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dentures > perio exam 2 > Flashcards

perio exam 2 Flashcards

1
Q

is bop sensitive?

A

no, b/c trauma could also cause bleeding. it is specific-if no bleeding then there is a great chance pt is healthy

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2
Q

gingivitis ( dental pq only) …

A

can have local contributing factors

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3
Q

ging w/ systemic disease modification

A

endocrine association or blood discrasias (ex. leukemia associated)
(which drug from pharm causes that?)

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4
Q

ging w/ systemic disease modification:

endocrine association ex’s:

A

puberty associated, menstrual cycle, pregnancy, diabetes

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5
Q

ging modified by meds

A

ging enlargements, oral contraceptives

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6
Q

ging from malnutrition

A

vit c deficiency or lack of vit A, B2, and B12 complex

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7
Q

summary slide: pq should be there for ging

A

unless pregnant or medicated

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8
Q

ging around implants

A

peri-mucositis

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9
Q

6 characteristics to all ging diseases:

A
  1. signs/symptoms limited to ging
  2. precursor-pq
  3. clinical signs of infmm
  4. no att loss or on a stable but reduced periodontium
  5. reversibility of the disease by removing the etiology
  6. possible role as a precursor of att loss
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10
Q

11 characterists of pq induced ging

A
  1. pq @ margin
  2. margin-start of disease
    change in:
    3.color 4. contour 5. sucular temp
  3. incresed gingival exudate
  4. absence of att loss
  5. absence of bone loss/9.bone loss
    9.histological changes
    10reversible w/pq removal
  6. bop
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11
Q

color: normal ging v. inflammed v. severly infmm

A

coral pink, tissue’s vascularity and overlying eli intact v. red and not intact v. red and CYANOTIC; vascular proflieration, decreased keratin and venous stasis

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12
Q

where do the color changes start?

A

g. margin and interdental papilla then spread to the att g

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13
Q

g bleeding: w/ inc infmm…
chronic/recurrent bleeding
when is there spontaneous bleeding?

A

inc infmm.. engorged caps, thinning/ulceration of the sulcular epi.
chronic/recurrent bleeding from trauma
spontaneous bleeding=acute/severe cases-maybe related to systemic disease

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14
Q

healthy adjectives

A

health=firm/resilliant w/dull surface texture (stippling maybe) and scalloped ging fills interdental spaces (papilla there)

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15
Q

what can lead to leathery, firm ging consistency?

A

chronic g can indue fibrosis and eli proliferation

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16
Q

infmm v. severe infmm descriptions

A

infmm=extracellular fl and exudate, degeneration of ct & epi, engorged ct/thin epi, and knife edged ging w/loose margins
sometimes clefts (Stillman’s) or festoons (McCalls) may develop
infmm w/ exudate=smooth and shiney,
infmm w/fibrotic changes=nodular and firm
swollen, soft, friable
severe: sloughing w/grayish flake-like debris (necrosis)

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17
Q

mild gingivitis

PD-? mm Plaque ?% BOP ? %

A

PD-1.5-3 mm Plaque 50% BOP 15 %

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18
Q

moderate gingivitis

PD-? mm Plaque ?% BOP ? %

A

PD-3-4 mm Plaque 50% BOP 30%

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19
Q

severe gingivitis

PD-? mm Plaque ?% BOP ? %

A

PD-pseudopockets to 5 mm Plaque 50% BOP 80 %
(no att loss still!)
all had same pq comp-BOP %’s changed

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20
Q

ging enlargement-3 descriptions

A
  1. chronic infmm response characteristic w/exudate and proliferative features
  2. clinically deep red lesions w/soft, friable, smooth, shiny surface and bleeding tendency
  3. relatively firm resilient and pink lesions w/ greater fibrotic component, abundant fibroblasts and collagen fibers
    (3 said “also”, I hope as in “could be this instead” vs. 2 and 3 together….)
21
Q

What is/are the primary etiological factor(s) for ging?

A

bacterial plaque

22
Q

What is/are the secondary etiological factor(s) for ging?

