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Perio Test 1 (Ch21, 25 & 27) > Perio Test 1 (Ch 21, 25, 27) > Flashcards

Perio Test 1 (Ch 21, 25, 27) Flashcards

1
Q

What are the 3 fundamental diagnostic questions?

A
  1. Does the clinical assessment indicate periodontal health or inflammatory disease?
  2. If the clinical assessment indicates inflammatory disease, is it periodontitis or gingivitis?
  3. If the pt has gingivitis what type is it? If pt has periodontitis what type is it?
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2
Q

What is the periodontal master treatment plan?

A

a sequential outline of the steps to be carried out by the DDS, DH and pt to eliminate disease and restore health in periodontium

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3
Q

What does the assessment and preliminary therapy phase in the master trx plan consist of?

A

assessment of collected data & urgent care for any acute conditions (like emerg dental care).
* some refer to this phase as emergency therapy

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4
Q

What does the nonsurgical periodontal therapy phase consist of in the master trx plan

A

all nonsurgical measures used to control gingivitis and periodontitis.
- intensive nonsurgical perio instrumentation & comprehensive pt education
- steps to minimize impact of local contributing factors

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5
Q

nonsurgical periodontal therapy other names

A

initial periodontal therapy, phase I therapy, bacterial control and anti-infective therapy

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6
Q

what does the surgical therapy phase of master trx plan consist of?

A

necessary perio surgery to control/eliminate perio disease that cant be managed by nonsurgical therapy alone.
-placement of implants if necessary

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7
Q

what does the restorative therapy phase in master trx plan consist of?

A

placement of restorations and replacement of teeth by fixed or removable prosthesis

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8
Q

what does the periodontal maintenance phase in the master trx plan consist of?

A

all measures used by dental team and pt to keep perio from recurring, once the inflammatory disease is brought under control

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9
Q

___ can be observed and measured by the clinician

A

Signs

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10
Q

___ are noted by the patient

A

symptoms

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11
Q

What are the visible signs of disease?

A

color, contour and consistency changes in gingiva

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12
Q

What are hidden signs of disease?

A

Bone loss, exudate, bleeding on probing

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13
Q

What measurement determines the difference between gingivitis and periodontitis

A

attachment loss

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14
Q

What does staging identify?

A

severity, complexity of management and extent of distribution of the disease

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15
Q

Describe the 4 disease stages of perio

A

Stage 1: initial periodontitis
Stage 2: moderate periodontitis
Sage 3: severe periodontitis with potential for bone loss
Stage 4: advanced periodontitis with extensive tooth loss and potential for loss of dentition

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16
Q

Grading is used as an indicator of

A

anticipated rate of progression of periodontal disease

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17
Q

Describe the progression of the 3 grades

A

grade a: slow rate of progression
grade b: moderate rate of progression
grade c: rapid rate of progression

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18
Q

Disease extent uses descriptive modifiers such as

A

localized, generalized, molar/incisor pattern

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19
Q

Localized disease extent percentage

A

30% or less involvement

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20
Q

Generalized disease extent percentage

A

more than 30% involvement

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21
Q

What are the 4 goals of periodontal instrumentation

A
  1. minimize bacterial challenge to pt
  2. eliminate/ control local contributing factors for perio disease
  3. minimize the impact of systemic factors of perio disease
  4. stabilize attachment level
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22
Q

What represents healing after periodontal instrumentation is complete?

A

formation of a long junctional epithelium, reduced pocket depths, reduced bleeding on probing

23
Q

How much time is left between completion of nonsurgical perio therapy and the re-eval appt?

A

4-6 weeks

24
Q

Why is 4-6 weeks left between completion of nonsurgical perio therapy and the re-eval appt.

A

allows time for tissue healing
*not possible to determine tru tissue response for at least 1 month after

25
Q

What happens/ what are the steps in a reevaluation appt

A

*Medical status update
* Thorough periodontal clinical assessment
* Compare results with initial assessment
* Decide on the next step in therapy
* Perform or schedule additional nonsurgical therapy
* Determine periodontal maintenance schedule
* Refer for periodontal surgery if needed

26
Q

What causes/triggers dentinal hypersensitivity?

A

When dentin loses its protected cemental cover, the dentinal tubules
are then exposed to the oral environment, which causes the intense
pain
*areas of exposed dentin are subjected to mechanical, thermal, or chemical stimuli
* Associated with gingival recession of the gingival margin

27
Q

What is the hydrodynamic theory?

