Brainscape's Knowledge GenomeTM

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


See full index

Clinical knowledge II > Periodontal Disease > Flashcards

Periodontal Disease Flashcards

1
Q

What is the first bacteria to colonise a clean tooth surface?

A

Gram positive streptococci

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

What are the 4 stages of periodontal disease?

A

The initial lesion
The early lesion
The established lesion
The advaed lesion

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

What is the initial lesion in periodontal disease?

A

Develops after 2-4 days after the plaque accumulation.
Vasculitis of vessels below the JE
Presence of serum proteins.
Streptococci dominant and is STABLE.

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

What is the early lesion?

A

Develops after 7-10 days.
Increased fluid exudate.
Oedema and erythema is visible.
proliferation of basal cells at the JE
Anaerobic filamentous bacteria dominant.

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

What is the established lesion?

A

Develops after 21-28 days.
Gingival crevice deepens.
Increase of neutrophils.
Loss of collagen.
T cells > B cells
Breakdown of connective tissue.

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

What is the advanced lesion?

A

Epithelium migrates apically to form a pocket.
Endotoxins permeate the surface layer of the cementum.
Loss of collagen and bone.
B cells > T cells.
Lesion is unstable.

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

What is the function of saliva?

A

To wash the teeth
dilute substances
Allows for swallowing and mastication.

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

What are the two main categories of risk factors in periodontal disease?

A

Local risk factors.
Systemic risk factors.

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

What are some acquired local risk factors of periodontal disease?

A

Plaque
Calculus
BoP
PPD
Poorly contoured prosthesis.

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

What is the role of plaque in periodontal disease?

A

It instigates periodontal disease.
The biofilm creates an environments which makes a change in health.

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

With regards to iatrogenic aspects, what should any restoration or prosthesis do?

A

Minimise plaque accumulation
Avoid physical injury to the periodontium.

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

What can iatrogenic factors arise from?

A

Overhangs
Partial dentures
Bulbous emergence profile.
Restorations which impinge on biological width.

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

What are cervical enamel projections?

A

Located apically to the CEJ
Often in furcation areas
triangular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are enamel pearls?

A

a Large spherical extension of the pulp.

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

What are systemic risk factors of periodontal disease?

A

Smoking
diabetes
medications
stress
nutrition
Genetics
Pregnancy
Hormonal changes
Immunodeficiency
Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are non-modifiable systemic risk factors of periodontal disease?

A

Genetic predispositions
Pregnancy
Hormonal changes
Immunodeficiency states
Age

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

Patients with poor OH and no periodontitis may have a genetic resistance, why is this?

A

Periodontitis is polygenetic
They are likely to be a result of polymorphisms that contribute to the immune response.

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

What should be taken in a full smoking history?

A

Type of tobacco
how many years
How many in a day
What time of day
Any attempts to quit

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

What are the effects of smoking on the periodontium?

A

Sites with deeper pockets
Greater attachment loss
Bone loss
Furcation involvement
Tooth loss
Accumulate plaque
Reduction in gingival vessels.
Poor healing response

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

What effect does smoking have on the gingival tissues?

A

Necrotising periodontal diseases.
Decreased bleeding
Decreased redness and inflammatory response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does smoking effect the neutrophils in the immune response?

A

Increased impaired neutrophil production

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

What effect does smoking have on the function of fibroblasts in the inflammatory response?

A

Inhibits fibroblast proliferation.
Fibroblast attachment is reduced.
Poor wound healing

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

What medications can cause gingival overgrowth?

A

Ca channel blockers
Anti-rejection immunosupressents
Anti-epileptic drugs

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

Why are women who are pregnant more likely to suffer from periodontitis?

A

Elevated levels of oestrogen and progesterone increase vascular permeability,
Plaque then promotes more inflammation.

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

Pregnant women with existing periodontitis are more likely to have…

A

Pregnancy periodontitis
Pregnancy epuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the risk factors for pregnancy complications?

A

Young mothers
Drug/alcohol use
Stress
Genetics
GU infection
Idiopathic
Periodontal disease.

26
Q

What are the oral complications of diabetes?

A

Xerostomia
Infections
Caries
delayed wound healing
Oral paraesthesia
Altered taste sensation

27
Q

Why do diabetics with poor glycaemic control have an increased risk of periodontitis?

A

Glycosylated haemoglobin gives an accurate indication of glycaemic control.
Patients with diabetes have higher levels of HbAIc.

28
Q

How do you manage a patient with periodontitis and diabetes?

A

Advise patients about the risks.
Collect diabetic history.
Review MH
Maintain the periodontal health.

29
Q

What can periodontal disease exacerbate?

A

Heart diseases.

30
Q

How does periodontal disease exacerbate heart disease?

A

Leads to entry of bacteria into the blood stream.
Bacteria activate the host inflammatory response.
Atheroma formation, maturation and exacerbation.

31
Q

How do you manage a patient with perio and a cardiovascular disease?

A

Stagger treatments
Multiple visits for treatment
Liase with cardiologist
Cardiac review

32
Q

What is supportive periodontal therapy?

A

It is directed towards limiting disease progression, identifying those sites that continue to break down and provide treatment when indicated.

