perio exam 2: chronic perio Flashcards

1
Q

clinical features of chronic perio 10:

A
  1. ging morphology changes like color texture volume
  2. bop
  3. inc probe depth
  4. att loss disease hallmark
  5. ging recession
  6. alveolar bone loss
  7. furcation involvement
  8. increased tooth mobility
  9. drifting of teeth
  10. tooth loss
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2
Q

oes probing depth =Aloss? (att loss)

A

no!

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3
Q

what is the normal level of the cej from the bone?

A

2mm; >2 maybe bone loss

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4
Q

symptoms of chronic perio

A
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 gums
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5
Q

define extent and severity

A

extent-how many sites and severity-how bad

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6
Q

extent categories

A

extent-

localized 30% of sites or less v generalized-over 30%

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7
Q

severity categories

A
severity:
slight
1-2mm
moderate
3-4 mm
severe
5mm and +
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8
Q

typical diagnosis?

A

generalized slight with localized moderate chronic perio

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9
Q

population distribution of disease severity
% very susceptible=?
% mixed susceptibility=?
% not susceptible=?

A

10%;80%10%

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10
Q

assessing risk for disease

define risk factor

A

env, bacterial, behavioral, or biological factors that when present inc likelihood of developing the disease

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11
Q

assessing risk for disease

risk factors

A

longitudinal evidence and intervention can modify risk factors ex. smoking and diabetes

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12
Q

smoking and cp

A

more fibrous;

my notes: studies suggest stop smoking eliminate like ~50% of perio

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13
Q

assessing risk for disease

risk determinant: non modifiables (2)

A
  1. age

2. gender

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14
Q

risk indicators-define and 3 ex’s

A

putative factors id’ed in cross section but not confirmed longitudinally

  1. hiv/aids
  2. osteoporosis
  3. infrequent dental visits
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15
Q

risk markers/predictors define and 3 ex’s

A

a characteristic associated with elevated risk for disease but may not be part of the causal disease chain

  1. furcation involvement
  2. calculus
  3. history of att loss
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16
Q

gingivitis as a risk factor-past

A

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

17
Q

gingivitis as a risk factor

A

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

18
Q

att loss-risk increases with ?

A

age

19
Q

epidemology NHANES
us pop w/perio?

mild
moderate
severe?

A
us pop w/perio=47% (65 million ppl)
of entire us pop:
mild 8.7% 
moderate 30% 
severe?8.5%
20
Q

epidemology NHANES
over 65 us pop w/perio?
highest prevalence in whom?

A

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

21
Q

severe perio is what # most prevalent disease in the world?

why is it increasing?

A

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)

22
Q

progression (pin like/rows and slide text covered by images…) page 10-find/compare notes!

A

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

23
Q

diagnosis 1 (5)

A
  1. probing depth
  2. ging recession
  3. CAL-probing depth + ging recession
  4. BOP-% of total sites
  5. furcation involvement
24
Q

diagnosis 2 (3)

A
  1. mobility
    2.fremitus-mobitiliy of a tooth in occlusion
    3.bone defects
    horizontal/vertical
    1 wall v two walled v 3 walled
25
Q

boney defects

A

1 walled v two walled v 3 walled or circumferential, never calculate the base when adding the defective walls

26
Q

tx goals of therapy:

A

eliminate etiology, and or reduce risk factors, prevent reoccurance

27
Q

initial perio therapy

A

remove both sub and supra gingival plaque, oral hygiene, remove local and systemic factors

28
Q

treatment 2

rationale for perio therapy

A

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!)

29
Q

outcomes of initial therapy

A

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)

30
Q

outcomes of initial therapy

pg 13-i am not following this…

A

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)

31
Q

outcomes of initial therapy 2

A

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!