Periodontics

Question 1

what 2 bacteria are associated with AgP?

Answer 1

Aggregatibacter actinomycetemcomitans (AA)

Porphyromonas gingivalis (PG)

Question 2

2 disorders that are associated with AgP

Answer 2

Ehlers Danlos syndrome
- defects in collagen synthesis

Papillon Lefevre

• genetic
• palms and feet have hyperkerotosis and periodontitis

Question 3

In Tx for AgP, why antibiotics is required? and what do we use?

Answer 3

• Aa bacteria diffuses into tissues, RSD alone is unable to eradicate them.
• 400mg Metronidazole

Question 4

Chronic periodontitis can be caused by neutropenia.

• what is neutropenia?
• what 3 disorders are associated with it?

Answer 4

Abnormal low conc of neutrophils

• Familial / acquired neutropenia
• Chediak Higashi Syndrome
• Downs syndrome

Question 5

what are the associated signs and symptoms of Chediak Higashi Syndrome? (2)

Answer 5

albinism

photophobia

Question 6

what is is the pathophysiology of Chediak Higashi syndrome?

Answer 6

mutation in lysosomal trafficking regulatory protein

Question 7

what 4 bacteria is associated with ANUG?

Answer 7

fuso-spirocheatal organism

gram -ve anearobes

• porphyromonas
• treponema
• prevotella

Question 8

what disease is called after ANUG? (4)

Answer 8

ANUG
ANUP
necrotizing stomatitis
cancrum oris

Question 9

what is another name for cancrum oris?

Answer 9

noma

Question 10

what 3 drugs causes DIGO?

+2 bonus points

Answer 10

phenyoin
calcium channel blockers
cyclosporin

oral contraceptives
carbamazepine

Question 11

what bacteria is associated with lateral perio abscess?

Answer 11

GNAB

Question 12

what is the another term for pregancy epulis?

Answer 12

pyogenic epulis

Question 13

what is the Tx for DIGO? (3)

Answer 13

OHI
consult GP
folic acid supplements

Question 14

why does pregancy epulis occur? (3)

Answer 14

• increased progesterone levels
• changes vaculature
• decreases thickness of keratin

Question 15

name the 2 types of implantitis

Answer 15

peri-implant mucositis (no LOA)
peri implantitis (LOA)

Question 16

how to calculate pack years

Answer 16

packs/day x no. of years

Question 17

how many cigarettes in one pack?

Answer 17

20

Question 18

equals to how many cigarettes?

• 1g of tobacco
• small cigar
• cigar

Answer 18

• 1 cigarette
• 3
• 5

Question 19

what is the effect of smoking on

• mucosa (3)
• gingiva (1)
• teeth (2)

Answer 19

mucosa

• SCC
• leukoplakia
• hyperkeratosis

gingiva
- strongly linked to AgP

teeth

• staining
• rough tooth surface

Question 20

what is the effect of smoking on

• saliva (1)
• gingival crevicular fluid (1)
• blood flow (2)

Answer 20

saliva
- decrease salivary flow in long term

GCF
- decreased GCF flow

blood

• large vessels transition into smaller blood vessels.
• vasoconstriction, decreased BOP

Question 21

3 effects of cannabis on oral health?

Answer 21

• hyperkeratosis
• xerostomia
• perio disease (suppressed immunity)

Question 22

which is more carcinogenic: cannabis or tobacco? and by how much?

Answer 22

cannabis

50% more carcinogenic

Question 23

5 effects of alcohol on oral health?

Answer 23

• xerostomia
• perio disease (defective neutrophils)
• reduced healing
• poor blood clot
• increased bone resorption
• SCC

Question 24

what is HbA1c?

