Periodontal disease

Question 1

Gingival diseases

Answer 1

All contained within gingival tissue
-no evidence of periodontal attachment loss
-may produce pseudopocketing
Inflammation present = bleeding on probing

Question 2

Chronic periodontitis

Answer 2

Local or generalised
Often subgingival calculus
Variable microbial pattern
Slow to moderate rate of progression (can have rapid periods)
Can be associated with local predisposing factors and systemic diseases e.g. diabetes melltisu
Can be modified by cigarrete smoking and stress
Probing should not be too painful
Bone loss

Question 3

Aggressive periodontitis

Answer 3

Rapid attachment loss and bone destruction
Possible familial aggregation of disease
Pxs systemically healthy
Localised and generalised forms
Features that may be present
-P tissue destruction > than expected given levels of local factors
->Ag. actinomyces. or Porphyromonas gingivalis
-Phagocyte abnormalities and > production of prostaglandin E2 and interleukin-1b
-Progression of attachment and bone loss may be self-arresting

Question 4

Periodontitis as manifestation of systemic diseases

Answer 4

Haematological disorders
Leukaemia: more prone to infection like severe anaemia
Genetic disorders
-Downs syndrome
-Papillon Lefevre syndrome (aggressive periodontitis and hyperkeratinisation)
-Ehlers Danlos syndrome type IV and VIII
-Cohen syndrome
-Glycogen storage disorder
Hypophosphatasia

Question 5

Necrotising periodontal diseases

Answer 5

Includes NUP and necrotising ulcerative gingivitis
< systemic resistance to bacterial infection
NUP extends into periodontal attachment
Ulceration, pain, necrosis, halitosis

Question 6

Gingival abscess

Answer 6

Localised, purulent infection that involves marginal gingiva or interdental papilla

Question 7

Periodontal abscess

Answer 7

Localised, purulent infection within tissue adjacent to periodontal pocket
May lead to destruction of PDL and alveolar bone

Question 8

Pericoronal abscess

Answer 8

Localised, purulent infection within tissue surrounding crown of partially erupted tooth

Question 9

Symptoms of gingivitis

Answer 9

Red
Inflamed
Oedematous (swelling)
Loss of stippling
Rolled gingival margin

Question 10

Symptoms of periodontitis

Answer 10

Periodontal pocketing
Bone loss (loss of attachment)
Teeth mobility
Halitosis

Question 11

Mobility test

Answer 11

0: immobile
1: slight horizontal movement
2: more horizontal movement
3: horizontal + rotational + vertical movement

Question 12

Furcation index

Answer 12

Using Naber’s probe

0: none
1: 1/3 into furcation
2: 1/3-2/3 into furcation
3: completely through

Question 13

Root surface debridement procedure

Answer 13

LA
Wash with chlorhexidine
Hoes to remove calculus/ plaque
Ultrasonic flush
Rinse with chlorhexidine