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BDS Finals > Periodontology > Flashcards

Periodontology Flashcards

1
Q

BPE 0 (3)

A

Black band completely visible
No calculus/overhangs
No bleeding on probing

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2
Q

BPE 1 (3)

A

Black band completely visible
No calculus/overhangs
Bleeding after probing

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3
Q

BPE 2 (2)

A

Black band completely visible
Supra- or sub gingival calculus/overhangs present

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4
Q

BPE 3 (2)

A

Black band partially visible
Probing depths of 3.5-5.5mm

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5
Q

BPE 4 (2)

A

Black band entirely within the pocket
Probing depths of 6mm or more

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6
Q

BPE *

A

Furcation involvement

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7
Q

BPE 0 Treatment

A

No need for periodontal treatment

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8
Q

BPE 1 Treatment

A

OHI

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9
Q

BPE 2 Treatment (2)

A

OHI
Removal of plaque retentive factors including supra- and sub- gingival calculus

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10
Q

BPE 3 Treatment (2)

A

OHI
Root surface debridement

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11
Q

BPE 4 Treatment (3)

A

OHI
RSD Assess need for more complex treatment and referral to a specialist

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12
Q

When should radiographs be taken to assess bone levels

A

When a BPE of 3 or 4 is found

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13
Q

Which part of a hand scalar should be parallel to the long axis of the tooth

A

Lower terminal shank

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14
Q

When should a 6 point pocket chart be carried out

A

When a BPE of 3, 4 or * is found
If BPE 3 in 1 sextant, carry it out only in that sextant

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15
Q

What is recorded on a 6PPC (6)

A
  1. Gingival margin
  2. Probing depth
  3. Loss of attachment
  4. Bleeding on probing
  5. Mobility
  6. Furcation involvement
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16
Q

What probe is used for a 6PPC

A

PCP 12 Probe

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17
Q

How is loss of attachment calculated

A

Probing depth + recession

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18
Q

Mobility Grade 1

A

<1mm movement

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19
Q

Mobility Grade 2

A

1-2mm movement

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20
Q

Mobility Grade 3

A

> 2mm movement
Or rotation or depression

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21
Q

When does recession have a negative value

A

If the gingival margin is above the ACJ
i.e. coronal to the ACJ

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22
Q

Furcation Grade 1 (2)

A

Initial furcation involvement
Furcation opening can be felt on probing but involvement is less than one third of the tooth width

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23
Q

Furcation Grade 2 (2)

A

Partial furcation involvement
Loss of support exceeds one third of the tooth width but does not include the total width of the furcation

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24
Q

Furcation Grade 3 (2)

