Periodontal Diagnosis Flashcards
common bacteria that causes gingivitis associated with dental plaque only in absence of AL
Actinomyces viscosis
gingival inflammation on a reduced periodontium
inflammation and recession but no evidence of active periodontitis
clinical features of dental plaque induced gingival diseases
- redness
- edema
- BoP
- smooth and shiny surface texture
- no radiographic bone loss (unless on a reduced periodontium)
- gingival cratering where the buccal and lingual tissues are present but directly intterproximally, some tissue is absent
gingival diseases modified by systemic factors
- pregnancy gingivitis
- puberty gingivitis
- associated with diabetes
puberty gingivitis is associated with what bacteria?
Prevotella intermedia (Pi)
gingival enlargement due plaque induced, drug influenced gingivitis is due to what?
an increase in fibroblast activity as a response to inflammation resulting in increased CT formation with a decrease in production of enzyme collagenase
drugs that induce gingival enlargement
- anti-convulsant medication - phenytoin
- immunosuppressants (for transplant patients) - cyclosporin
- calcium channel blockers - nifedipine, verapamil, amlodipine
how is acute necrotizing ulcerative gingivitis (classified under necrotizing perio disease) characterized?
- pain
- spontaneous bleeding
- punched-out interdental papillae
- gray necrotic pseudomembrane
- erythematous borders
- fetid odor
- possible lymphadenopathy
- modified by malnutrition
viral non-plaque induced gingivitis
acute herpetic gingivostomatitis (children)
genetic non-plaque induced gingivitus
hereditary gingival fibromatosis
what is the hallmark for periodontitis?
progressive attachment loss in the presence of inflammation
periodontitis is most typically (but not always) is accompanied with what?
- periodontal pockets
2. radiographic bone loss
what factors must be taken into consideration when dx’ing periodontitis?
- radiographic bone loss
- clinical attachment loss
- pocket depth
- inflammation
where will the jxnal epithelium be if there is facial, lingual, or proximal gingival recession in the absence of inflammation (a reduced but healthy periodontium)?
will also be on the root
is patient considered to have periodontitis if there is radiographic bone loss but no inflammation?
the disease may be inactive
pseudo-pocket
gingiva several mm coronal to CEJ without attachment loss
the most typical pattern of perio disease progression occurs where?
at interproximal sites
what is the most diagnostic descriptor of periodontal disease?
forms of periodontitis
chronic periodontitis affects who?
most prevalent in adults over 35, but can occur younger adults destruction is consistent with local factors
how can chronic periodontitis be classified?
- basis of extent (localized or generalized)
2. severity (slight, moderate or severe)
aggressive periodontitis is associated with what?
immunologic defects (familial aggregation but patients are otherwise healthy)
who is affected by localized aggressive periodontitis?
- circumpubertal (adolescent) onset
2. greater incidence in African-Americans
characteristics of localized aggressive periodontitis
- neutrophil chemotaxis defect
2. robust serum antibody response
where does localized aggressive periodontitis affect?
localized to 1st molar/incisor involvement with no more than 2 other involved permanent teeth
which bacteria is traditionally associated with localized aggressive periodontitis?
Aggregatibacter actinomycetemcomitans (Aa)
T/F: for patients with localized aggressive periodontitis, there may be a burst of activity followed by a prolonged period of inactivity (quiescence) or burn-out (not episodic) however may generalize in later life
true
T/F: patients with localized aggressive periodontitis may have their incisors undergo pathologic migration/drifting/shifting
true
who is affected by generalized aggressive periodontitis?
persons under 30 years of age (age is important)
characteristics of generalized aggressive periodontitis
- poor serum antibody response to infecting agents
- pronounced (exaggerated) episodic pattern for attachment loss and bone loss at different sites
- generalized interproximal attachment loss on at least 3 permanent teeth in addition to first molars and incisors
periodontitis due to systemic disease associated with hematologic disorders
- acquired neutropenia
2. leukemia (various forms)
periodontitis due to systemic disease associated with genetic disorders or inborn errors of metabolism (frequently neutrophil defects present)
- familial and cyclic neutropenia
- Down’s syndrome
- leukocyte adhesion deficiency
- Papillon-Lefevre syndrome
- Chediak-Higashi syndrome
- histiocytosis
- genetic agranulocytosis
- Ehlers-Danlos syndrome (collagen synthesis defect)
- hypophosphatasia
nectrotizing ulcerative periodontitis (NUP) may be associated with what type of patients?
patients who are HIV+
clinical findings of nectrotizing ulcerative periodontitis (NUP)
- gingival craters/loss of interproximal papillae
- pseudo-membranous slough
- linear gingival erythema
- possibly exposed bone
- fetid odor
- lymphadenapthy
- angular chelitis
predisposing factors of nectrotizing ulcerative periodontitis (NUP)
- smoking
- stress
- poor OH
- poor nutrition
types of abscess of periodontium
- gingival
- periodontal
- pericoronal
how is abscess of periodontium treated?
- I&D
2. amoxicillin
mucogingival deformities
- gingival recession
- lack of keratinized tissue (gingiva)
- pocketing that reaches mucogingival junction and aberrant frenum or muscle pull
primary occlusal trauma
excessive forces on a normal periodontium
secondary occlusal trauma
normal or excessive forces on a weakened periodontium
localized
less than 30% of teeth involved (different criteria for generalized aggressive)
generalized
equal to or greater than 30% of teeth involved
slight bone loss
1-2 mm attachment loss
moderate bone loss
3-4 mm attachment loss
severe bone loss
5 mm or greater attachment loss
