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PERIODONTICS > PERIODONTAL EXAMINATION AND DIAGNOSIS > Flashcards

PERIODONTAL EXAMINATION AND DIAGNOSIS Flashcards

1
Q

Periodontal Examination & Diagnosis:

A

Overall Appraisal of the Patient Health History
Dental History
Photographic Documentation Clinical Examination
Tactile Periodontal Examination Periodontal Charting
Examination of the Teeth (and Implants) Radiographic Examination
Laboratory Aids to Clinical Diagnosis
Periodontal Diagnosis
Assessment of Biofilm Control and Patient Education

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2
Q

Consider the Patient’s:
• Mental and Emotional Status
• Temperament
• Attitude
• Physiologic Age

A

Overall Appraisal of the Patient

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3
Q

Importance of Health history

A

1) the possible impact of certain systemic diseases, conditions, behavioral factors, and medications on periodontal disease, its treatment, and treatment outcomes;
(2) the presence of conditions that may require special precautions or modifications of the treatment procedure; and
(3) the possibility that oral infections may have a powerful influence on the occurrence and severity of a variety of systemic diseases and conditions
Hx

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4
Q

Morphological alterations evident

A

visual exam

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5
Q
  • check for disease with periodontal manifestations (plaque / non plaque induced)
    -oral hygiene status (amount of plaque on the tooth surfaces, distribution and localization)
A

visual exam

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6
Q

clinically healthy gingiva

A

Interdental Papilla
-pointed
Marginal Gingiva
-knife edge
Color
-coral pink
Consistency
-firm
Bleeding
-absent

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7
Q

inflamed gingiva

A

Interdental Papilla
-blunted
Marginal Gingiva
-rolled
Color
-erythematous
Consistency
-spongy
Bleeding
-present

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8
Q

color of clinically healthy gingiva

A

coral/salmon pink

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9
Q

consistency of clinically healthy gingiva

A

firm, well adapted

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10
Q

contour of clinically healthy gingiva

A

scalloped, sharp papillae, knife edge margin

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11
Q

surface texture of clinically healthy gingiva

A

matte stippled

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12
Q

marginal bleeding of clinically healthy gingiva

A

absent or slight

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13
Q

probing depth of clinically healthy gingiva

A

2-3mm

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14
Q

tissue resistance of clinically healthy gingiva

A

present to probe penetration

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15
Q

bleeding on probing of clinically healthy gingiva

A

absent,slight

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16
Q

pain on probing of clinically healthy gingiva

A

absent,slight

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17
Q

color of inflamed gingiva

A

erythematous,cyanotic

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18
Q

consistency of inflamed gingiva

A

edematous, spongy, loosely adapted

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19
Q

contour of inflamed gingiva

A

bulbous, swollen papillae, rolled margins

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20
Q

surface texture of inflamed gingiva

A

smooth, shiny

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21
Q

marginal bleeding of inflamed gingiva

A

moderate to severe

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22
Q

probing depth of inflamed gingiva

A

> 3mm

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23
Q

tissue resistance of inflamed gingiva

A

minimal to probe penetration

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24
Q

bleeding and pain to probing of inflamed gingiva

A

,moderate to severe

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25
Q

When probing, the probe tip should be
_______ as it slides down along the tooth surface to get to the bottom of the gingival crevice

A

in contact with the tooth surface

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26
Q

probing allows detection of

A

tooth surface irregularities,
furcation invasion, and
subgingival calculus

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27
Q

important indicator of presence of inflammation but does not reveal disease progression

A

bleeding on probing

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28
Q

indicator of absence of burst but does not indicate possible burst

A

bleeding on probing

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29
Q

active loss of connective tissue attachment thus the best time to intervene

A

burst

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30
Q

absence of ___ is a sign of stability and health (if there is no BOP, there is 0 chance of attachment loss)

A

bleeding

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31
Q

severity of bleeding

A

pinpoint
• thin linear or multiple pinpoint
• triangular
• droplets or pooling

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32
Q

does not reveal the true picture of attachment

A

pocket depth probing

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33
Q

measure the distance from the gingival margin to the bottom of the pocket.

A

pocket depth probing

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34
Q

measured on all surfaces using a graduated probe on 6 sites (like walking or sweeping)

A

pocket depth probing

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35
Q

in pocket depth probing we record the

A

deepest reading per site

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36
Q

in pocket depth probing you insert the probe until

A

there is resistance

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37
Q

Factors which Affect Probing

A

dimensions of perio probe
position of the probe
reference point location
pressure on the instrument
gingival tissue conditions
presence of surface accretions

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38
Q

dimension of perio probe

A

tip 0.4-0.5mm, uncomy of greater

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39
Q

position of the probe should be

A

parallel to the long axis of the tooth

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40
Q

reference point location

A

gingival margin

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41
Q

clinically healthy gingival margin

A

at the level,of CEJ

42
Q

inflamed gingival margin

A

coronal to the CEJ

43
Q

gingival margin in recession

A

apical to the CEJ

44
Q

normal pressure on the instrument should be

A

force 20-25g

45
Q

less than 20-25g of force means

A

inadequate force therefore no bleeding

46
Q

more than 25g force means

A

there is bleeding to to force or trauma

47
Q

if the collagen is firm, there would be

A

underestimation

48
Q

gingival tissue conditions beyond CJ, there would be

A

overestimation

49
Q

presence of calcular deposits, overhanging resto

A

presence of surface accretions

50
Q

treatment for surface accretions

A

perform initial scaling and remove overhangs

51
Q

Normal Gingival Sulcus

A

apical termination of JE is at the CEJ

52
Q

periodontal pocket depth considered as pristine

A

0.5mm

53
Q

normal PPD

A

2-3mm

54
Q

types,of pockets

A

pseudopockets
true pockets

55
Q

created by gingival enlargement. There’s no apical migration. 1mm increase due to inflammation in the coronal area