A

Through and through involvement
Probe can pass through the entire furcation

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25
What do the black bands mean on a PCP 12 probe when carrying out a 6 point pocket chart
3, 6, 9, 12
26
How much more likely are periodontal patients to lose teeth off they don’t return for regular visits
5.6
27
What should be established when a patients periodontitis keeps recurring
Why there has been recurrence
28
Periodontitis Stage 1
Less then 15% or 2mm bone loss at worst site
29
Periodontitis Stage 2
Coronal third of root of bone loss
30
Periodontitis Stage 3
Mid two thirds of root of bone loss
31
Periodontitis Stage 4
Apical third of root of bone loss
32
If they patient has lost teeth due to periodontitis what stage should they be assigned
Stage 4
33
How is the grade for periodontal bone loss calculated
Percentage of bone loss divided by age
34
Periodontitis Grade A (3)
<0.5 Bone loss less than half the patients age Slow
35
Periodontitis Grade B (2)
0.5-1.0 Moderate
36
Periodontitis Grade C (3)
> 1 Rapid Max bone loss more than the patients age
37
How is localised periodontitis defined
Effects less then 30% of teeth
38
How is generalised periodontitis defined
Effects more than 30% of teeth
39
What are the components of a full periodontal diagnosis (5)
1. Stage 2. Grade 3. Periodontitis status/stability 4. Risk factors 5. Generalised/Localised
40
Currently stable periodontitis (3)
1. BoP less than 10% 2. PPD less than 4mm 3. No BoP at 4mm sites
41
Currently in remission periodontitis (3)
1. BoP 10% or more 2. PPD 4mm or more 3. No NoP at 4mm sites
42
Currently unstable periodontitis (2)
PPD 5mm or more BoP at 4mm sites
43
Non-plaque induced gingivitis
Uncommon and will need a specialist to help diagnose
44
What can cause periodontitis without plaque
Squamous cell carcinoma Langerhans cell histiocytosis
45
How can you assess patient engagement with periodontal services
Modified plaque and bleeding scores
46
What surfaces are used for modified plaque scores
Interproximal Buccal Lingual
47
What surfaces are used for modified bleeding scores
Buccal Lingual Mesial Distal
48
Modified plaque scores (3)
0 - No plaque 1 - No visible plaque but a probe reveals plaque 2 - Visible plaque
49
Modified bleeding scores
0 - No bleeding 1 - Bleeding
50
How do you calculate modified plaque score
Add up the score for each surface and divide by max possible score (36)
51
What does modified bleeding score measure
Marginal bleeding which indicates how well the patient is able to carry out effective plaque control daily
52
How should you carry out a modified bleeding score (3)
Use ramfjords teeth Run a probe around margins in continuous sweep at 45 degree angle Check for bleeding up to 30 seconds after
53
How do you calculate modified bleeding score
Score / 24 Or max possible score
54
What should you do if one or Ramfjords teeth is missing
Use a similar alternative tooth
55
When should you calculate plaque and bleeding scores
Not needed at initial session Every subsequent session
56
Goals for modified plaque and bleeding scores (3)
Plaque <30% Bleeding <35% Or more than a 50% improvement
57
What is the length of biological width
Connective tissue + junctional epithelium 2mm
58
Supportive Periodontal Care Tx (3)
1. OH reinforcement 2. Scaling 3. Polishing
59
Oral Hygiene TIPPS
Talk Instruct Practice Plan Support
60
Periodontal - Teeth in right/left
7-4
61
Periodontal - Teeth in anterior sextant
3-3
62
How many teeth should be in a sextant to qualify it for recording BPE?
2+
63
When should third molars be included in BPE?
When first and second molars are missing
64
What do vertical defects in bone loss indicate
More rapid progression of disease process
65
How long after step 1 should you re-evaluate
8 weeks
66
How long after step 2 should you re-evaulate
12 weeks
67
How often should a review chart be carried out
Yearly
68
Before starting perio tx as a GDP
Record all costs involved at start prior to commencing tx and give estimate
69
What should the patient be informed of for perio tx (2)
1. Potential side effects during and after tx 2. If there is any difficulties during tx
70
Indications for mucogingival surgery (5)
1. Lesions requiring regenerative tx 2. Poor aesthetics 3. Short clinical crown height 4. Frenal pull causing recession defect 5. Socket preservation for future implant tx
71
Mucogingival surgery - common procedures (3)
1. Free gingival graft 2. Pedicle graft 3. Connective tissue graft
72
Free Gingival Graft (2)
Partial thickness flap Connective tissue exposed which heals to graft
73
Pedicle sliding graft (3)
Partial thickness flap Flap rotated to cover defect Good blood supply
74
How does the donor site heal in mucogingival surgery
Secondary inention
75
Connective Tissue Graft (2)
1. Doesn't leave an exposed donor site as flap as closed again after connective tissue removed 2. Can also use coronally advanced flap
76
GBR
Guided Bone Regeneration
77
Infrabony Defects
1 wall, 2 wall, 3 wall 3 wall responds better to treatment
78
DBBM
Deproteinised bovine bone matrix
79
EMD
Enamel matrix derivative
80
Biomaterials used in GBR (3)
1. Barrier membrane (collagen) 2. DBBM 3. EMD
81
Long junctional epithelium (2)
Weaker than normal anatomy OH must be excellent
82
Gingival Recession Classification (2)
1. Cario 2012 2. RT1 RT2 RT3
83
RT1 (2)
No inter proximal tissue loss Full root coverage may be achievable
84
RT2 (2)
Interproximal tissue loss not as significant as mid-buccal Partial root coverage may be expected
85
RT3 (3)
1. Gingival recession associated with loss of inter proximal attachment 2. Interproximal tissue loss worse than mid buccal 3. No root coverage expected
86
Gingival Recession Tx (7)
1. Record magnitude 2. Eliminate etiological factors (habits/peircings) 3. OHI 4. Topical desensitisation 5. Gingival veneer 6. Crowns 7. Mucogingival surgery
87
What is crown lengthening
Apically repositioning the entire periodontal attachment, usually including bone
88
Crown lengthening indications (4)
1. Increase for restorations 2. Increase ferrule 3. Expose subgingival margins/caries/fractures 4. Uneven gingival contour compromising aesthetics
89
Crown Lengthening Procedure (2)
1. 3-4mm bone removed 2. Hand bone chisels used close to tooth so no iatrogenic damage
90
When is a collagen membrane used
Over bone regeneration treatment under the epithelium
91
Suitable patient for referral for mucogingival surgery (4)
1. After thorough non-surgical 2. Highly motivated/engaged with optimal plaque control 3. Non-smoker and no contraindications in MH 4. Reasonable prognosis of teeth
92
Periodontitis systemic links (5)
1. Diabetes 2. CV 3. Pregnancy 4. Rheumatoid arthritis 5. Alzheimers
93
Aims of Step 3 (2)
Tx non-responding sites Regenerating or resecting lesions that add complexity
94
What might regenerative/resecting procedures be (3)
1. Access flap surgery 2. Resective flap surgery 3. Regenerative flap surgery
95
Step 3 options (3)
Repeated sub gingival instrumentation With or without tx adjuncts Regenerative options
96
Drawback of 6PPC
Assumes everyones roots are same length Can show worse prognosis if short roots

BDS Finals (22 decks)

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