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INBDE > Periodontics > Flashcards

Periodontics Flashcards

1
Q

What does the periodontium consist of?

A
  • Alveolar Bone
  • PDL
  • Cementum
  • Gingiva
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2
Q

Gingival Sulcus

A
  • Aka Gingival Crevice
  • Natural space b/w the tooth and gingiva
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3
Q

Gingival Margin

A
  • Aka Free Gingival Margin/ Gingival Crest
  • Peak of the gingiva
  • Used in Periodontal pocket depth (PPD) measurement
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4
Q

Free Gingival Groove

A
  • Shallow linear depressino on the gingival surface
  • border b/w free gingiva and attached gingiva
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5
Q

Mucogingival Junction

A
  • Border b/w the attached gingiva and alveolar mucosa
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6
Q

Free Gingiva vs Attached Gingiva vs Alveolar Mucosa

A

Free Gingiva:
* Not bound
* Keratinized

Attached Gingiva:
* Bound
* Keratinized

Alveolar Mucosa:
* Not Bound
* Non-keratinized

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7
Q

What is the initiating factor for gingivitis and periodontitis?

A
  • Microbial Plaque (BIofilm)
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8
Q

Biofilm

A
  • Microbial plaque
  • Thin layer of bacteria on the tooth surface
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9
Q

What are the 3 states of the periodontium? Describe each

A

Periodontal Health:
* No inflammation
* No PDL and Bone destruction

Gingivitis:
Inflammation
* No PDL and Bone Destruction

Periodontitis:
* Inflammation
* PDL and Bone Destruction (CAL)

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10
Q

What is the Pathogenesis of Periodontal Disease?

A
  1. Microbial challenge (LPS, antigens) subgingival plaque bacteria
  2. Upregulated host immune inflammatory response (Cytokines, prostaglandins, MMPs)=gingivitis (inflammation, no PDL or bone destruction)
  3. Tissue Destruction=Periodontitis (Inflammation w/PDL and bone destruction
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11
Q

Erosion

A
  • caused by acidic foods/beverages or gastric acid
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12
Q

Abrasion

A
  • Loss of tooth structure by mechanical wear
  • ex: Aggressive w/Hard Bristled tooth brush
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13
Q

Attrition

A
  • occlusal wear from functional contacts w/opposing teeth
  • Bruxism and clenching
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14
Q

Abfraction

A
  • Loss of tooth structure in cervical areas
  • due to tooth flexure
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15
Q

Hypersensitivity

A

Result of exposed dentinal tubules in root surface

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16
Q

What are the 3 objective findings in a Periodontal Exam?

A
  1. Probing Pocket Depth (PPD)
  2. Clinical Attachment Loss (CAL)
  3. Bleeding on Probing (BOP)
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17
Q

How do you measure Probing Pocket Depth

A
  • Gingival magin to base of pocket
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18
Q

How do you measure clinical attachment loss (CAL)?

A
  • CEJ to base of pocket
  • CAL=PPD + Recession (CEJ to gingival margin)
19
Q

Bleeding on Probing (BOP)

A
  • best measure of inflammation in periodontal tissues
19
Q

Bleeding on Probing (BOP)

A
  • best measure of inflammation in periodontal tissues
20
Q

Gingival Recession

A
  • From CEJ to gingival margin
  • Apical shift of gingival margin
  • exposes root surface
21
Q

Suppuration

A
  • Indicates large number of neutrophils in pocket
  • Puss
22
Q

Mobility is due to

A
  • due to loss of periodontal support, traumatic occlusion, or combo
23
Q

Define Furcation vs Furcation involvement

A

Furcation:
* branching point of a tooth root

Furcation Involvement:
* area of bone loss at the furcation

24
Q

What does An oral exam consists of?

A

Home Care:
* measure w/local factors-plaque & calculus
* How much they are brushing and flossing? Proper technique?