A

pseudopocket

56
Q

example of pseudopocket

A

gingivitis

57
Q

types of true pocket

A

suprabony
infrabony

58
Q

supracrestal or supraalveolar

A

suprabony

59
Q

-proliferating pocket epithelium
-remnant of base of pocket is coronal to the alveolar crest
-junctional epithelium persistent

A

suprabony

60
Q

location of base pocketnof suprabony

A

coronal,to the alveolar crest

61
Q

intrabony, subcrestal, intraalveolar

A

infrabony

62
Q

can be simple, compound or complex

A

infrabony

63
Q

can be 3 walled, 2 walled, 1 walled defect

A

infra

64
Q

the bone loss in this pocket is vertical in nature

A

infra

65
Q

location of the base/ bottom pocket of infrabony

A

apical to the adjacent alveolar crest

66
Q

the clinical attachment level is measured from

A

CEJ to the base of the pocket.

67
Q

evaluates amount of periodontal ligament lost in the disease and identifies apical extension of the lesion

A

CAL

68
Q

measures severity of the tissue attachment loss/connective tissue destruction.

A

CAL

69
Q

displacement of the soft tissue margin apical from the CEJ and exposure of the root surface, form of loss of attachment
and is measured from CEJ to the margin of gingiva

A

gingival recession

70
Q

formula for CAL

A

CAL=PPD+GR

71
Q

if there is furcation involvement, there is

A

loss of periodontal support in furcation areas of multi rooted teeth

72
Q

to look for furcation involvement we use

A

•
findings from probing (Nabers probe) and radiographic analysis ( radiolucencies at furcation areas)

73
Q

Diagnosis of furcation involvement

A

F1,F2,F3,F4

74
Q

loss of periodontal support tissue not exceeding 1/3 of the width of the tooth

A

F1

75
Q

loss of periodontal support tissue (horizontal) greater than1/3 but not encompassing the total width.

A

F2

76
Q

through and through destruction at furcation areas (total width of the furcation area)

A

F3

77
Q

same as F3 except that the entrance to the furca is clinically visible because of the presence of recession of the gingival margin

A

F4

78
Q

Glickman Classification of Furcation Invasion

A

GRADE, I,II,III,IV

79
Q

Glickman Classification of Furcation Invasion
-pocket formation into the flute but intact interradicular
bone

A

GRADE 1

80
Q

loss of interradicular bone and pocket formation of
varying depths into the furcation but not completely through to the opposite side of the tooth

A

GRADE II

81
Q

Through and through lesion

A

GRADE III

82
Q

same as grade III with gingival recession, rendering
the furcation clinically visible

A

GRADE IV

83
Q

provides evidence that the site is undergoing a period of exacerbation.

A

suppuration

84
Q

presence of pus

A

suppuration

85
Q

when in combination with other parameters, it increases the positive predictive value for progression of disease (increased chance of attachment loss)

A

suppuration

86
Q

the degree of movement within the socket is measured in mm.

A

mobility

87
Q

apply alternate forces on buccal and lingual

A

mobility

88
Q

physiologic tooth mobility

A

0.2mm

89
Q

0.5-1mm facial lingual tooth movement

A

grade 1

90
Q

1-2mm facial lingual tooth movement

A

grade 2

91
Q

over 2mm facial lingual tooth movement with vertical mobility

A

grade 3

92
Q

causes of mobility

A

occlusal trauma
loss of attachment
periapical abscess

93
Q

treatment for mobility

A

depends on the cause

94
Q

Normal bone level
• Normal attachment level
• Excessive Occlusal Force

A

occlusal trauma

95
Q

provides information which is not clinically detectable and confirms clinical findings

A

radiographic assessment

96
Q

Limitation of Parameters

A

only reveals history of the disease
does not show presence of active disease nor predict its
occurrence
reveals only the consequence of past disease
inherent inaccuracies

97
Q

Goals of Diagnostic Techniques

A

identify disease initiation and progression
monitor response to treatment
identify persons that are susceptible
differentiate between periodontal diseases

98
Q

New Diagnostic Techniques

A

controlled face, standardized probes (pressure sensitive probes)
• Computer Assisted Digital Radiography
• Bacteriologic DNA analysis
• Immunologic Based Test

99
Q

assessment of the susceptible host using markers in peripheral blood (PMN-leukocyte function, circulating
antibody levels, monocyte responsiveness to
lipopolysaccharide)

A

Immunofluorescent microscopy

100
Q

Enzyme-Linked Immunosorbent Assay Test

A

ELISA

101
Q

Used primarily to detect serum antibodies to periodontal
pathogens, can also be used to quantify specific pathogens
in subgingival samples using specific monoclonal antibodies.

A

ELISA Test

102
Q

Test pressure of production of proteases by P. Ging
and B. Forsythus

A

BAA (Benzoyl-Arginine-Naphthylamide) hydrolysis
test/perio scan

PERIODONTICS (4 decks)

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