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Perio > Perio Final Review > Flashcards

Perio Final Review Flashcards

1
Q

the tissues of the periodontium

A

gingiva cementum PDL alveolar bone

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2
Q

protects underlying tooth structures from oral environment

A

gingiva

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3
Q

suspends and maintains the tooth in the socket

A

PDL

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4
Q

hard, mineralized tissue that attaches to the dentin

A

cementum

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5
Q

protects the dentin and compensates for tooth wear

A

cementum

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6
Q

valley like depression apical to the contact area of 2 adjacent teeth that connects facial and lingual papillae

A

gingival col

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7
Q

there will be no col if

A

there is a large space in between 2 teeth

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8
Q

5 functions of the PDL

A

tooth support sensory nutrition cementoblasts/osteoblasts bone remodeling

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9
Q

primary function of cementum

A

PDL attachment

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10
Q

terminal endings of periodontal ligaments attached to the cementum

A

sharpeys fibers

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11
Q

seals the ends of open dentinal tubules

A

cementum

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12
Q

compensates for occlusal attrition to maintain tooth length

A

cementum

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13
Q

excess cementum in apical 1/3 of root

A

hypercementosis (radiopaque)

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14
Q

sensitive to mechanical forces and inflammation

A

alveolar bone

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15
Q

compact bone

A

cortical bone

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16
Q

bone closest to the PDL

A

ABP

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17
Q

cementum that is closer to the oral cavity; doesn’t rebuild

A

acelluar cementum

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18
Q

covers cervical 1/3 of root; closer to the oral cavity; doesn’t rebuild

A

acelluar cementum

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19
Q

covers the apical half of root; continuously deposited; thickness increases w/age

A

cellular cementum

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20
Q

the process which epithelial cells on the surface of the skin become stronger and waterproof

A

keratinization

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21
Q

type of epithelium that comprises flat cells arranged in several layers

A

stratified squamous epithelium

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22
Q

cell to basal lamina connection

A

hemidesmosomes

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23
Q

connect neighboring epithelial cells together

A

desmosomes

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24
Q

located at base of sulcus

A

JE

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25
Q

connect neighboring epithelial cells together; “cell-to-cell”

A

desmosomes

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26
Q

covers the free and attached gingiva

A

oral epithelium (OE)

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27
Q

network of roselike collagen fiber bundles located coronal to the crest of the alveolar bone

A

supragingival fiber bundles

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28
Q

brace the free gingiva firmly against the tooth and reinforce the attachment of the JE to the tooth

A

supragingival fiber bundles

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29
Q

connect adjacent teeth to one another to control tooth positions within the dental arch

A

supragingival fiber bundles

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30
Q

5 principal fiber groups of PDL

A

horizontal oblique interradicular apical alveolar crest

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31
Q

3 possible arrangements of the enamel & cementum

A

overlap meet gap (OMG)

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32
Q

sequence of events that occur during the development of a disease or abnormal condition

A

pathogenesis

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33
Q

sequence of events that occur during the development of a disease or abnormal condition

A

pathogenesis

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34
Q

fibers that are regenerated continuously and separated the site of inflammation from remaining alveolar bone

A

transseptal fibers

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35
Q

in health, the crest of the alveolar bone is located approx. ___ mm apical to the CEJs

A

2mm

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36
Q

suprabony defects are

A

horizontal

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37
Q

infrabony defects are

A

vertical

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38
Q

infrabony defects are more _______ than suprabony defects

A

aggressive & complex

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39
Q

describing health of the gingiva

A

color size consistency texture position of margin shape bleeding/exudate

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40
Q

describing health of the gingiva

A

color size consistency texture position of margin shape bleeding/exudate

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41
Q

a type of periodontal disease characterized by apical migration of JE, connective tissue loss, and alveolar bone loss

A

periodontitis

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42
Q

gingivitis that may exist without ever progressing to periodontitis; resolves upon professional care/self care; tissues can appear bluish/red to purplish (usually no pain)

A

chronic

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43
Q

papillary inflammation includes

A

interdental

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44
Q

marginal inflammation includes

A

margins papillary

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45
Q

diffuse inflammation include

A

gingival margin papilla attached gingiva

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46
Q

modifying factors for dental biofilm-induced gingivitis

A

systemic conditions oral factors drug influenced

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47
Q

NAME THE STAGE 1-2 mm CAL RBL coronal 1/3 <15% No tooth los Max PD

A

Stage I

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48
Q

NAME THE GRADE -no loss over 5 yrs -heavy biofilm deposits w/low levels of destruction -

