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perio > Perio Final > Flashcards

Perio Final Flashcards

1
Q

driving force behind all major related disorders?

A

inflammaton

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2
Q

___ of americans over 30 yos have PD

A

1/2

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3
Q

3 aspects of pathogensis of PD and systemic diseaeas

A

infection

inflamma

adaptive immunity

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4
Q

6 systemic links to PD

A

CV disease

respiratory

diabetes

RA

osteoporoesis

pre term baby

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5
Q

TF

more likely to have diabetes if you ahve PERIODONTAL INFLAMMATION

A

TURE

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6
Q

TF

earlier have diabetes -> earlier have PD

why?

A

true

PD play a role in woresening glycemic control

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7
Q

____ is significant predictor of PD and is independent of

age

smking

race

ethinicty

A

obesity

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8
Q

which types of diabtetes increases the risk of PD?

But type I has a ___ and ___ inflammatory response to bac

A

I and II

type I has eariler and higher inflamm

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9
Q

_____ mediates the relations bt obesitty and PD

A

insulin resistance

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10
Q

___ of US americans are overweight

A

60%

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11
Q

obesity

10x fold of being ____

3x fold of gettting ____

A

10x = diabetic

3x = PD

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12
Q

___ and ___ which contribute to systemic hyperinflammation, increase hyperlipidemia and increase insulin resistance

A

IL 6 and TNF alpha

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13
Q

Diabetic patients with severe PD has a ___worsening of glycemic control over 2 years

A

6x

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14
Q

HB1Ac

A

life of RBC

120 days

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15
Q

if pt is above 7% of Hb

is 170 =?

A

high

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16
Q

deep pockets = ____

in NON diabettics

A

impaired glucose tolerance

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17
Q

TF

Poor control diabetic patients have worse periodontal status than control subject, but well controlled diabetic patients have PD status similar to controls

A

true

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18
Q

TF

periodontal pathogens can contribute to atherolscerolsis

A

true

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19
Q

TF

pt with artificial heart valves are they at greater risk?

A

true

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20
Q

smokers are ___ x faster bone loss than non smokers

A

4x

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21
Q

tf

bruxers [occlusal factors] increases the rate of bone loss

A

debatable

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22
Q

in healthy tissue pocket depth is

A

1 - 3 mm

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23
Q

pseudopockets are created how?

are they reversible?

A

during gingivitis the coronal movment of the gingival margin creates these psudeopockets

yes reversible, remove inflamma and returns to normal

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24
Q

___ is activated during the 2nd stage of PD and destroys CT fibers [attachment loss] and bone loss

A

osteoclast

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25
Q

why do deeper pockets favor bioflim accumulation

A

cleansibiity of pt and for us to get in with instruments

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26
Q

4 ways to repair/ eliminate pockets

repair

resection

regeneration

extraction

A
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27
Q

repair

A

create LONG junctional epithelium

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28
Q

resection

A

excise the wall of the pocket

trim the gingiva [soft tissue] DOWN to the level of the BONE

GINGIVA, DOWN, BONE LEVEL

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29
Q

regeneration

A

REGROW

bone to the level of soft tissue

REGROW, BONE, SOF TISSUE

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30
Q

tx of PD [a ROOT SURFACE DISEASE , not in bone or soft tissue] invovles

A

complete ELIMINATion of clean surface = HAVE TO DO SRP

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31
Q

the most important factor for LONG TERM SUCCESS

A

OHI

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32
Q

repair

SRP is better on atnerior teeth bc

A

1 root

no furcation

easy access

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33
Q

SRP is predicatble and effective in pockets up to

A

5 mm

34
Q

epithelial cells [gingiva] - _____ - tooth surface

A

epi cells attach to desmosomes to tooth surface [LONG JUNCTIONAL EPI

35
Q

2 WAYS ELIMINATE POCKETS WITH SRP

A
  1. tissue shrinkage = gingival recession
36
Q
  1. adherence of gingiva [epithelial cells] via desmosomes to the junctional epithelium = long junctional epi
A
37
Q

waht is the main purpose of periodntal surgery

A

enhance the surgeons ability to do SRP

38
Q

deep pockets

A

greater tahn 5 mm

and BOP

39
Q

waht is the main reason we do perio surgery

A
  1. access for SRP
  2. pocket reduction
40
Q

2nd reason we do periodntal surgery

A

easy env for maintanence control

41
Q

3 reasons for doing gingivectomy

A
  1. lots of keratinzed attached gingiva
  2. no osseous defects
  3. drug induced irregular gingival contour [overgrowth]
42
Q

3 reasons NOT to do gingivectomy

A
  1. little keratinized attached gingiva
  2. has osseous defects
  3. if pt HIGH RISK OF post-operative BLEEDING

[taking plavix, coumadin, baby asprin]

43
Q

how many days shoud peple taking baby asprin, coumadin, and plavix stop B4 perio surgery

A

4 - 7 das

44
Q

if blood sugar for diabetic is b/t 150 -180 progronossi for healing is ?

greater than 180?

