periodontal diagnosis, prognosis and tx planning

Question 1

chief complaints with periodontal disease

Answer 1

bleeding gums, bleeding on brushing, dull generalized pain, mobility of teeth

Question 2

t/f PSR is recorded in sextants

Answer 2

yes. the probe has a 0.5mm ball at the end so the first line up is 3.5mm. the highest score is recorded for each sextant

Question 3

psr code 0

Answer 3

colored area of probe is visible in deepest cervice. no calculus or defective margins, tissues are healthy with no bop

Question 4

psr code 1

Answer 4

same thing as 0 but there is bop (gingivitis).

DO A PROPHY

Question 5

psr code 2

Answer 5

colored area of probe is visible in deepest probeing depth. supra/subgingival calculus and defective margins (overhangs)
CALCULUS AND PLAQUE REMOVAL, CORRECT OVERHANGS

Question 6

psr code 3

Answer 6

colored area partly visible (between 3.5-5.5mm)

COMP EXAM and CHARTING (probe, mobility, recession, furcation, radiographs)

Question 7

psr code 4

Answer 7

colored area of probe completely disappears
1 section of code 4 or 2 of code 3 = full mouth exam
COMP EXAM AND CHARTING

Question 8

psr code *

Answer 8

whenever there is a problem with codes 0, 1, 2

Question 9

psr code X

Answer 9

edentulous sextant

Question 10

t/f you should drag the probe and point the probe away from the tooth when perio charting

Answer 10

false. walk the probe and keep the tip on the tooth

Question 11

what does BOP tell you

Answer 11

objective indication of inflammation

Question 12

recession

Answer 12

distance from the cej to the gingival margin when the margin is apical to the cej (+)

Question 13

pseudopocket/overgrowth

Answer 13

distance from the cej to the gingival margin when the gingival margin is coronal to the cej with no attachment loss (-)

Question 14

t/f al can be present without recession

Answer 14

true

Question 15

how do you measure the fgm if you cant see the cej

Answer 15

feel for the cejj with your rpobe and measure how much further the probe goes beyond the cej

Question 16

pocket depth is relative to what

Answer 16

the gingival margin. you can have attachment loss without a pocket (recession)

Question 17

mobility index I

Answer 17

1st distinguishable sign of movement greater than normal

Question 18

mobility index II

Answer 18

movement of the crown by up to 1 mm in any direction

Question 19

mobility index III

Answer 19

movement of crown more than 1 mm in any direction and/or vertical depression or rotation

Question 20

what do you use to detect furcation involvement

Answer 20

nabers probe

Question 21

how many furcations are there on mandibular molars compared to maxillary molars

Answer 21

2 mand (B/L), 3 max (B/ML/DL)

Question 22

glickmans furcation I

Answer 22

pocket formation into the flute but intact interradicular bone

Question 23

glickmans furcation II

Answer 23

loss of interradicular bone and pocket formation of varying depths into the furcation.
probe sticks

Question 24

glickmans furcation III

Answer 24

through and through lesion to the other side

Question 25

glickmans furcation IV

Answer 25

same as III with recession and the furca is clearly visible clinically

Question 26

max 1st: furcal aspect of the root is concave in what percent of MB roots

Answer 26

94

Question 27

max 1st: furcal aspect of root is concave in what percent of DB roots

Answer 27

31

Question 28

max 1st: furcal aspect of root is concave in what percent of P roots

Answer 28

17

Question 29

max 1st: where is the deepest furcal concavity found

Answer 29

MB root (about 0.3 mm)

Question 30

t/f the concavity in the mand 1st molar is bigger than the max 1st molar

Answer 30

true. about 0.7 mm

Question 31

mand 1st: furcal aspect of root is found in what percent of M roots

Answer 31

100

Question 32

mand 1st: furcal aspect of root is found in what percent of D roots

Answer 32

99

Question 33

why is it so hard to clean furcations

Answer 33

furcation is narrower than the instrument we use (curret) in 58% of 1st molars

Question 34

what do furcation triangle show us

Answer 34

there could be bone loss

Question 35

width of attached gingiva is the distance from

Answer 35

the bottom of the pocket to the mgj

Question 36

t/f lack of attached ging means there is loss of attachment

Answer 36

no

Question 37

how do you tell if the tissue is attached gingiva or mucosa

Answer 37

using the rolling technique, if you roll the probe and the tissue moves, it is mucosa, if not it is attached gingiva

Question 38

fremitus

Answer 38

movement of tooth when in function

Question 39

where does healthy bone lie in a radiograph

Answer 39

2mm below cej

Question 40

slight bone loss

Answer 40

loss up to 25% of root length

Question 41

moderate bone loss

Answer 41

bone loss from 25-50% of root

Question 42

severe bone loss

Answer 42

loss more than 50%

Question 43

t/f. angular/vertical bone loss can be fixed

Answer 43

true. you can place a bone graft, whereas horizontal you cannot

Question 44

what can radiographs tell you about a perio patient?

Answer 44

``` bone loss (amount and type), furcation involvement, overhangs, crown root ratio (should be less than 1) must also check clinically to further evaluate radiographic findings ```

Question 45

how do you classify localized aggressive perio

Answer 45

M1 and incisors

Question 46

how do you classify generalized aggressive perio

Answer 46

3+ teeth in addition to M1 and molars

Question 47

how do you classify localized perio

Answer 47

less than 30% of sites | can be slight (1-2mm), moderate (3-4) or severe (5+)

Question 48

prognosis

Answer 48

prediction of the probable course, duration, and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease

Question 49

when do you establish the prognosis

Answer 49

after diagnosis, before tx plan

Question 50

determination of prognosis is what kind of process?

Answer 50

dynamic

Question 51

should the prognosis be reevaluated?

Answer 51

yes. after the completion of all phases of therapy and perio maintenance

Question 52

good prognosis

Answer 52

control of etiologic factors and adequate periodontal support ensure the tooth will be easy to maintain by the patient and clinician

Question 53

fair prognosis

Answer 53

25% of AL, Class I furcation involvement

Question 54

poor prognosis

Answer 54

50% AL, Class II furcation

Question 55

questionable prognnosis

Answer 55

more than 50% AL, poor crown:root ratio, poor root form, Class II/III furcation, more than 2+ mobility, root proximity

Question 56

hopeless prognosis

Answer 56

inadequate attachment to maintain health, comfort, and function, class 3 mobility

Question 57

Tx protocol for periodontitis

Answer 57

1. ohi and Tx plan discussion 2. intial therapy: SRP 3. reeval (4-6 wks) with ohi 4. probe deph resolved (pocket 3mm or less) = perio maintenence 5. probe deph not resolved = surgery/referral with perio maintenance