A

A

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49
Q

NAME THE STAGE CAL: 1 - 2 mm RBL: coronal 1/3 (<15%) No tooth loss Max PD = 4mm Mostly horizontal bone loss

A

Stage I

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50
Q

NAME THE STAGE CAL: 3 - 4mm RBL: coronal 1/3 15-33% No tooth loss Max PD >/= 5mm Mostly horizontal bone loss

A

stage II

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51
Q

NAME THE STAGE: CAL: >/= 5mm RBL: middle 1/3 & beyond Tooth loss: = 4 teeth PD: >/= 6mm Vertical bone loss: >/= 3mm Class 1 or 2 furcation Moderate ridge defects

A

Stage III

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52
Q

NAME THE STAGE CAL: >/= 5mm RBL: middle 1/3 & beyond Tooth loss: >/= 5 teeth PD: >/= 6mm Vertical bone loss: >/= 3mm Class 1 or 2 furcation Masticatory dysfunction Secondary occlusal trauma Bite collapse, drifting, flaring Severe ridge defects 20 remaining teeth

A

Stage IV

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53
Q

assessment data for periodontal diagnosis

A

radiographs med/dental hx gingival observations perio charting

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54
Q

assessment data for periodontal diagnosis

A

radiographs med/dental hx gingival observations perio charting

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55
Q

features of a disease that can be observed or are measurable by a clinician

A

signs

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56
Q

features of a disease that are noticed by the patient

A

symptoms

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57
Q

initial periodontitis stage

A

stage I

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58
Q

moderate periodontitis stage

A

stage II

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59
Q

severe periodontitis w/potential f/tooth loss stage

A

stage III

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60
Q

advanced periodontitis w/extensive tooth loss & potential for loss of dentition

A

stage IV

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61
Q

localized extent of disease is ____% or less of the teeth in the mouth

A

30%

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62
Q

initial periodontitis stage

A

Stage I

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63
Q

moderate periodontitis stage

A

Stage II

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64
Q

severe periodontitis w/potential f/tooth loss stage

A

Stage III

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65
Q

advanced periodontitis w/extensive tooth loss & potential for loss of dentition

A

Stage IV

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66
Q

SHARE approach 5 steps

A

share info discuss & agree on goals jointly review plan record & share plan agree on follow-up schedule jointly develop care plan

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67
Q

needs to have: understandable language opportunity for pt questions assesses pt understanding

A

informed consent

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68
Q

risk factors for periodontal disease

A

smoking systemic disease medications social atmosphere habits periodontal pathogens

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69
Q

periodontal pathogens

A

a. actinomycetemcomitans tannerella forsythia p. gingivalis

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70
Q

occurs when there is a balance between disease-promoting factors and health-promoting factors

A

biologic equilibrium

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71
Q

occurs when there is a balance between disease-promoting factors and health-promoting factors

A

biologic equilibrium

72
Q

a living film of well-organized bacteria that grows on a surface

A

biofilm

73
Q

dense protective barrier; protects bacteria from antibiotics, antimicrobials and the body’s immune system

A

slime layer

74
Q

most effective way to control dental plaque biofilms

A

mechanical cleaning

75
Q

best achieved by brushing, interproximal plaque removal and periodontal instrumentation

A

mechanical cleaning

76
Q

plaque biofilms are the cause of initial inflammation, but the ______ determines the periodontal destruction progresses

A

host response

77
Q

body’s protective response to pathogens, foreign bodies or an injury

A

inflammation

78
Q

capture and destroy bacterial invaders

A

polymorphonuclear leukocytes (PMNs)

79
Q

attracted to bacteria by chemotaxis

A

PMNs

80
Q

contains many strong bactericidal and digestive enzymes called lysosomes

A

PMNs

81
Q

periodontal pathogens are most effectively destroyed by

A

PMNs

82
Q

essential for the control of bacterial infections

A

PMNs

83
Q

large leukocytes with one kidney-shaped nucleus and some granules

A

macrophages

84
Q

highly phagocytic cells that actively engulf and destroy microorganisms

A

macrophages

85
Q

slower to arrive at the infection site than PMNs

A

macrophages

86
Q

macrophages are most numerous in ______ infection

A

chronic

87
Q

TRUE or FALSE PMNs are short lived; macrophages are long-lived

A

TRUE

88
Q

macrophages are in the tissue and when in the bloodstream they are called

A

monocytes

89
Q

secrete antibodies and can further differentiate into plasma B-cells and memory B-cells