33
Q

What are the aims of supportive periodontal therapy?

A

To prevent perio progression
Prevent tooth loss
Increase the likelihood of detection of other oral diseases

34
Q

When is supportive periodontal therapy useful?

A

Stable disease
Compliant patient
Good response to treatment
Good prognosis
Teeth are expected to be retained

35
Q

How is supportive periodontal therapy achieved?

A

Regular clinical assessments
Retreatment of certain sites
Patit motivation

36
Q

What are the stages of supportive periodontal therapy?

A

Review MH
Review OH
Clinical assessment
Radiographs
Diagnosis
Discuss findings
Treatment
Reinforce advice
Arrange recall.

37
Q

Why may a patient have non-responding sites in perio?

A

Incorrect diagnosis
Inadequate plaque control
Inadequate sub-gingival debridement
Smoking

38
Q

Why may a patient not be compliant with periodontal therapy?

A

Time
Cost
Social issues
Treatment complexity
Treatment dissatisfaction

39
Q

What are the systemic conditions that perio is related to?

A

Cardiovascular
Diabetes
Pregnancy
Obesity
Respiratory disease
Chronic kidney disease
Rheumatoid arthritis
Cognitive impairment
Metabolic syndrome
Cancer

40
Q

What are the anatomical risk factors of periodontitis?

A

Dental crowding
Furcation
Bone defects
Mucosal defects
Root grooves
Cervical enamel projections
Enamel pearls
Canine fossa.

41
Q

What do subgingival margins risk?

A

Plaque accumulation
Marginal tissue regression

42
Q

When can definitive restorations be placed in a patient with periodontal disease?

A

When a patient is engaging with periodontal advice.

43
Q

What questions would you as someone who smokes?

A

Type of tobacco
How many years they have been smoking.
What time of day is their first cigarette
Attempts to quit
Interest in quitting.

44
Q

What are the affects of smoking on the periodontium?

A

More sites with deeper pockets
Greater attachment loss
More teeth with furcation involvement.
Increased tooth loss
Accumulate more plaque.
Reduction in gingival vessels.
Poor healing response.

45
Q

What affect does smoking have on the inflammatory response?

A

Increased number of neutrophils with impaired function.
Inhibits fibroblast proliferation.

46
Q

What drugs cause gingival overgrowth?

A

Ca channel blockers - Amlodipine, nifedipine, felodipine.
immunosuppressants - ciclosporin.
Anti-epileptic drugs - Phenytoin.

47
Q

Why are pregnant women more likely to suffer with perio?

A

Due to the elevated oestrogen and progesterone vascular permeability is increased.

48
Q

What is a pregnancy epulis?

A

A small non-cancerous growth on the gingiva.

49
Q

How does an epulis form?

A

Inflammation from plaque formation.

50
Q

What are the oral complications to diabetes?

A

Xerostomia
Opportunistic infections (candida)
Caries
Delayed wound healing
Periodontal disease
Oral paraesthesia
Altered taste sensation
Glossodynia
Sialosis
Lichenoid drug reactions

51
Q

What are diseases associated with diabetes?

A

Retinopathy
Nephropathy
Neuropathy
Macro-vascular disease
Impaired wound healing
Periodontal disease.

52
Q

Explain the relationship between diabetes and perio.

A

It is Bi-directional.
Poor diabetic control is likely to have more rapidly progressing perio disease.
Leads to immune dysfunction, cellular stress and cytokine imbalance.
Enhanced tissue destruction and impaired tissue repair due to reduced collagen.

53
Q

How would you mange a patient with cardiovascular disease and perio?

A

Should be informed of increased CVD risk.
Should be informed of risk of cardiac event risk.
Take careful history.
Focus on prevention.
Regular monitoring
Be mindful of anti-platelet medications.

54
Q

For patients who are likely to not retain teeth, what should you do?

A

Regular clinical assessment
Retreatment
Motivation
Modify risk factors
Discuss progression
Manage symptoms
If they are compliant why may the disease still be progressing.

55
Q

When is SPT likely to be effective?

A

Good OH
Healthy looking gingiva
Shallow pockets
Stable attachment levels
Intact dentition
Removal of deposits.

56
Q

What is included in a periodontal assessment?

A

PPD
Bleeding scores
Plaque scores
Recession
Attachment loss
Suppuration
Mobility
Furcation

57
Q

Why may sites not be responding?

A

Incorrect diagnosis
Inadequate plaque control
Inadequate sub-gingival debridement
Smoking
Systemic/bacterial

58
Q

What makes a patient stable?

A

BoP less than 10%
PPD less than 4mm
No BoP at sites of 4mm

59
Q

What makes a patient in remission?

A

BoP more than 10%
PPD less than 4mm
No BoP at 4mm sites

60
Q

What makes a patient unstable?

A

PPD mroe than 5mm or PPD 4mm with BoP

61
Q

When are frequent recalls indicated?

A

Unstable disease
Grade C disease
Poor plaque control
Deep pockets
Poor response to treatment
Guarded prognosis
Risk factors
Special care

62
Q
A

Clinical knowledge II (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions