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BOARDs > Periodontics Part 1 > Flashcards

Periodontics Part 1 Flashcards

1
Q

The periodontium consists of:

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

Gingival Sulcus

A

Aka: Gingival Crevice
* natural space b/w tooth and gingiva

PERIODONTAL POCKET: Pathologically Deepened
* > 3 mm

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3
Q

Free Gingival Margin

A
  • Peak of gingiva
  • Base periodontal Measurements off of
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4
Q

Free Gingiva

A
  • unbound
  • Keratinized
  • b/w Free gingival margin and Free Gingival Groove
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5
Q

Free Gingival Groove

A
  • Shallow, linear depression on gingival surface
  • border b/w free gingival and attached gingiva
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6
Q

Attached Gingiva

A
  • Bound (attached to bone)
  • keratinized
  • extends from gingival groove to mucogingival junction
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7
Q

Mucogingival Junction

A
  • border b/w attached gingiva and alveolar mucosa
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8
Q

Alveolar Mucosa

A
  • Unbound
  • Non-Keratinized
  • b/w mucogingival jxn and vestibular fold
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9
Q

Vestibular Fold

A

Transition b/w alveolar mucosa and labial/buccal mucosa

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10
Q

Initiating Factor for Periodontal Disease

A

Microbial Plaque

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11
Q

Periodontal Health vs Gingivitis vs Periodontitis

A

Periodontal Health:
* No inflammation + No PDL & Bone Destruction

Gingivitis:
* Inflammation + No PDL & Bone Destruction

Periodontitis:
* Inflammation + PDL & Bone Destruction (CAL)

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12
Q

Periodontitis: Pathogenesis

A
  1. subgingival plaque bacteria=Microbial Challenge (LPS, antigens)
  2. inflmmatory response (Cytokines, prostaglandins, MMPs)
  3. Tissue Destruction
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13
Q

Erosion

A

Caused by acidic foods/beverages or gastric acid

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14
Q

Abrasion

A
  • Loss of tooth structure by mechanical wear
  • ex: aggressive tooth brushing
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15
Q

Attrition

A

Occlusal wear due to functional contacts w/opposing teeth

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16
Q

Hypersensitivity

A
  • due to exposed dentin tubules on root surface
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17
Q

Periodontal Exam consists of:

A

Objective:
* Probing Pocket Depth (PPD)
* Clinical Attachment Loss (CAL)
* Bleeding on Probing (BOP)

Additional:
* Gingival Recession
* Alveolar Bone Loss
* Suppuration
* Mobility
* Furcation

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18
Q

Probing Pocket Depth (PPD)

A
  • from gingival margin to base of pocket
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19
Q

Clinical Attachment Loss (CAL)

A
  • From CEJ to base of pocket
  • CAL=PPD + Recession
20
Q

Bleeding on Probing (BOP)

A
  • Best measure of inflammation
21
Q

Gingival Recession

A
  • from CEJ to gingival margin
  • apical shift of gingival margin
  • exposes root surface
22
Q

Alveolar Bone Loss

A
  • Radiographic measure-not realiable
  • BWs=Best
23
Q

Suppuration

A

Pus
* Large number of neutrophils in pocket

24
Q

Mobility is due to?

A

Due to:
* loss of periodontal support
* traumatic occlusion
* Both

25
Q

Furcation vs Furcation involvement

A

Furcation:
* branching point of tooth root

Furcation involvement:
* area of bone loss at furcation

26
Q

Oral Exam consists of

A

Home Care:
* Plaque
* calculus

Inflammation:
* redness
* swelling
* BOP

Destruction of Periodontal tissues:
* PPD
* CAL
* Alveolar BOne Loss
* Mobility
* Furcation involvement

27
Q

Miller Classification (MOBILITY)

A

Mobility
Class 0:
* Normal physiologic mobility

Class 1:
* Slightly more than normal

Class 2:
* moderately more than normal (</= 1mm)

Class 3:
* severely more than normal (> 1mm) & Vertically depressable

28
Q

What are some factors that predispose a tooth to furcation involvement?

A
  • Short root trunk
  • Short Roots
  • Narrow interradicular dimensions (B/w roots)
  • Cervical enamel projections
29
Q

Hamp Classifiction:Furcation involvement

A

Furcation
Class 0:
* No furcation involvement

Class 1:
* Horizontal furcation involvement < 3mm

Class 2:
* Horizontal furcation involvement > 3mm

Class 3:
Through-and-through furcation invovlement

30
Q

Glickman Classification

A

Furcation
Class 1:
* Pocket formation into the FLUTE
* incipient furcation involvement
* one 1 FLUTE

Class 2:
* Pocket formation into the FURCA (Furcation area)
* cull-de-sac furcation involvement

Class 3:
* Through-and-Through furcation lesion

Class 4:
Throgh and-through furcation lesion THAT YOU CAN SEE THROUGH

31
Q

What is the normal distance b/w CEJ and Alveolar Crest?