A

B-lymphocytes (plasma cells)

90
Q

inflammation

A

**********

91
Q

no symptoms exaggerated host response

A

chronic inflammation

92
Q

heat redness pain loss of function inflammation

A

acute inflammation

93
Q

body’s response to bacteria

A

host response

94
Q

unresolved acute inflammation will progress to

A

sustained chronic inflammation

95
Q

biologically active compounds secreted by immune cells that activate the body’s inflammatory response

A

biochemical mediators (middle men) cytokines, MMPs, prostaglandins

96
Q

regulatory proteins released by host immune cells that influence behavior of other cells

A

cytokines

97
Q

initial tissue destruction and bone loss; play major role in perio

A

cytokines IL1, IL6, IL8, TNF-a

98
Q

inflammatory mediators that increase permeability and dilation of blood vessels

A

prostaglandins

99
Q

can trigger osteoclasts to destroy alveolar bone

A

prostaglandins

100
Q

can promote overproductions of MMPs

A

prostaglandins

101
Q

enzymes that act together to break down the connective tissue matrix

A

MMPs

102
Q

PMNs and gingival fibroblasts are the major source of ____ in periodontitis

A

MMPs

103
Q

increased MMPs cause the destruction of _____ in the periodontal tissues

A

collagen

104
Q

elevated levels lead to greater activation of osteoclasts and bone resorption

A

RANKL

105
Q

binds to RANKL and jams the signal between RANKL and RANK offering bone protection

A

OPG

106
Q

binds to RANKL and jams the signal between RANKL and RANK offering bone protection

A

OPG

107
Q

conditions or diseases that increase an individual’s susceptibility to periodontal infection by modifying or amplifying host response to microbial infection

A

systemic risk factors

108
Q

the relationship between periodontal disease and systemic disease is a

A

two-way street

109
Q

diabetes leads to a hyperinflammatory response to the bacteria in periodontitis and

A

impaired repair

110
Q

the hyperinflammatory response and impaired repair in diabetes are partly mediated by the signaling mechanisms of the

A

AGE-RAGE reaction

111
Q

when glucose in the bloodstream attaches to proteins and lipids, it forms harmful new molecules called

A

advanced glycation end products (AGES)

112
Q

AGE formation is increased in pt’s that have

A

hyperglycemia

113
Q

degrade collagen and elastin causing fibers to lose elasticity

A

AGEs

114
Q

pathologic tissue destructions happens when AGEs interact with

A

RAGEs

115
Q

3 meds that cause gingival enlargement

A

phenytoin (anticonvulsant) cyclosporine (immunosuppressive) nifedipine (calcium channel blocker)

116
Q

what type of contributing factors are listed? restoration overhangs rough surfaces calculus ill-fitting appliances frenum attachments trauma from occlusion

A

local factors

117
Q

calculus is always covered with

A

pathogenic bacteria

118
Q

trauma from occlusion

A

%****************

119
Q

zone of tissue occupied by the JE and connective attachment tissue fibers, approx. 2mm

A

biologic width

120
Q

when violates, the body attempts to re-establish this zone through the inflammatory process

A

biologic width

121
Q

elevated production of both inflammatory cytokines and ROS (reactive O2 species) are linked to

A

obesity

122
Q

how do antioxidants help the body?

A

neutralize free radicals

123
Q

smokers are ___ times more likely to develop periodontal disease

A

7x

124
Q

smoking has a negative effect on fibroblast function and ___________

A

wound healing

125
Q

efficient info-gathering process used to determine the periodontal health of the pt

A

periodontal screening

126
Q

intensive info-gathering process used to gather detailed data needed to make a periodontal dx and to document periodontal health of a pt for long-term monitoring

A

comprehensive periodontal assessment

127
Q

components of a CPC

A

-eval of gingiva -pocket/sulcus -teeth -presence of local contributing factors -radiographs

128
Q

BOP can be either

A

immediate or delayed

129
Q

exudate can occur through either

A

probing or finger press

130
Q

palpable or visible movement of a tooth when in function

A

fremitus

131
Q

name the SPC calc classification: No calculus present

A

A-0

132
Q

name the SPC calc classification: light supragingival and/or localized light subgingival

A

A (light)

133
Q

facial to lingual movement of tooth less than 1mm (slight)

A

class 1 mobility (horizontal)

134
Q

facial to lingual movement of tooth greater than 1mm but less than 2mm

A

class 2 mobility (horizontal)

