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Regeneration > Periodontal Disease and Regeneration > Flashcards

Periodontal Disease and Regeneration Flashcards

1
Q

peri

A

around

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2
Q

odont

A

tooth

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3
Q

What four tissues make up the periodontium?

A
  1. gingiva
  2. PDL
  3. cementum
  4. bone
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4
Q

What is supracrestal attachment or biological width?

A

where the gum attaches to the tooth at the CEJ

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5
Q

What should the sulcus depth be

A

connective tissue ~ 1.0 mm
junctional epithelium ~ 1.0 mm

biological width = 2.0 mm

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6
Q

The connective tissue attaches ___ to the CEJ

A

apical

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7
Q

What are the fibers that help attach the gum to the tooth?

A
  1. DGF - dentogingival fibers
  2. CF - circumfrential fibers
  3. TF - trans-septal fibers
  4. DPF - dentoperiosteal fibers
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8
Q

What are the 6 PDL fibers?

A
  1. ACF - alveolar crest
  2. HF - horizontal
  3. OF - oblique
  4. APF - apical
  5. ABP
  6. RC - inter-radicular
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9
Q

What are the three different terms for bone depending on what field you are studying in?

A
  1. alveolar bone proper - gross anatomy
  2. bundle bone - histology
  3. lamina dura - radiographic anatomy
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10
Q

What is the disease spectrum?

A

*not everyone who has gingivitis will develop periodontitis, it depends how the body responds to certiain bacteria

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11
Q

What are the 4 main factors which lead to periodontitis?

A
  1. local risk factors and environment
  2. bacteria
  3. time
  4. host immune response and genetics
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12
Q

What is gingivitis?

A

An inflammatory lesion resulting from interactions between the plaque biofilm and the host’s immune response, which remains contained within the gingiva and does not extend into the periodontal attachment.

Inflammation is contained in the gingiva and does not extend past the mucogingival junction and is reversible by reducing the levels of plaque at and apical to the gingival margin.

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13
Q

What is periodontitis?

A

Chronic *multifactorial inflammatory disease associated with dysbiotic plaque biofilms characterized by progressive destruction of the tooth-supporting apparatus. Primary features include loss of periodontal tissue support manifested through clinical attachment loss (CAL) and radiographically assessed alveolar bone loss, presence of periodontal pocketing and gingival bleeding.

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14
Q

Compare and contrast health, gingivitis and periodontitis.

A
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15
Q

What is the normal probing pocket depth?

A

1-3 mm

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16
Q

How do you calculate clinical attachment loss?

A

CAL = probing depth + recession

17
Q

If you have a 4mm pocket, does that mean you have abnormal pocket depths?

A

CAL = 4 mm - 4 mm = 0

*not an abnormal pocket depth and might not have periodontal disease

18
Q

If you have 4 mm probing depth and 2 mm gingival recession, does this person have periodontal disease?

A

Yes. Patient has lost 6mm of bone

CAL = 4 + 2 = 6 mm

19
Q

What are the 4 consequences of untreated disease?

A
  1. further attachment loss
  2. periodontal abscess
  3. tooth mobility and altered position
  4. tooth loss
20
Q

Describe the fate of a pocket

A
  1. reduce bacteria
  2. reduce inflammation
  3. pocket becomes inactive
  4. reduction in probing depth
    - recession
    - long junctional epithelium formation
21
Q

Inactive pockets heal with a

A

long junctional epithelium

22
Q

What happens if the long junctional epithelium has a chance to re-open?

A
  • pocket reformed
  • depends on OH levels and host response
23
Q

True or false: Inactive pockets can be maintained for long periods with little CAL if frequent maintenance and excellent OH on patients part

A

True

24
Q

What type of environment does a bacteria love in deep pockets?

A

warm, dark, damp, oxygen free

25
Q

What does altering pocket depth via SURGICAL REDUCTION result in?

A
  • healthy sulcus with or without gain in attachment
  • recession of gingiva exposing the attachment loss caused by previous bout of disease
26
Q

What does altering pocket depth via PERIODONTAL REGENERATION result in?

A
  • improved gingival attachment
  • restoration of bone height, with re-formation of periodontal ligament fibers and cementum
27
Q

What are the three ways of altering a pocket depth?

A
  1. surgical reduction
  2. periodontal regeneration
  3. tooth extraction
28
Q

Compare and contrast the three methods of pocket reduction

A
29
Q

Which method of pocket reduction offers an ideal result?

A

periodontal regeneration

30
Q

True or False: The goal of periodontal regeneration is to create a long junctional epithelium.

A

False

Long junctional epithelium is not a true attachment, it is just a tightening after removal of bacteria

31
Q

What is repair?

A

healing of a wound that does not fully restore the architecture or the function of the long junctional epithelium

32
Q

What is reattachment?

A

reattachment of the gingiva to areas from which it was mechanically removed

33
Q

What is new attachment?

A

occurs when newly generated fibers are embedded in new cementum on a portion of the root that was uncovered by disease

34
Q

What is regeneration?

A

reproduction or reconstruction of the lost or injured part in such a way that the architecture and function is completely restored

35
Q

What is resorption?

A

loss or blunting of some portion of a root, sometimes idiopathic, also associated with orthodontics, inflammation, trauma, endocrine disorders and neoplasia

36
Q

What is ankylosis?

A

fusion of the tooth and alveolar bone

37
Q

Periodontal regeneration must consider what 4 environmental factors?

A
  1. coordinated formation from
    - bone
    - PDL
    - cementum
  2. role of bacterial contamination during healing
  3. faster moving epithelium vs bone, PDL, cementum (growth)
  4. functional environment (i.e., tongues)
38
Q

How many mm/day does bone and epithelium move?

A
  1. epithelium = 0.5 mm/day
  2. bone = 0.05 mm/day **slower

Regeneration (5 decks)

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