Answer 24

• glycated haemogoblin

- finds out glucose levels over the past 3 months

Question 25

what is a ___ HbA1c level (in mmol/mol and %)? - normal - diabetic

Answer 25

normal - <42mmol/mol - <6% diabetic - >48mmol/mol - >6.5%

Question 26

what are the key cells/elements responsible for - healing (1) - clotting (3) - immunity (2)

Answer 26

healing - fibroblast clotting - prothombin - clotting factors - vitamin K immunity - neutrophils - macrophages

Question 27

what is the effect of diabetes on oral health? (3)

Answer 27

reduced collagen production - increase in AGE (advanced glycated end-products) reduced immunity - defective neutrophils reduced healing - defective fibroblast

Question 28

what test would you use to determine the current blood sugar levels? (1) and what level is considered diabetic? (1)

Answer 28

- Random Blood Sugar (RBS) test | - >200mg/dL

Question 29

what is the role of Vitamin C in perio? (2)

Answer 29

- collagen synthesis | - helps in crosslinking

Question 30

a deficiency in Vitamin C can cause? (1)

Answer 30

Scurvy

Question 31

after RSD, how long should we wait before recharting?

Answer 31

10-12 weeks

Question 32

what does the TIPPS behavioural therapy stand for?

Answer 32

``` talk instruct plan practice support ```

Question 33

what is name of the theory behind dentine hypersensitivity?

Answer 33

Brannstrom Hydrodynamic Theory (1960)

Question 34

What is the Brannstrom theory? (2) How does it work? (4)

Answer 34

- nerves that contain stretch sensitive ion channels - in the dentinal tubules, which is fluid filled. Outflow of fluid - decreased hydrostatic pressure - caused by drying, cooling, evaporation Inward flow - increased hydrostatic pressure - caused by heating, mechanical

Question 35

name the 4 types of wear

Answer 35

attrition abrasion erosion abfraction

Question 36

how does fluoride varnish work?

Answer 36

forms calcium fluoride in the tubules

Question 37

Listerine - what is the active ingredient? - how does it work?

Answer 37

dipotassium oxalate monohydrate 1.4% forms insoluble calcium oxalate crystals in tubules

Question 38

contraindications to using Listerine?

Answer 38

liver problems

Question 39

Novamin - what is the active ingredient? - how does it work?

Answer 39

calcium sodium phosphosilicate forms calcium phosphate layer.

Question 40

What is the technology used in Sensodyne?

Answer 40

Novamin

Question 41

Emdogain - when is it used? - what is in it?

Answer 41

used in guided perio tissue regeneration contains enamel matrix protein (amelogenin) taken from developing teeth in pigs/porcine.

Question 42

what is amelogenin? (2)

Answer 42

- enamel matrix protein | - secreted by HERS

Question 43

what does amelogenin do? (3)

Answer 43

- mineralizes to form hyaline layer - induces dental follicle to form cementoblast - producing cementum matrix mineralizes, entrapping PDL fibers.

Question 44

name 4 types perio surgeries

Answer 44

- periodontal flap surgery (access for debridement) - crown lengthening - guided tissue regeneration - mucogingival surgery (for recessions)

Question 45

what are the gingival biotypes (4)

Answer 45

thick, flat - short papillae - suggest thick bony architecture, resistant to inflammation and trauma thin, scalloped - long papillae - suggest thin bony architecture, prone to inflammation and trauma

Question 46

what is the prevalence of - thick biotype - thin biotype

Answer 46

thick 85% thin 15%

Question 47

what is Raynaud's disease?

Answer 47

- spontaneous restriction of arteries (especially in extremities, ie fingers) - associated with Ehlers Danlos

Question 48

why placing free gingival grafts on root surface has an unpredictable outcome? (1) what is the alternative?(2)

Answer 48

- root surface does not provide a nutrient bed for free graft ti survive. - coronally repositioned flap - lateral pedicle graft

Question 49

in perio 2017 classification, | how do you assessing staging? (5)

Answer 49

check severity ``` stage 1 - <15% of bone loss 2 - coronal 1/3 3 - mid 3rd 4 - apical 3rd ```

Question 50

in perio 2017 classification, | how do you assessing grading? (4)

Answer 50

% bone loss / age Grade A - <0.5 B - 0.5-1 C - >1