135
Q

facial to lingual OR vertical displacement; tooth depressible in socket

A

class 3 mobility (vertical)

136
Q

PASS scores are performed on all pts over the age of

A

12

137
Q

incipient furcation; detects but cannot enter furcation

A

class I furcation

138
Q

probe penetrates furcation greater than 1mm; does not pass through

A

class II furcation

139
Q

the probe passes completely through the furcation

A

class III furcation

140
Q

the entrance to the furcation is VISIBLE looking into the mouth

A

class IV furcation

141
Q

calculate the CAL: PD: 4mm GM: +2mm

A

CAL = 6mm _______________________ 4mm + 2mm = 6mm

142
Q

the surfaces of the interdental bone are smooth and covered in a thin layer of ______ bone

A

cortical bone

143
Q

the thin, dense layer of cortical bone that lines the tooth socket appears as a thin, white line on a radiograph called the

A

lamina dura

144
Q

TRUE or FALSE radiographs reveal presence or absence of periodontal pockets

A

FALSE

145
Q

TRUE or FALSE radiographs do not reveal presence of early stages of bone loss

A

TRUE

146
Q

TRUE or FALSE radiographs do not reveal precise morphology of any existing alveolar bone destruction

A

TRUE

147
Q

TRUE or FALSE radiographs do not reveal any information about periodontal disease activity

A

TRUE

148
Q

bone loss that is measured from a plane parallel to a tooth-to-tooth line drawn from the CEJs of adjacent teeth

A

horizontal bone loss

149
Q

bone loss seen on the interproximal aspect of one tooth more than the adjacent tooth; bone level is at an angle from the CEJs

A

vertical bone loss

150
Q

bone loss seen on the interproximal aspect of one tooth more than the adjacent tooth; bone level is at an angle from the CEJs

A

vertical bone loss

151
Q

which furcations are harder to detect on radiographs?

A

maxillary molars

152
Q

what will a furcation area of a maxillary molar look like on a radiograph?

A

triangle radiolucency

153
Q

ideal crown to root ratio

A

1:2

154
Q

bone loss around an implant is a major sign of

A

periimplantitis

155
Q

the bone levels around an implant should ideally be at or above the

A

first screw

156
Q

the conscientious, explicit and judicious used of current best evidence in making decisions about the care of individual pts

A

evidence-based practice

157
Q

requires integration of pt preference, individual clinical expertise and external clinical evidence

A

evidence-based decision making

158
Q

what level(s) of evidence represent the best levels of evidence?

A

systematic reviews; randomized clinical trials

159
Q

what levels of evidence have the lowest levels of evidence?

A

case reports; expert opinion

160
Q

term used to describe the many nonsurgical steps used to eliminate inflammation in the periodontinum of a pt with periodontal disease

A

nonsurgical periodontal therapy

161
Q

goals of nonsurgical periodontal therapy

A
  1. minimize bacterial challenge 2. eliminate local contributing factors 3. minimize impact of systemic risks factors 4. stabilize attachment level
162
Q

instrumentation to remove plaque biofilm and calculus from the root surface

A

scaline

163
Q

removing diseased cementum that is contaminated with toxins or microorganisms

A

root planing

164
Q

removal or disruption of plaque biofilm, its byproducts and biofilm retentive calculus deposits from coronal and tooth root surfaces

A

periodontal instrumentation

165
Q

pts with periodontitis that have returned to a state of health and free from inflammation, have a _______ JE

A

long JE

166
Q

when inflammation resolves, epithelial cells can readapt to the root surface with is referred to as a

A

long JE

167
Q

what do pts need to be warned of the possibility of during and after NSPT?

A

hypersensitivity

168
Q

formal step in NSPT that is designed to gather into to be used in several critical clinical decisions regarding future care

A

re-evaluation

169
Q

formal step in NSPT that is designed to gather into to be used in several critical clinical decisions regarding future care

A

re-evaluation

170
Q

periodontitis usually damages the _______ tissue first

A

interdental

171
Q

cribriform plate which is a thin layer lining the socket

A

alveolar bone proper (ABP)

172
Q

layer of compact bone that forms the outer wall on the facial and lingual

A

cortical bone

173
Q

spongy bone that fills the interior portion of the alveolar process and is found MOSTLY in interproximal

A

cancellous bone

174
Q

layer of connective tissue that covers the outer surface of the bone

A

periosteum

175
Q

TRUE or FALSE epithelial cells do not co stain blood vessels

A

TRUE

Perio (3 decks)

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