loss of?
can occur with?

A
  • Loss of bone in the furcation area of a multi-rooted tooth
  • Can occur with HBL and VBL
46
Q

what is happening at the molar?

A

furcation involvement with HBL/VBL (M)

47
Q
A

furcation involvemwnt with VBL

48
Q

Crown:Root Ratio
* Defined as?
* gives an indication of?
* poor prognosis with?

A
  • Defined as: Length of radiographic crown Length of radiographic root
  • An index expressed as a ratio that givesan indication of a tooth’s prognosis
  • A ratio of more than (>) 1:2 has a poor prognosis
49
Q

radiographic crown

A

all of the crown above the alveolar crest

50
Q

radiographic root

A

root below the alveolar crest

51
Q

Radiographic examination
limitations
* Accuracy requires what % demin?
* 2-D Infra-bony defects?
* Soft-tissue?
* No Information on?
* Difficult to assess disease where?
* Mobility?

A
  • Accuracy 40 - 50% demineralization necessary for radiographic changes
  • 2-D Infra-bony defects difficult to observe
  • Soft-tissue Changes edema, color, plaque
  • No Information on relationship of soft tissue to hard tissue i.e., pocketing
  • Difficult to assess disease on B and Li bone plates adjacent B and Li tooth surfaces
  • Mobility
52
Q

Periodontal Disease Treatment

A
    1. Plaque control
    1. Antimicrobial agents
      – Topical
      – systemic
  • 3.Professional Cleaning, scaling, root planning, curretage
  • 4.Surgical techniques to re-establish physiologic contours
53
Q

which is moderate loss? which is advanced?

A

L: moderate
R: advanced

54
Q

what is the follicular space significance

A

this is where the bone will attatch to the tooth establishing horizontal level
always apical to the CEJ (1.3-1.5mm)

55
Q

how can an alveolar crest that is angled be healthy?

A

this can be angled so long as it is parallel to a plane formed by adjecent teeth CEJ

56
Q

what anatomical strucutre becomes more prevalent with chronic bone loss?

A

nutrient canals

57
Q
A

nutrient canals

58
Q
A

loss of cortication

59
Q
A

loss of cortication with horizontal bone loss

60
Q
A

loss of cortication

61
Q

what bone loss is present

A

horizontal but some veritcal at the 1st molar

62
Q

H or V?

A

both are occuring

63
Q

how are furcations involved with HBL/VBL

A

when these become involved with bone loss they can worsen the effects by acting as plaque traps

64
Q

crown root ratio

A

2:1, bad prognosis

65
Q

crown to root ratio

A

1:0 (infinity), bad prognosis

66
Q

Crown root ratio

A

approx 6:1, bad

RADIO INTERPRETATION (18 decks)

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