A

local factors such as 1. calculus 2.marginal deficiencies 3.malocclusion 4.tooth/root anomalies (enamel pearls/cemental tears) 5. BW 6. roots fractures 7. cervical toot reabs

23
Q

BW=?

A 
histo dimensions of the dento-gingivl junction
health .69-sulcus
.97=epi attachment
1.07-ct
total 2.73
24
Q

bw = a min of ?mm coronal to alveolar crest?

A

3 mm

25
Q

does perio start with gingivitis

A

YEES!

26
Q

does gingivitis progress to perio?

A

not always!

27
Q

define recurrent periodontitis

A

return of infmm to the sites treated. recurrent periodontitis may be confined to the ging tissue and may not cause further attachment loss.

28
Q

with ging modified by endocrine factors, do you need to have plaque?

A

YES! (page 11)

ex.’s pregnancy, puberty and menstral cycle

29
Q

pregnancy associated ging-the microbiota is characteristic of what?

A

microbiota is characteristic of ging

30
Q

exaggerated localized host response modulated by what hormones?

A

modified by levels of endogenous hormones (estrogens, androgens, progesterone)

31
Q

changes with pregnancy associated ging appear in what trimester?

A

the 2nd trimester and regress upon parturition (birth)

32
Q

puberty associated gingivitis-what is a secondary factor?

A

mouth breathing

33
Q

puberty associated gingivitis: localized host response mediated by…

A

high hormones, estrogen, testosterone

34
Q

do clinically detectable changes seem to be associated with the menstrual cycle?

A

no but and inc in GCF (ging crevicular fl) by 20% described

35
Q

pyogenic granuloma of pregnancy…
arises from…
presentation timeline…

A

highly vascularized mass of granuloma tissue
arises from prix ging tissues and has a pedunculated base
2nd or 3rd trimester

36
Q

ging modified by systemic conditions (5)

A 
diabetes ! & II, 
leukemias and other blood dysplasias, 
acute  myeloid leukemia associated w/ ging changes,
 cyclic neutropenia, 
thrombocytopenia
37
Q

what are the ging modifications with cyclic neutropenia?

A

ulcerations (14-36 days per cycle)

38
Q

what are the ging modifications with thrombocytopenia?

A

persistent unexplained ging bleeding

now explained lol

39
Q

what are three drugs associated with ging overgrowth?

A

1.anticonvulsants (phenytoin or epinutin)
2. immunosuppressants (cyclosporin A)
3.ca2+ channel blockers (Nifedipine)
why didn’t we learn that one in pharm….?

40
Q

Necrotizing ulcerative ging (nug)

A

pt’s: adolescents, smokers or psychological stress, have
pain, ulceration and necrosis of interdental papillae*, bleeding
*starts there

41
Q

Necrotizing ulcerative ging (nug)-what’s often required for resolution?

A

systemic antibiotics

42
Q

what’s the differential diagnosis for Necrotizing ulcerative ging (nug)?

A

primary herpatic gingivostomatitis

43
Q

Necrotizing ulcerative ging (nug)-predisposing factors

A

systemic disease ex. ulcerative colitis, blood dyscrasias, nutritional deficiency states
white blood cell function compromised
AIDS pts

44
Q

is nug associated with peril att loss?

A

yes

45
Q

what can nug progress to?

A

can progress to noma or cancrum oris

noma (wiki): “Noma is a rapidly progressive, polymicrobial, opportunistic infection that occurs during periods of compromised immune function. estimates that 80-90% die from it”

46
Q

differential diagnosis nug vs herpes (PHS)

A

nug=bacterial and noncontagious vs.herpes-very contagious
nug NOT in attached ging
herpes=everywhere

47
Q

symptoms nug v. PHS

A

ulcerative tissue, yellowish white plaque

mult vesicles burst leaving sm round fibrin covered ulcers (phs)

48
Q

duration nug vs phs

A

1-2 days if treated for nug w/anitb’s

1-2 wks phs

dentures (5 decks)

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