perio exam 2: chronic perio Flashcards
clinical features of chronic perio 10:
- ging morphology changes like color texture volume
- bop
- inc probe depth
- att loss disease hallmark
- ging recession
- alveolar bone loss
- furcation involvement
- increased tooth mobility
- drifting of teeth
- tooth loss
oes probing depth =Aloss? (att loss)
no!
what is the normal level of the cej from the bone?
2mm; >2 maybe bone loss
symptoms of chronic perio
1. mostly painless
localized dull pain/gingival tenderness, itching gums
2. loose teeth
3. food impaction
4. drifted teeth/inc spacing
5. root sensitivity
6. bleeding gumsdefine extent and severity
extent-how many sites and severity-how bad
extent categories
extent-
localized 30% of sites or less v generalized-over 30%
severity categories
severity: slight 1-2mm moderate 3-4 mm severe 5mm and +
typical diagnosis?
generalized slight with localized moderate chronic perio
population distribution of disease severity
% very susceptible=?
% mixed susceptibility=?
% not susceptible=?
10%;80%10%
assessing risk for disease
define risk factor
env, bacterial, behavioral, or biological factors that when present inc likelihood of developing the disease
assessing risk for disease
risk factors
longitudinal evidence and intervention can modify risk factors ex. smoking and diabetes
smoking and cp
more fibrous;
my notes: studies suggest stop smoking eliminate like ~50% of perio
assessing risk for disease
risk determinant: non modifiables (2)
- age
2. gender
risk indicators-define and 3 ex’s
putative factors id’ed in cross section but not confirmed longitudinally
- hiv/aids
- osteoporosis
- infrequent dental visits
risk markers/predictors define and 3 ex’s
a characteristic associated with elevated risk for disease but may not be part of the causal disease chain
- furcation involvement
- calculus
- history of att loss
gingivitis as a risk factor-past
early studies-all ging led to perio
later-ging and cp separate
(past or current?) ging can be stable for years, B pq induces ging but host response determines if chronic perio will develop
gingivitis as a risk factor
now-ging and cp=diff aspects of the same disease
chinese studies-ging infmm a risk for a loss at any site
norwegian study-tooth loss greater in sites with baseline severe ging infmm
lang: absence of ging=good indicator if perio health
att loss-risk increases with ?
age
epidemology NHANES
us pop w/perio?
mild
moderate
severe?
us pop w/perio=47% (65 million ppl) of entire us pop: mild 8.7% moderate 30% severe?8.5%
epidemology NHANES
over 65 us pop w/perio?
highest prevalence in whom?
64% had moderate or severe
highest in currently smoking, mexican american men with less than a high school education and 100% below the federal poverty levels
severe perio is what # most prevalent disease in the world?
why is it increasing?
6th most prevalent disease in the world!
inc due to growing world pop
inc life expectancy
decreases in tooth loss (aka more teeth to get perio)
progression (pin like/rows and slide text covered by images…) page 10-find/compare notes!
main idea: destruction can keep going once it starts and only have the rate change or be a burst
asynchronous- defined period of life where most starts. sometime a burst the consistent
diagnosis 1 (5)
- probing depth
- ging recession
- CAL-probing depth + ging recession
- BOP-% of total sites
- furcation involvement
diagnosis 2 (3)
- mobility
2.fremitus-mobitiliy of a tooth in occlusion
3.bone defects
horizontal/vertical
1 wall v two walled v 3 walled
boney defects
1 walled v two walled v 3 walled or circumferential, never calculate the base when adding the defective walls
tx goals of therapy:
eliminate etiology, and or reduce risk factors, prevent reoccurance
initial perio therapy
remove both sub and supra gingival plaque, oral hygiene, remove local and systemic factors
treatment 2
rationale for perio therapy
it’s effective=at or less than .1 tooth loss/year
vs noncompliant pts at .2/yr (2x)
untreated pts-.6/year! (6 teeth in 10 years!)
outcomes of initial therapy
probing depth reduction
ging recession, gain of clinical att and pocket shrinkage
sites w/initially shallow pockets tend to lose CAL (possible trauma)
critical probing depth (lindhe)-probe depths less than which root planing will cause att loss (2.9 mm)
outcomes of initial therapy
pg 13-i am not following this…
sites w/initially shallow pockets tend to lose CAL (possible trauma)
critical probing depth (lindhe)-probe depths less than which root planing will cause att loss (2.9 mm)
outcomes of initial therapy 2
greater risk for additional att loss if presenting multiple sites with residual probing depths greater than or equal to 6 mm after active tx
so…You can’t maintain pockets over 6 mm and book em for surgery!