A

150 - 180 = good

+180 = BAD tissue wont heal

45
Q

open wound is bad for gingivectomy bc

A
  1. possible post operative bleeding
  2. possibly post operative discomfort
46
Q

3 things periodontal flaps do

A
  1. provide access to root and osseous defects
  2. eliminate pocket
  3. primary closure [minimize trauma and more comfort to pt]
47
Q

beveled incisions are usually used for

A

gingivectomy

48
Q

reversed bevel for

A

sulcular incisions

flap surgery

49
Q

advantage of vertical incison

A
  1. increase access
  2. increased flap mobility
50
Q

vertical incisors would you rather

split a papilla

incise over a radicular root surface [prominent root surface]

A

radicular surface

51
Q

vertical incisors

disadvantage

  1. severe neurovascular bundeles
  2. compromised blood suppy
A

greater palatine artery [distal to the 1st molar max]

lingual nerve [distal to the lwer 1st molar]

mental nerve [mesial to the lower 2nd pm]

  1. flap necrosis

and delayed wound healing

52
Q

long narrow flap

margin > base

A

vertical incisons

53
Q

flap fundamentals

i.e. CS

A

incison

elevation

coaptation

suturing

54
Q

elevations

full thickness flap aka

A

mucoperiosteal flap

55
Q

full flap thickness = mucoperiosteal flap

partial thickness = split thickness flap

A
56
Q

flap coaptation

non displaced flap

apicall displaced flap

A
57
Q

non displaced flap

A

bone defect within the attached kera gingiva:

  1. can do a scallop incision
  2. reposition witout displacement
58
Q

apically displaced flap

A

bony defect beyond the mucogingival junction:

  1. flap apically displaced
  2. preserve keratinized tissue
59
Q

incisions that are staying close to the tooth as much as possible

A

submarginal incison

60
Q

what type of flaps

if you are looking at bone =

if you are looking at tissue =

A

bone = full thickenss flap = non displaced flap or apically displaced flap

tissue = partial thickness flap = apically dispalced flap

61
Q

where is the tissue thinnest

A

mucogingival junction

62
Q

when you make a vertical incision over the radicular part of the root [root prominence] there is a lot of tension and can result in what?

also if you make and incson in the mucosa you can get this as well

A

scarring

63
Q

indications for distal flap

A

distal angular defects

distal furcation

64
Q

3rd molar extractions is a good example of waht type of flap technique

A

distal falp

65
Q

waht type of flap techniques is when you make an incision and the two incisions meet

A

distal wedge flap

66
Q

for distal wedge incisions should be made how far apart?

A

1/2 - 2/3 distal probe depth

NEVER BEYOND THE LINE ANGLE

67
Q

for horizontal inscisons:

how do you know where to make the incison

A

1/2 - 2/3 the probe debth

68
Q

4 reasons to do INTERNAL bevel incision

A
  1. rid inflammed pocket
  2. conserve kera tissue
  3. primary closure is mini trauma and reduce discofmromt [primary healing]
  4. SHARP, thin flap margin
69
Q

modified distal wedge

A

do a vertical incison to merge the to incisons

70
Q

for edentulous areas its better to do waht type of suture

A

simple

71
Q

distal flap procedure

wrap around the tooth

A

figure 8 suture

72
Q

simple suture

figure 8 suture

anchor suture

continous sling suture

A

continuous sling suture - suture the buccal then lingual falp and anchored around the tooth

73
Q

tf

continus sling suture needs only one knot since it is continuous

A

true

74
Q

how far does the suturing have to be from the flap margin

A

at least 3 mm

75
Q

normal week 1 healing

A

swelling = edema

erythmea

NO tissue NECROSIS

76
Q

if there is tissue necrosis waht does that mean?

and waht does that indicate clinically

A

immune system suppressed

= POOR WOUND HEALING

77
Q

how long does it take for tissue necrosis to heal

A

4 weekq

78
Q

2 types of regenerative

A

papilla preservation flap

conventional flap

79
Q

indications for papilla preservation flap for regneration

A
  1. need interdental space LARGE ENOUGH for push back

[if not tissue necrosis]

  1. scallop incision on the palatal side
  2. push whole papilla back in
80
Q

what is papilla preservation used mostly for?

A

esthetic areas

81
Q

further therapy = perio surgery

  1. esthetic areas
  2. non esthetic areas
A

esthetics:

  1. perioscopy
  2. conservative surgery [but tend to stay away]

non esthetic:

  1. resective
  2. regneration
82
Q
A

perio (5 decks)

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