A

Movement of dentinal fluid in the tubules results in nociceptor activation at the dentin-pulp complex.
*Cold, hot, and pressure stimuli cause dentinal fluid to shift back and
forth within the tubule
* Movement of the fluid excites the nociceptors at the dentin-pulpal
complex, and triggers sharp pain response

28
Q

traditional instrumentation terminology uses the terms scaling and root planing. How are they traditionally, each, defined?

A

scaling= instrumentation to remove plaque biofilm and calculus off the root surface
root planing= trx procedure designed to remove diseased cementum that is contaminated with toxins or MOs

29
Q

Traditional terminology is being replaced with new terminology to better reflect modern therapy. What are the terms suggested to replace traditional terminology?

A

Periodontal instrumentation or periodontal debridement

30
Q

Traditionally the “toxic/infected” cementum was removed in root planing so the root would be glassy smooth. What is the modern beliefs about cementum removal?

A

conservation of cementum is of
primary importance for optimal healing
- root surfaces should only be instrumented to a level that results in resolution of tissue inflammation in periodontal tissues (bc cementum is necessary for new attachment)

31
Q

Nonsurgical therapy is the cornerstone of periodontal therapy. It is termed the

A

Gold standard

32
Q

What risk factors in pts would push you to co-manage your trx with a periodontist?

A

Unresolved inflammation and continued attachment loss despite nonsurgical perio therapy
- crown lengthening or surgical procedures for tissue regeneration
- significant medical issues of pt that affect management
-stage 3 or 4 perio with severe destruction
-intensive management of grade b or c perio

33
Q

What are some factors that would influence a necessary referral to a periodontist ?

A

*Pt wants a specialist
* General practitioner may not have the depth of experience to treat
advanced cases
* Presence of complicating medical factors

34
Q

Within each dentinal tubule is an ___ ___, which is a direct extension of a cell in the tooth pulp known as an ___ and dentinal fluid

A

odontoblastic process ; odontoblast
* dentinal fluid is extracellular fluid that surrounds the odontoblastic process

35
Q

To control dentinal hypersensitivity what are some measures that can be taken?

A

*In-office application of potassium oxalate, ferric oxalate
* Fluoride and fluoride varnish
* Potassium nitrate, strontium chloride, and sodium citrate—found in
toothpaste for sensitive teeth

36
Q

How long do recently exposed roots take to decrease in sensitivity without sensitivity trx by the hygienist

A

within a few weeks
* if exposed root surfaces are kept biofilm free by thorough self care

37
Q

What is the objective of patient-applied home irrigation?

A

diminish gingival
inflammation by disrupting biofilms coronal to the gingival margin

38
Q

What is the goal of professional irrigation?

A

reduce the number of bacteria in the
periodontal pocket space

39
Q

What is the dental water flosser mechanism of action?

A

Delivers a pulsating fluid that incorporates a compression and
decompression phase
* This creates two zones of fluid movement called hydrokinetic activity

40
Q

Describe the impact and flushing zones in hydrokinetic activity

A

*Impact zone—initial fluid contact near the gingival margin
* Flushing zone—depth of fluid penetration within a subgingival sulcus or
periodontal pocket

41
Q

What solutions can be used in home irrigators

A

*water
*chlorhexidine (diluted with water)
*listerine

42
Q

what is the ability of a chemical plaque control agent to be retained
in the oral cavity and be released slowly over time with a continued
antimicrobial effect

A

substantivity

43
Q

Subgingival irrigations is used to deliver medicament in?

A

deep pockets, furcations,
around implants

44
Q

supragingival and subgingival irrigation role?

A

removal of biofilm, reduction in bleeding, reduction in gingival inflammation, reduction in periodontal pathogens and reduction in inflammatory mediators and destructive host response

45
Q

Indications for water flossers?

A

*Periodontal maintenance
* Those noncompliant with dental floss
* Individuals with special needs
* Around dental implants
* Individuals with diabetes
* Around orthodontic appliances

46
Q

Depth of fluid penetration of a water flosser?

A

6mm

47
Q

Placement of standard irrigation tip

A

*Place the tip at a 90-
degree angle at the neck
of the tooth
* Use the water spray to
trace along the gingival
margin

48
Q

Placement of ortho irrigation tip

A
  • Place the tip at a 90-
    degree angle
49
Q

Placement of subgingival irrigation tip

A

*Adjust water
pressure to lowest
setting
* Slide rubber tip
gently beneath the
gingival margin
* Direct tip at 45-
degree angle

50
Q

penetration of a toothbrush in mm

A

1-2mm

51
Q

oral rinsing penetration in mm

A

2mm

52
Q

toothpick/wooden wedge and interdental brush penetration in mm depends on

A

embrasure size

53
Q

dental floss penetration in mm

A

3mm

Perio Test 1 (Ch21, 25 & 27) (1 decks)

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