A

2mm

32
Q

Alveolar Bone Loss

A

Radiographic Measure: not reliable
* BWs=Best

Normal: 2mm from CEJ to alveolar
* parallel to lines connecting CEJs of adjacent teeth

Horizontal Bone Loss: > 2mm; parallel

Vertical Bone Loss
* Aka Angular
* classified by number of bony walls
* Not Parallel

33
Q

Vertical Bone Loss/Infrabony defects: Classification

A

1 wall:
* hemiseptal (horizontal defect)

2 wall:
* Crater
* most common

3 Wall:
* trough
* best prognosis

4 wall:
* circumferential
* extraction socket

34
Q

Miller Classification (Recession)

A

Regain Root Coverage w/Connective Tissue Graft (CTG)

Class 1:
* recession does not extend to mucogingival junction
* no loss of interdental bone or soft tissue
* 100% to regain

Class 2:
* to or beyond mucogingival junction
* no loss of interdental bone or soft tissue
* 100% to regain

Class 3:
* to or beyond the mucogingival jxn
* Interproximal bone or soft tissue loss, or tooth malpositiioning
* Partial root coverage

Class 4:
* to or beyond the mucogingival jxn
* Severe interdental bone, soft tissue loss, or tooth malpositioning
* 0%

35
Q

Gingivitis:

A

3 C’s:
Color
* Normal: Coral Pink
* Diseased: Red; Increased Blood Flow

Contour:
* inflammatory exudate and edema (swelling)
* Normal: Knife Edged
* Diseased: Blunted

Consistency:
* Chronic Gingivitis leads to fibrosis
* Normal=stippled

36
Q

Gingivitis:

A

3 C’s:
Color
* Increased Blood Flow (redness)
* Normal: Coral Pink
* Diseased: Red

Contour:
* inflammatory exudate and edema (swelling)
* Normal: Knife Edged
* Diseased: Blunted

Consistency:
* Chronic Gingivitis leads to fibrosis
* Normal=stippled

37
Q

Plaque Induced Gingival Diseases

A

Most common
* due to plaque bacteria & inflammatory response

Modified By: (not caused by)
Systemic Factor
* Endocrine changes (Puberty, prgenancy, diabetes)
* Blood dyscrasias (leukemia)

Medications:
* Drug-induced gingival enlargement w/CCB (Calcium channel blockers-nifedipine), dilantin, and cyclosporine (CDC)
* oral contraceptives

Malnutrition:
* Vit C Deficiency (Scurvy)

38
Q

Non-Plaque-Induced Gingival Diseases

A

Less Common

Due to
* Infections
* allergy
* trauma

Hereditary Gingival Fibromatosis:
* non-hemorrhagic and firm

39
Q

Periodontal Disease: Old Classification

A
  1. Severity (Based on CAL)
    * Slight: 1-2 mm CAL
    * Moderate: 3-4mm CAL
    * Severe: 5+ CAL
  2. Distribution
    * Localized: < 30%
    * Generalized: >/= 30%
  3. Type
    * Chronic Periodontitis
    * Aggressive Periodontitis
    * Necrotizing (ANUG or ANUP-Acute NEcrotizing Ulcerative Periodontitis)
40
Q

Chronic vs Aggressive Periodontitis

A

Chronic
* common
* Clinically Not healthy
* Slow progressive bone loss
* Microbial depositss consistent w/extent of destruction
* Modified by systemic issues (Smoking, diabetes)

Aggressive:
* rare
* Clinically Healthy
* Rapid Bone loss
* Familial aggregation
* Microbial deposits NOT CONSISTENT w/extend of destruction
* Localized version has first molar/incisor presentation(deeper poickets only around molars and incisor)

41
Q

Necrotizing (ANUG, ANUP)

A

Acute Necrotizing Ulcerative Gingivitis/Periodontitis
**
* Pseudomembrane
* Fetid Breath (Bad smalling)
* Blunted Papillae
* Fever**

Predisposing factors:
* stress
* smoking
* immunocompromised

42
Q

Supragingival vs Subgingival plaque bacteria species

A

Supragingival: Aerobic
* Tooth=Gram +
* Outer surface of plaque: Gram -

Subgingival: Anaerobic
* Tooth: G+ Coronal and G- apical
* Epithelium: G-

43
Q

Where is supragingival & subgingival components of plaque derived from

A

Supra gingival: Saliva
Sub gingival: GCF

44
Q

Steps in Dental Plaque Formation

A
45
Q

Plaque Composition: Organic vs Inorganic

A

Organic:
* polysaccharides
* proteins
* glycoproteins
* lipids

Inorganic:
* Calcium
* Phosphorus
* Sodium
* Potassium Fluoride

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