periodontology 1

Question 1

SYMBIOSIS

Answer 1

• DYNAMIC BALANCE EXISTS BETWEEN
RESIDENT COMMUNITIES OF
MICROORGANISMS AND THE HOST

Question 2

DYSBIOSIS

Answer 2

• DISEASE RESULTS FROM A BREAKDOWN OF

THIS DELICATE RELATIONSHIP

Question 3

GINGIVITIS

Answer 3

NON-SPECIFIC, REVERSIBLE INFLAMMATORY
RESPONSE TO AN INCREASED ACCUMULATION
OF BIOFILM AROUND THE GINGIVAL MARGIN

Question 4

PERIODONTITIS

Answer 4

AN INFLAMMATORY DISEASE AFFECTING ALL OF THE PERIODONTAL STRUCTURES CAUSED BY PLAQUE
• THERE IS A LOSS OF ATTACHMENT
• THERE IS A LOSS OF BONE HEIGHT

Question 5

HOW DO WE RECORD AND MONITOR GINGIVAL

HEALTH AND DISEASE?

Answer 5

1. BPE-TELLS US WHAT’S HAPPENING
2. PLAQUE AND BLEEDING SCORES-TELL US HOW MUCH PLAQUE IS PRESENT, AND THE PATIENT’S
   ADHERENCE TO ORAL HYGIENE
3. PHOTOS (USEFUL FOR MEMORY, AND MOTIVATION!)
4. 4. CPE

Question 6

O’LEARY PLAQUE SCORE

Answer 6

1. DISCLOSE THE TEETH
2. THE PRESENCE OF PLAQUE AT THE GINGIVAL MARGIN IS RECORDED FOR ALL TEETH AT 4 SITES:
   MESIO-BUCCAL, BUCCAL, DISTO-BUCCAL, LINGUAL/PALATAL.
3. THE NUMBER OF SITES WITH PLAQUE IS EXPRESSED AS A PERCENTAGE OF THE TOTAL NUMBER OF SITES IN THE MOUTH

Question 7

CPE

Answer 7

• PROBING POCKET DEPTH
• BLEEDING ON PROBING (FROM THE BASE OF THE POCKET)
• PUS ON PROBING
• TOOTH MOBILITY
• FURCATION INVOLVEMENT
• RECESSION

Question 8

HOW ARE POCKETS MEASURED?

Answer 8

WE USE A GRADUATED PERIODONTAL PROBE (METAL OR PLASTIC) WHICH IS 0.5MM AT THE TIP
• THE THIN TIP ALLOWS THE PROBE TO ENTER A NARROW POCKET
• IT IS BLUNT SO THAT IT DOES NOT PERFORATE THE TISSUES

Question 9

WHAT DETERMINES HOW MUCH A PROBE WILL PENETRATE BEYOND THE GINGIVAL
MARGIN?

Answer 9

• CALCULUS/RESTORATIONS/CAVITIES SUBGINGIVALLY
• THE INTEGRITY OF THE EPITHELIAL BARRIER
• SIZE/SHAPE/TIP OF PROBE
• OPERATOR PRESSURE
• PATIENT’S REACTION!
• WHETHER LOCAL ANAESTHETIC IS USED

Question 10

WHAT DO WE USE TO MEASURE TOOTH MOBILITY

Answer 10

WE USE MILLER’S CLASSIFICATION (1950)

Question 11

MILLER’S CLASSIFICATION GRADE 1

Answer 11

SLIGHT MOBILITY, LESS THAN 1MM IN A HORIZONTAL DIRECTION

Question 12

MILLER’S CLASSIFICATION GRADE 2

Answer 12

MOBILITY 1-2 MM IN A HORIZONTAL DIRECTION

Question 13

MILLER’S CLASSIFICATION GRADE 3

Answer 13

MOBILITY OVER 2MM IN ANY DIRECTION

Question 14

WHAT IS A FURCATION INVOLVEMENT?

Answer 14

THIS IS WHEN THE PROGRESSION OF PERIODONTAL DISEASE AFFECTS THE
FURCATION AREA OF A MULTI ROOTED TOOTH

Question 15

WHAT IS USED TO MEASURE FURCATION?

Answer 15

NABERS PROBE

Question 16

CLASSIFICATION BY HAMP ET AL. (1975)

CLASS 1

Answer 16

CLASS 1 LOSS OF HORIZONTAL PERIODONTAL SUPPORT NOT EXCEEDING

ONE THIRD OF THE WIDTH OF THE TOOTH

Question 17

CLASSIFICATION BY HAMP ET AL. (1975)

CLASS 2

Answer 17

LOSS OF HORIZONTAL PERIODONTAL SUPPORT EXCEEDING ONE THIRD OF THE WIDTH OF THE TOOTH, BUT NOT ENCOMPASSING THE TOTAL WIDTH OF THE FURCATION AREA

Question 18

CLASSIFICATION BY HAMP ET AL. (1975)

CLASS 3

Answer 18

HORIZONTAL ‘THROUGH AND THROUGH’ DESTRUCTION OF THE

SUPPORTING TISSUES IN THE FURCATION

Question 19

RECESSION

Answer 19

• RECESSION IS THE EXPOSURE OF THE ROOTS OF THE TEETH CAUSED BY A LOSS
OF GUM TISSUE AND/OR RETRACTION OF THE GINGIVAL MARGIN AND IS THE
DISTANCE MEASURED FROM THE CEJ TO THE GINGIVAL MARGIN

Question 20

ATTACHMENT LOSS

Answer 20

THIS IS DEFINED AS THE APICAL MIGRATION OF THE JE FROM ITS ACCEPTED NORMAL POSITION AT THE CEJ, IN CONJUNCTION WITH THE LOSS OF CONNECTIVE TISSUE ATTACHMENT

Question 21

WHY DOES LOSS OF ATTCHMENT OCCUR?

Answer 21

LOSS OF ATTACHMENT OCCURS AS A RESULT OF PERIODONTAL PATHOGENETIC DESTRUCTION

Question 22

WHAT MUST OCCUR IF THE JE IS TO MIGRATE SIGNIFICANTLY

Answer 22

BONE LOSS MUST OCCUR IF THE JE IS TO MIGRATE SIGNIFICANTLY

Question 23

LOA

Answer 23

LOA
• IT IS THE DISTANCE FROM THE CEMENTO-ENAMEL JUNCTION TO THE LOCATION OF
THE INSERTED PROBE TIP
• BUT! WE MEASURE THE DISTANCE FROM THE PROBE TIP TO THE OBSERVABLE GINGIVAL
MARGIN

Question 24

• IF THERE IS RECESSION THEN LOSS OF ATTACHMENT/CLINICAL ATTACHMENT LOSS=

Answer 24

RECESSION PLUS THE PROBING DEPTH