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Perio Problems Flashcards

1
Q

Gingivitis

A

Inflammation of gingival tissues

No loss of attachment or bone

Occurs in response to plaque bacteria

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2
Q

Clinical signs of gingivitis

A

Erythema
BOP
Edema

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3
Q

Young children has less

A

Plaque and less reactivity to plaque

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4
Q

Puberty Gingivitis

A

Some children exhibit severe gingivitis at puberty

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5
Q

Puberty gingivitis peak prevalence is

A

10 years in girls and 13 years in boys

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6
Q

Puberty gingivitis gingiva enlarged with

A

Granulomatous changes similar to pregnancy

Related to increase in steroid hormones

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7
Q

Local factors of gingivitis

A

Crowded teeth
Ortho
Mouth breathing
Erupting primary and permanent teeth

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8
Q

Treatment of gingivitis

A

Reversible
Improve oral hygiene
Appropriately sized toothbrush
Patently assistant 8-10 years of age

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9
Q

Long-standing gingivitis can lead to

A

Chronic inflammatory gingival enlargement

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10
Q

Common chronic sites

A

Around ortho appliances

Areas chronically dried by mouth breathing

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11
Q

Chronic inflammatory gingival enlargement the ___enlarged

A

Interdental papillae and marginal gingiva

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12
Q

Chronic inflammatory gingival enlargement tissue tends to

A

Bleed easily and erythematous

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13
Q

Chronic inflammatory gingival enlargement tissue may be

A

Soft friable with a smooth shiny surface

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14
Q

Chronic inflammatory gingival enlargement may resolve

A

Slowly when adequate plaque control is instituted

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15
Q

Chronic inflammatory gingival enlargement ___often required

A

Gingivectomy

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16
Q

Drug induced gingival overgrowth

A

Phenytoin
Cyclosporine
Calcium channel blockers

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17
Q

Phenytoin

A

Anti convulsants

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18
Q

Cyclosporine

A

Immunosuppressant for host resection

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19
Q

Calcium channel blockers

A

Hypertension control

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20
Q

Drug-induced gingival overgrowth differs

A

From chronic inflammatory enlargement

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21
Q

Drug-induced gingival overgrowth appears

A

Fibrous firm and pale pink with little tendency to bleed

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22
Q

Drug-induced gingival overgrowth occurs

A

Slowly

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23
Q

Drug-induced gingival overgrowth occurs first in

A

Papilla

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24
Q

Drug-induced gingival overgrowth spreads to

A

Gingival margin

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25
Q

Drug-induced gingival overgrowth may cover

A

And interfere with eruption or occlusion

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26
Q

Drug-induced gingival overgrowth may improve or resolve

A

When medication is discontinued

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27
Q

Drug-induced gingival overgrowth severity affected by

A

Adequacy of oral hygiene and concentration of medication in gingiva

and susetable is genetic compontic

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28
Q

Drug-induced gingival overgrowth if medication cant be stopped

A

Overgrowth can be surgically removed but will recur

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29
Q

Drug-induced gingival overgrowth tissue can be removed by

A

Gingivectomy or by flap with internal bevele

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30
Q

Drug-induced gingival overgrowth surgery indicated when

A

Appearance is unacceptable to patient

Interferes with function

Overgrowth has produced periodontal pocket that cannot be maintained

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31
Q

Teeth erupt through

A

Existing band of keratinized gingiva

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32
Q

Width of keratinized gingiva band and relationship to teeth

A

Changes very little during subsequent growth and development

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33
Q

Deflection in path of eruption due to over crowding or over retention of primary teeth

A

May result in narrowed band of attached gingiva

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34
Q

Development and defects of the attached gingiva common when

A

Mandibular incisor erupt labial to alveolar ridge

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35
Q

If band of attached gingiva narrow

A

Small loss of attachment results in mucogingival defect (Pocket depth exceeds width of keratinized gingiva)

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36
Q

Development and defects of the attached gingiva recession may occur

A

Rapidly

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37
Q

Gingival architecture makes

A

Labially erupted teeth difficult to clean even more so after recession

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38
Q

__________vulnerability to peridonits and attachment loss

A

Plaque increases vulnerability

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39
Q

Other factors that may contribute to recession

A

Use of smokeless tobacco

Habit related self induced injury

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40
Q

Gingival graft to

A

Stabilize and replace lab nail kerat5nized gingiva

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41
Q

When defect not severe

A

Best to postpone grafting until after orthodontic treatment

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42
Q

Orthodontic movement of back onto alveolar ridge

A

May produce increase in attached gingiva and place tooth in periodotnally more stable position

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43
Q

Maxillary frenum penetrating incisive papilla often accompanied by

A

Large midline diastema

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44
Q

Maxillary frenum penetrating incisive papilla traumatic forces

A

On the facial attached gingiva will cause loss of papilla

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45
Q

Maxillary frenum penetrating incisive papilla look for

A

Blanching

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46
Q

Maxillary frenum penetrating incisive papilla treatment can be

A

Delayed until permanent teeth present

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47
Q

Prominent maxillary frenum treatment usually delayed

A

Until permanent incisor or cuspids erupted to allow natural closure of diastema

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48
Q

Prominent maxillary frenum treatment indicated

A

If appearance unacceptable after closure or ortho

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49
Q

Tip of papilla will

A

Fill embrasure

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50
Q

Ankyloglossia

A

Restricted tongue movement

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51
Q

Restrictive lingual frenum (“tongue tie”) prevelance

A

Common in children

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52
Q

Restrictive lingual frenum (“tongue tie”) if normal mobility limited treatment may be indicated

A

Speech
Feeding

Or if tongue cannot be protrude or touch upper alveoplasty process

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53
Q

Frenectomy

A

Infant surgery for feeding controversial

Evidence to improve speech very limited

54
Q

Chronic Periodontitis

A

Attachment loss >2 at >1 site

Number and severity of affected sites increases with age

55
Q

Molar/Incisor pattern ( Aggressive periodontitis)

2 forms

A

Localized and generalized

56
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Localized form affects

A

Young patients

57
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Generalized form affects

A

Young adults

58
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Characterized by

A

Loss of attachment and bone around permanent incisor and 1 permanent molar

59
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Attachment loss is

A

Rapid occurring at 3x rate of adult onset disease

60
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Most commonly seen in

A

African American population

61
Q

Molar/Incisor pattern ( Aggressive periodontitis) may be seen

A

After mild trauma luxates tooth

62
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Undetected diseases in primary dentin

A

Suggest that LAP and prepub are all same

63
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Linked to

A

A neutrophil chemotactic defect and can be inherited

64
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Linked to presence of

65
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Successful treatment outcomes

A

Correlate well with eradication of the bacteria

66
Q

Molar/Incisor pattern ( Aggressive periodontitis) treatment

A

SRP combined with systemic antibiotic therapy and monitoring

67
Q

Molar/Incisor pattern ( Aggressive periodontitis)

Systemic antibiotic choice

A

Tetracyclines
Metronidazole alone or with amoxicillin

Newest therapy azithromycin

  • concentrates in neutrophils
  • short course compliance superior
68
Q

Molar/Incisor pattern ( Aggressive periodontitis)

After treatment

A

Some reattachment and resolution can occur after antibiotic therapy

69
Q

Localized surgery intervention

A

Often necessary for residual defects

70
Q

Localized aggressive (formerly prepubertal) periodontitis is

A

Localized loss of attachment in the primary dentition

71
Q

Localized aggressive (formerly prepubertal) periodontitis occurs in

A

Children without evidence of systemic disease

72
Q

Localized aggressive (formerly prepubertal) periodontitis most commonly manifested in

A

Molar area

73
Q

Localized aggressive (formerly prepubertal) periodontitis usually

A

Bilaterally symmetrical loss of attachment

74
Q

Localized aggressive (formerly prepubertal) periodontitis may be present

A

Calculus may be present

Heavier than average plaque

75
Q

Localized aggressive (formerly prepubertal) periodontitis commonly 1st diagnosed in

A

Late primary dentition or early transitional dentition

76
Q

Localized aggressive (formerly prepubertal) periodontitis may progress to

A

Localized aggressive periodontitis in permanent dention…probably the same disease

77
Q

Localized aggressive (formerly prepubertal) periodontitis believed to be the result of

A

A bacterial infection combined with specific but minor host immunologic deficit is

78
Q

Tetracyclines commonly used to treat

A

LJP contraindicated for LPP because of potential for staining of developing permanent teeth

79
Q

Treatment of LPP

A

Metronidazole and amoxi
Or
Azithromycin

80
Q

Systemic disease in the immune system

A

Neutropenia may cause loss

81
Q

Systemic diseases in developmental defect

A

In the attachment apparatus as in hypophosphatasia

82
Q

Systemic diseases of neoplastic cells

A

In leukemia can lead to loss

83
Q

Diabetes has increased risk

A

And earlier onset of periodontitis in diabetes Mellitus types 1 and 2

84
Q

10-15% of teenagers with type 1 diabetes

A

Have significant periodontal disease

85
Q

Periodontitis may worsen

A

Glycemic control

86
Q

Down syndrome

A

3 copies of chromosome 21

87
Q

Down syndrome increased

A

Susceptibility periodontist

88
Q

Most Down syndrome patients develop periodontist by age

89
Q

Down syndrome plaque levels high but

A

Severity of periodontal diseae out of proportion

90
Q

Down syndrome various minor immune deficits

A

Particularly in neutrophil function

91
Q

Down syndrome predisposed to recession because

A

Shallow anterior mandibular vestibule

Frenum pull common

92
Q

Hypophosphatasia

A

Genetic disorder in which the enzyme bone alkaline phosphatase is deficient or defective

93
Q

Hypophosphatasia diagnosed by

A

A finding of low alkaline phosphatase levels in serum sample

94
Q

Hypophosphatasia phenotypes vary from

A

Premature loss of deciduous teeth to severe bone abnormalities leading to neonatal death

95
Q

Hypophosphatasia the earlier the presentation of symptoms

A

The more severe the diseae

96
Q

Hypophosphatasia in mild form 1st clinical sign

A

Early loss of primary teeth

Bone symptoms common in later adulthood

97
Q

Hypophosphatasia early tooth loss is a result of

A

Defective cementum formation that results in weakened attachment of tooth to bone

98
Q

Hypophosphatasia roots

A

Not resorbed

Development may not be complete

99
Q

Hypophosphatasia teeth are affected in order

A

Of formation so that those that form the earliest are most likely to be involved and the most severely affected

100
Q

Hypophosphatasia primary incisor exfoliated at

101
Q

Hypophosphatasia permanent dention

A

May be normal

102
Q

Hypophosphatasia other signs

A

Fair caucasians

Frontal bossing

103
Q

Leukocyte
adhesion
deficiency (LAD) is a group of

A

Rare recessive genetic syndromes

The severity is variable

104
Q

Leukocyte
adhesion
deficiency (LAD) affects how

A

White blood cells respond and travel to site of wound or infection

105
Q

Leukocyte
adhesion
deficiency (LAD) susceptible to

A

Bacterial infections and lack of pus at infection sites

106
Q

_____ can be curative for LAD

A

Bone marrow transplant

107
Q

Leukocyte
adhesion
deficiency (LAD) recurrent

A

Otitis media and other bacterial infections of soft tissues

Periodontal disease symptoms manifest in primary dentition

108
Q

Neutropenia is

A

Suppressed neutrophil counts in blood and bone marrow

109
Q

Neutropenia diagnosed by

A

Depressed neutrophils count on differential blood count

110
Q

Neutropenia increased susceptibility to

A

Recurrent infections

111
Q

Neutropenia will have severe

A

Gingivitis and pronounce alveolar bone loss that rapidly progressing

112
Q

Neutropenia patients may not

A

Be able to maintain level of oral hygiene necessary to prevent disease

113
Q

Papillon-LeFèvre syndrome

A

Rare genetic disorder with onset of severe periodontitis in primary or transitional dention

114
Q

Papillon-LeFèvre syndrome severe

A

Inflammation and rapid bone loss characteristic

115
Q

Papillon-LeFèvre syndrome easily identified by

A

Hyperkeratosis of the palms of the hands and soles of the feet

116
Q

Papillon-LeFèvre syndrome therapy

A

Consists of aggressive local measures to control plaque

117
Q

Papillon-LeFèvre syndrome successful treatment in children

A

Have been reported with antibiotic therapy

118
Q

Langerhans Cell Histiocytosis (LCH)

A

Infiltration of bones skin liver and other organs with histiocytes

119
Q

Langerhans Cell Histiocytosis (LCH) will have

A

Gingival enlargement ulceration mobility of teeth with alveolar expansion and discreet destructive lesions of bone on radiographs

120
Q

Langerhans Cell Histiocytosis (LCH)

Radiograph

A

Teeth may be left floating in air and eventually exfoliated

121
Q

Langerhans Cell Histiocytosis (LCH) diagnosed by

122
Q

Langerhans Cell Histiocytosis (LCH) therapy

A

Local measures such as radiation and surgery to remove lesions and systemic chemo for disseminated cases

123
Q

Leukemia best prognosis

A

Acute lymphoblastic leukemia’s

124
Q

Leukemia poorer long term survival

A

Acute myeloid leukemia

125
Q

AML but not ALL

A

May present with gingival enlargement caused by infiltrates of leukemia cells

126
Q

AML lesions are

A

Bluish red and may invade bone

127
Q

AML patient will have

A

Fever mailable gingival or other bleeding and bone or joint pain

128
Q

AML may be diagnosed by

A

Complete blood cell count

Anemia
Abnormal leukocyte and differential counts
Thrombocytopenia

129
Q

Periodontal health of children should be

A

Assessed at each examination

Plaque index provides method for monitoring and documenting oral hygiene practices

130
Q

Most common calculus sites

A

Lingual mandibular incisors

Buccal of maxillary molars

131
Q

Erupting teeth can be probed

A

All the way to the CEJ

Deep pockets are normal

132
Q

Normal crystal height within

A

1-2 mm of the CEJ

Peds Final (7 decks)

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