Periodontal Disease Flashcards
_________ is the initial process of swollen and/or inflamed gingival margins +/- hemorrhage. This is caused by bacterial plaque in conjunction with host responses.
gingivitis
T/F: gingivits is a multifactorial disease process
true – bacterial presence + host response to bacteria
What are the risk factors for gingivitis?
- age
- breed (toys)
- crowding of teeth
- soft foods
- chewing habits
- lack of oral care
________ is an organic, transparent, adhesive BIOFILM that colonizes the teeth in 24-36 hours after cleaning or brushing.
plaque
T/F: plaque is food residue left behind after meals that is removed by brushing
false – NOT food residue. its a biofilm
what are the 3 steps to plaque formation?
- attachment and colonization
- growth and proliferation
- maturation and detachment
what type of bacteria are involved with gingivitis?
anaerobes and spirochetes
gram negatives
what does the gingival inflammatory response to plaque involve?
- vasculitis
- edema
- collagen loss
What occurs after plaque calcifies into dental calculus?
calculus attracts more plaque which promotes periodontal disease
progressive periodontitis destroys the ___________.
periodontium (hard and soft tissues)
describe stage 0 of periodontal disease
normal – no gingivitis or bone loss
this is practically never seen and is the ONLY exception to the rule of not grading periodontal disease solely by appearance/without radiographs.
describe stage 1 of periodontal disease
gingivitis only, no bone loss.
describe stage 2 of periodontal disease
<25% attachment loss or stage 1 furcation involvement
Stage 3 of periodontal disease has _____% attachment loss or stage 2 furcation involvement
25-50%
Stage 4 periodontal disease has ____% attachment loss or stage 3 furcation involvement.
> 50%
__________ furcation involvement is when periodontal probe extends LESS THAN half way under the crown of a multirooted tooth
stage 1
__________ furcation involvement is when periodontal probe extends greater than halfway under the crown of a multirooted tooth, but NOT all the way through
stage 2
__________ furcation involvement is when periodontal probe extends under the crown of a multirooted tooth from one side through to the other side.
stage 3
what is the ONE exception to for which you can make a diagnosis of stage 4 periodontal disease WITHOUT needing dental radiographs to prove bone loss?
stage 3 furcation involvement. This is automatically stage 4 PD.
how do we treat stage 1-2 PD?
dental cleaning and subgingival scaling
how do we treat stage 3 PD?
dental cleaning
subgingival scaling
closed root planing (aggressive scaling to remove subgingival calculus and diseased tissue)
what is the purpose of preparing a periodontal pocket?
- remove plaque, calculus, and bacteria from root surface
- remove inflamed soft tissue from pocket lining.
What can we instill into the gingival sulcus that binds to calcium, has antimicrobial activity for 10-14 days, and has anticollagenase activity for weeks to months?
Doxirobe (doxycycline gel)
what product can we instill into the gingival sulcus that has antimicrobial activity for 7-10 days but NO anticollagenase activity?
Clindoral
For all PD stages, we should apply ________ to delay the reattachment of plaque and promote healing.
barrier sealant (oravet or sanos)
Stage 4 peridontal disease with deep pockets must be treated with a surgical approach and open root planing or extraction. What is the downside to open root planning in these cases?
you would create a flap, curette the calculus, pack with bone graft, and then close. This can stimulate new bone growth and provide support to the tooth.
The downside is that is requires EXCELLENT home care.
what are the 3 bone graft options?
- autograft
- allograft
- synthetic consil
T/F: pre-operative antibitoics do NOT prevent bacteremia and should NOT be used unless there is a tooth root abscess with facial swelling
true
T/F: perioperative IV antibiotics prevent bacteremia
false – they dont prevent it, but they are indicated with invasive procedures, prolonged procedures, in immunocompromised patients, or in patients with underlying diseases (ex. chronic kidney failure)
when can antibiotic therapy be extended for dental procedures?
in cases of osteomyelitis that is present on radiographs.
what should antibiotic therapy cover?
pathogenic oral flora (gram negatives and anaerobes)
clindamycin and clavamox are great options.
