Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Perio Exam 2 > Perio Sweep 1.1 > Flashcards

Perio Sweep 1.1 Flashcards

1
Q

TFO and inflammation are

A

separate processes
No enhanced attachment loss

NO co-destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Co-destructi0n: TFO and inflammation

A

at same site
Lesions merge
Enhanced attachment loss
Co-destruction

Inflammation in same area of TFO: co-destruction and accelerated bone loss
Inflammation reaches apical to the crest of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Methods of Occlusal Therapy: Irreversible

A 
Intracoronal splints (require tooth preparation)
Occlusal adjustment by selective grinding
Orthodontics
Orthognathic surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Occ. Trauma and PD: Evidence

Periodontitis (inflammation) must be present for

A

attachment loss to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Occlusal trauma in the absence of periodontitis may be

A

reversible and result in adaptation (a mobile but otherwise healthy tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

No repair can occur unless

A

inflammatory periodontal disease is first resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Occlusal trauma superimposed on an existing periodontitis may under certain conditions

A

accelerate attachment loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Occlusal therapy in conjunction with periodontal treatment is indicated when

A

occlusal trauma is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Occlusal therapy should not be done until

A

inflammatory PD is first controlled during initial periodontal therapy (helps decrease inflammation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Occlusal therapy is especially indicated prior to

A

periodontal regenerative therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Occlusal adjustment is not justified in the absence of

A

periodontal disease as a preventive measure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Primary stability=

A

stability of the implant at the time of placement (mechanical interlocking mechanism between a screw and bone surface)

- Bone density
- Implant fixture design
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Healing at the interface=

A

Bone formation and remodeling
[Conventional healing time:
*Mandible…. 3 months
*Maxilla …. 6 months]

The effect of functional implant loading on bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Functional Loading of the Implant

A 
Immediate Loading (at the time of placement)
 Early loading (before conventional healing time)
 Late loading (following 3 or 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Restorative Design

A

Single tooth restoration
Multiple unit fixed type restoration
(splinted versus individual crowns)
Full mouth fixed type implant supported restoration
Full mouth removable type implant supported restoration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Implants in excessive occlusion

A

Porcelain Fracture
Implant to abutment (screw loosening or fracture)
Implant fixture fracture

Increasing mobility of adjacent teeth

Eruption/malocclusion etc of adjacent teeth (observed following functional loading of the dental implant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Periodontal Tactile Perception and Peri-implant Osseoperception

A

Tooth extraction&raquo_space;> Sensory amputation
Myelinated fiber content of the inferior nerve reduced by 20%
Presence and potential function of sensory nerve fibers in the bone and peri-implant environment
Gradual increase in free nerve endings close to implant-bone interface during healing
Existing mechanoreceptors in the periosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

“Tactile Sensibility” and “Thickness Discrimination”

A

Sensory feedback through receptors localized within pdl (viscoelasticity) and within bone (elasticity)…
Necessary for fine tuning of jaw and limb motor control.
Detection thresholds of 20 m of thickness in between antagonist teeth and 1-2 g upon tooth loading.
After implant placement, detection thresholds of 50-100 m of thickness and 50-100 g upon tooth loading.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Functional occlusal forces and implants(summary from various studies)

Loading time depends on:

A
  • Primary stability of the implant
    • Implant design
    • Restorative design
    • Presence/absence of risk factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Functional (and well controlled) loading may increase

A

bone to implant contact BUT

Hundred percent bone-implant surface contact is NOT possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Occlusal trauma is a ——— for periodontal disease but …

A

secondary etiological factor

it can be a primary etiological factor for peri-implant disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bruxism: LONGER AND WIDER

A

DENTAL IMPLANTS TO TOLERATE CHALLENGES !!!