Inflammation-> redness, swelling, BOP

Destruction of Periodontal tissues–>PPD, CAL, Alveolar bone loss, mobility, furcation involvement

25
Q

Miller Classification of Mobility

A
26
Q

Furcation involvement factors:

A
  • Short root trunk (measured from CEJ to furcation)
  • Short roots
  • Narrow interradicular dimension (Distance b/w roots)
  • Cervical enamel projection (Enamel dips down into furcation area, should be cementum)
27
Q

Hamp Classification of Furcation

A

Use NABERs Probe (3mm increments)
Class 0:
* no furcation involvement

Class 1:
* horizontal furcation invovlement
* < 3mm

Class 2:
* Horizontal furcation involvement
* > 3 mm

Class 3:
* through-and-through furcation involvement
* Nabers probe sticks out the other side-can see clinically

28
Q

Glickman Classification of Furcation

A

Class 1
* pocket formation in the FLUTE (only have 1 flute)
* incipient furcation involvement

Class 2:
* Pocket formation into the FURCA (Furcation areabranching b/w your 2 fingers)
* Cul-de-sace furcation involvement

Class 3:
* Through-and-Through Lesion
* same as Hamp classification

Class 4:
* Through-and-Through Lesion
* YOU CAN SEE THROUGH

29
Q

What is the normal distance from the CEJ to Alveolar Crest in a healthy patient?

A

2 mm

30
Q

Alveolar Bone Loss

A
  • Crest should be PARALLEL to line connecting CEJs of adjacent teeth

Horizontal Bone loss:
* Stays parallel to line connecting CEJs

Vertical or angular Bone Loss:
* classified by # of bony walls remaining
* not parallel to line connecting CEJs

31
Q

What is the best radiograph to assess bone height?

A

Bite Wings (Horizontal or vertical)

32
Q

Classification of Vertical/Infrabony Defects

A

1 wall= Hemiseptal

2 wall: Crater
* most common
* occurs b/w two teeth (lose interseptal bone)

3 Wall: Trough

4 Wall: Circumferential (Extraction socket)

33
Q

Millers Classification of Recession

A
34
Q

Gingivitis

A

Inflammation of Gingiva

Measured by 3 C’s:
Color
* from Increased Blood Flow=Red
Contour
* Inflammatory exudate and edema (Swelling)
Consistency
* Chronic gingivitis leads to fibrosis
* Ideal=Stippling (Like an orange peel)

35
Q

Plaque-Induced Gingival Diseases

A
  • Most common
    Result of an interaction b/w plaque bacteria and inlammatory cells of host

Modified by: (Not Caused by!)
Systemic Factors
* endocrine changes (Puberty pregnancy, diabetes)
* Blood dyscrasias (Leukemia)

Medications
** Drug induced gingival enlargement w/CCB (Nifedipine), dilantin, cyclosporine*
* Oral contraceptives*

Malnutrition
* Vitamin C Deficiency (Scurvy)

36
Q

Non-Plaque-induced Gingival Diseases

A
  • Less common than plaque induced

In response to:
* Infections
* allergy
* Trauma

Hereditary Gingival Fibromatosis
* non-hemorrhagic
* firm

37
Q

Periodontal Disease: Classification System (OLD)

A
  1. Severity (CAL)
  2. Distribution
  3. Type
38
Q

Periodontal Disease: Severity

A

Based on CAL
* Slight: 1-2 mm CAL
* Moderate: 3-4 mm CAL
* Severe: >/= 5 mm CAL

39
Q

Periodontal Disease: Distribution

A

How many sites in mouth with the CAL
* Localized: < 30%
* Generalized: >/= 30%

40
Q

Periodontal Disease: Types

A
  • Chronic
  • Aggressive (opposite of chronic)
  • Necrotizing
41
Q

Chronic vs Aggressive Periodontitis

A

CHronic:
* Clinically not Healthy (Smoker, diabetes)
* Slower, progressive bone destruction
* Microbial deposits CONSISTENT w/extent of destruction
* Modied by systemic Issues (Smoking, diabetes)
* Older

Aggressive (Opposite):
* Clinically Healthy
* Rapid Bone destruction
* Familial aggregation
* Microbial deposits NOT consistent w/extent of destruction
* Localized version has first MOLAR/INSOR presentation (Deeper pockets ONLY aroudn molars and inciros)
* Younger

42
Q

Necrotizing Periodontal Disease

A

ANUG: Acute Necrotizing Ulcerative Gingivitis
ANUP: Acute Necrotizing Ulcerative Periodontitis

  • Pseudomembrane
  • Fetid breath (Bad breath)
  • Blunted Papillae
  • Fever

Predisposing factors:
* stress
* smoking
* immunosuppresion

INBDE (1 decks)

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