SURROUNDED WITH THICK BONE SUPPORT !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Lateral loads induced

A

high bone strain and implant stress than vertical loads.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Periodontal disease is currently diagnosed almost entirely on the basis of its

A

clinical manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Assessment of host resposne
Biochemical analysis as part of periodontal diagnosis Source of samples: GCF, saliva, and serum (blood)
26
Genetic Analysis (only for research)
There is a genetic susceptibility to periodontitis | Gene polymorphism as a risk marker for periodontitis
27
Diagnostic limitations
Lack of sensitivity and reproducibility Probing depth: gingival inflammation, insertion force, placement and angulation, size, probing technique, probe calibration, presence of subgingival calculus, overhanging restorations
28
Limited sensitivity in small bone change
– Changes in bone can be identified by eye only after 30% to 50% of the bone mineral has been lost (Subtraction radiography: detect bone density change as low as 5 %) No value in evaluating disease activity or progression
29
Ultrasonic periodontal probing
Ultrasonic periodontal probe uses a hollow tapered tip that is filled with water for coupling of the ultrasonic beam into the tissues (non-invasive)
30
Conventional radiographs (PA; Pano) are very
specific, but lack sensitivity
31
Recently, dental CBCT has been introduced in periodontology for the detection of
periodontal defects in in vitro settings
32
CBCT is promising for
periodontal applications, especially for intrabony defects, dehiscence and fenestration defects, periodontal cysts, furcation defects and thickness of palatal masticatory mucosa
33
The sensitivity of a diagnostic test refers to the probability of the test being
positive when the disease is truly present
34
The specificity of a diagnostic test refers to the probability of the test being
negative when the disease is not present
35
1. Bacterial Culturing
Gold standard (reference) method Assess for antibiotic susceptibility of microbes Can only grow live bacteria: strict sampling and transport conditions are essential Some putative pathogens are fastidious and difficult to culture Sensitivity is low: detection limits for selective and nonselective media average 104 to 105 bacteria Sophisticated equipment and experienced personnel required; relatively time-consuming and expensive
36
Fastidious microorganism – microorganisms that will grow only if
special nutrients are presence
37
2. Direct Microscopy
Alternative to culture methods Dark-field or phase-contrast microscopy Morphology and motility of bacteria in a plaque sample Most of the main putative perio pathogens are non-motile (so it is difficult to identify)
38
3. Immunodiagnostic Methods
``` Use Ab that targets specific bacterial Ag Direct and indirect immunofluorescent microscopic assay (IFA) Able to identify pathogens using a plaque smear Used mainly to detect Aa and Pg Comparable to bacterial culture Does not require viable bacterial cells ```
39
3. Immunodiagnostic Methods
- Cytofluorography (flow cytometry) complexity and cost prevent its wide use - Enzyme-linked immunosorbent assay (ELISA) Used primarily to detect serum antibodies to periodontal pathogens Membrane immunoassay (EvalusiteTM): chairside use to detect Aa, Pg, and Pi (detection limit of 105 for Aa and 106 for Pg) - Latex agglutination Based on the binding of protein to latex: latex beads are coated with species-specific antibody Currently these assays only for research purposes
40
4. Enzymatic Methods
Several putative periodontal pathogens such as Pg, Tf, and Aa possess in common a trypsin-like enzyme that hydrolyzes a substrate N-benzoyl-DL-arginine-2-naphthylamide (BANA). Chair-side kit (PerioscanTM) was available in the 1990s Inability to distinguish between individual bacteria - It may be positive at clinically healthy sites Negative result does not rule out the presence of other important periodontal pathogens
41
5. Molecular Biology Techniques
Analysis of DNA, RNA, and structure or function of protein from target microorganisms Nucleic acid probes Synthesized and labeled DNA (20-30 nucleotides) Genomic DNA probe (whole DNA strand): significantly ↓ in sensitivity and specificity due to cross-reactivity to non-target microorganisms 16S rRNA – oligonucleotide probes (high sensitivity and specificity) Checkerboard DNA-DNA hybridization Whole genomic digoxigenin-labeled DNA Up to 40 oral bacterial species in a single test Not been generalized for diagnostic purpose PCR High sensitivity and specificity for the identification of target pathogens PCR lower detection limit: 25-100 cells (Culture: 104-105 cells) Unable to quantify pathogens accurately in clinical samples Real-time PCR Real-time PCR: good correlation between the fluorescent signal measured and the number of bacterial cells been used Expensive and sophisticated technology in real-time PCR
42
16s rRNA is like a
finger print: comparing certain locations on a 16s rRNA molecule with a database of known organisms allows the identification of organisms whose 16s rRNA signature is known.
43
Real-time PCR is also known as
The quantitative real time polymerase chain reaction (qPCR). The Real-Time-PCR enables both detection and quantification.
44
Hypophosphatasia (OMIM 146300, 241500, 241510) is an inherited disorder characterized by
``` defective bone and teeth mineralization and deficiency of serum and bone alkaline phosphatase (AP) activity. urinary phosphoethanolamine (PEA) is increased in hypophosphatasia. urinary inorganic pyrophosphate (PPi) level is also increased. tissue-nonspecific alkaline phosphatase (TNAP) inorganic phosphate (Pi) ```
45
Collecting GCF
Paper strips placed within the crevice for 30 seconds Fluid volume can be quantified by Periotron® Captured samples may not represent the entire periodontium Selection of the teeth and sites is often difficult
46
GCF | Currently > 65 components of
GCF have been evaluated Host-derived enzymes and their inhibitors Byproducts of tissue breakdown Inflammatory mediators and host-response modifiers
47
Intracellular destruction enzymes
Possible markers of active periodontal destruction | Released from dead or dying PMN/Neutrophils from periodontium
48
Intracellular destruction enzymes: - Aspartate amino-transferase:
released during tissue destruction (cell death)
49
Intracellular destruction enzymes: - Alkaline phosphatase:
a membrane-bound glycoprotein involved in maintenance of alveolar bone
50
Intracellular destruction enzymes: - β-glucuronidase:
a lysosomal enzyme degrades proteoglycans and ground substance
51
Intracellular destruction enzymes: - Elastase:
a proteolytic enzyme found in lysosomal granules of neutrophil
52
Aspartate aminotransferase (AST)
Periogard Periodontal Tissue MonitorsTM (chair-side test kit) A marked elevation in AST levels in GCF from sites with severe gingival inflammation Inability to discriminate between sites with severe inflammation with or without attachment loss
53
Alkaline phosphatase (ALP)
ALP in GCF are higher in diseased then healthy sites alkaline phosphate in disease.
54
β-glucuronidase (βG) | Elevated βG in GCF from sites with
severe periodontal disease High sensitivity and specificity when related to occurrence of clinical attachment loss Good predictor for future periodontal breakdown
55
Elastase
Periocheck® (chair-side test kit) | Positive correlation of elastase in GCF with clinical attachment loss
56
``` Matrix metalloproteinases (MMPs) Secreted by ```
fibroblasts and macrophages
57
MMPS: Responsible for the initial destruction of periodontal ECM
remodeling and degradation of ECM components
58
MMPS: Regulated by tissue inhibitors of
MMPs (TIMPs)
59
MMPS: High MMP levels in GCF are at
significantly greater risk for progression of periodontitis
60
GCF MMPs level reduces in response to
treatment
61
MMP-2 (gelatinase A), MMP-9 (gelatinase B), MMP-8 (collagenase 2), MMP-13 (collagenase 3), and MMP-3 (stromelysin-1) involve in
in the initial destruction of periodontal ECM
62
Destruction of collagen
The ECM of the periodontium is composed of collagen (predominant), proteoglycan (versican, decorin, biglycan, syndecan) and non-collagen proteins (elastin, fibronectin, laminin, osteocalcin, osteopontin, bone sialoprotein, osteonectin, and tenascin) Elevated levels of hydroxyproline (breakdown from collagen), glycosaminoglycans (from matrix degradation) and osteocalcin & type I collagen (from alveolar bone destruction) can be found in the GCF from sites with periodontitis
63
Bio-Plex Cytokine Assay Incorporates
novel technology using color-coded beads, permits the simultaneous detection of up to 100 cytokines in a single well of a 96-well microplate Are multiplex bead-based assays designed to quantitate multiple cytokines in tissue fluid including GCF
64
OPTICAL SPECTROSCOPY | Infrared (IR) Spectroscopy
Vibrating covalent bonds of organic molecules absorb a characteristic wavelength of IR light The wavelength of light absorbed depends on the nature of the covalent bond (e.g., C=O and N–H), the type of vibration (e.g., bending and stretching), and the environment of the bond The spectrum of absorbed light can be used to establish a molecular fingerprint of a tissue or fluid
65
Diagnosis of Periodontitis Based on IR Spectra of GCF
Measure the total contents of GCF IR spectroscopy can be used to characterized GCF from healthy, gingivitis, and periodontitis sites Vibrations of peptide groups: C=O stretching (amide I band) and N–H bending (amide II band) IR spectroscopy of GCF is reagent free, requiring only small sample volumes, requiring minimal training for

Perio Exam 2 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions