Periodontology Flashcards
Perio
gingiva
pdl
cemetum
alveolar bone
gingiva is
keritinized
what category describes most gingivitis?
chronic plaque associated gingivitis
bulbous «>
festooned
where the gingival condition appears to large for the space “squeezed out
bulbous
rounding and enlargement of the gingival margin
life saver
festooned
marginal tissue is not stippled
true
hallmark sign of acute inflammation is
edema
the most obvious result of vasodialtation of the peripheral circulation was edema
true
fibrosis is the hallmark sign of
chronic inflammation
what is the shock absorber for nerve vessels?
PDL
extend interproximally over alveolar crest embedded in cementum of 2 adjacent teeth “ortho:
transseptal fibers
largest and most significant fiber group that extends from cementum coronally to the bone
oblique fiber
with stands masticaory stress in vertical direction
oblique
most prominant cell in the pdl responsible for collagen synthesis and degradation
fibroblasts
cementum is thinnest at the
cej
the main function of cementum is to provide attachment to the collagen fibers presented in the
pdl
crest of the alveolar bone should be
1-2 mm apical to the cej
base of the pocket is coronal to the alveolar bone “all gingival pockets”
suprabony defect
base of pocket is apical to the crest of the alveolar bone
infrabony defect
all gingival pockets are
suprabony defects
pregnancy associated gingivitis and pyogenic granuloma result from
prevotella intermedia and camphylobacter rectus
a healthy periodontium needs vitamin — and —-
c and protien
incubation 1 week, fever, lymphodenopathy and pain
herpes
specific causes of gingival inflammation include open contact and subgingival margins of restorations
true
downward or apical migration of the je
loss of connective tissue attachment
periodontitis
aggressive periodontitis is usually genetic
true
what tooth is most often the first affected regarding periodontitis
max first molar
the most common pathogens involved in aggressive periodontitis is aggregatibacter actinomyucetemcomitans and porhyromas gingivalis
true
deficiency of neutrophils or polymorphonucleur cells are called
neutropenia
most active cells in a perio pocket
PMNS
there is evidence for an association between periodontal inflammation and multiple sclerosis suggesting perio therapy may positively impact ms
true
in patients with no known systemic disease or immune dysfunction NUP appears to share many of the clinical and eitologic characteristics of nug except that patients with NUP
demonstrate loss of CAL and alveolar bone
the microbes most often associated with NUP/ NUG are
spirochetes especially treponema denticola
prevotella intermedia and porphyromonas gingivals
nug and nup tx
tetra
punched out papillae
pseudomembrane
fetid odor
pain sever inflammation
nup/nug
a common lesion that develops exclusively on the gingiva and is characteristically found at the opening of a fistula tract of a periapical infection. it can vary in size and removal of the source of infection through endodontic therpay or tooth extraction
parulis “gum boil”
results when infection spreads deep into periodontal pockets and drainage is blocked food impaction calculus etc may develop after perio debridement
periodontal abscess
a periapical abcess requires a periapical film, a — abcess will not generally show up on a radigraphy
periodontal
stillmans cleft is indicated by — loss of tissue or papilla
stillmans cleft
occlusal trauma does not cause perio disease
true
the process by which neutrophils sqeese between the endothilial cells and emigrate into the tissue from the blood vessel
diapidesis/emigration
what immediately follows initial vasoconstriciton in the acute inflammatory responce
vasodialition
movement of cells to the site of inflammation is termed
chemotaxis
what stage is the initial lesion 2-4 days with no clinical changes
stage 1
4-7 days, clinical signs of gingivitis appear, sulular lining develops rete pegs
stage 2 gingivitis or early lesion
2-3 weeks gingival enlargment, wided intra cellular spaces in pocket lining
stage 3 established lesion
advanced lesion. transitions from gingivitis to periodontitis, irreversible, 3 weeks to life, bone loss
stage 4 advanced
to check tooth mobililty
use two hard handed instruments no fingers
is the palpable vibration of root surfaces, as the patient taps teeth together, generally checked by using the pad of the index fiingers against the tissue overlying the root surface
fremitus
the attached gingiva is tightly connected to the cementum on the cervical 1/3 of the root and to the periosteum of the alveolar bone
true
what is related to hyperemia
reversible pulpitis
a mild pupal inflammation usually resulting from placement of a deep restoration
reversible pulpitis
is a condition in which there is a connection from the sinus to the exraction site
penumatization
following initial periodontal therapy a —- to — re evaluation appointment is necessary to determine effectiveness of tx
4-6
the first thing to asses is degree of inflammation still present
phenytoin (dilantin)
cyclosporine
nifedipine (procardia)
gingival enlargement
enlargement due to an increase in cell cize
hypertrophy
enlargerment due to an increase in cell numbers
hyperplasia
smokers are at increased risk for developing perio disease due to microvasculature vasoconstriction they do not have an increase risk for caries
true and true
black hairy tongue is associated with
a smoking habit
hairy leukoplakia is associated
with hiv infection and caused by EBV not smoking
what has spontaneous bleeding and increased incidence of apthous ulcers
nup
a case study featuring a patient with marginal inlammation around a max anterior crown would want you to identify the cause as
poorly fitted crown
plaque formation
primary colonizers gram +
secondary gram - and gram +
and late include porphyromonas gingivallis and spirochetes
pellicle formation begins within
seconds of debridement, within one week tertiary colonizers may be present
group of bacteria that are recongized as the most important pathogen in adult perio disease. these bacteria are usually found together in perio pockets suggesting that they mau cause destruction of perio tissue in a cooperative manenr
red complex
most common periopathogen
porpyromonas gingivallis
treponema denticola
nup/nug
associated wtih aggressive perio
aggratibacter actinomycetemcomians
critical role in biofilm formation
fusoabacterium nucleatum
what shape are most bacteria found in periodontally diseased sites
rod shaped
what increases as plaque matures
facultative anaerobes
makes up the bulk of plaque biofilm and fuctions to hold bacteria together in a biofilm
facultative anaerobes
what are found in acquired pellicle
glycoprotiens
what is used to tx psuedo pockets and gingival hyperplasia
gingivectomy
what requires gingival flap
osseous surgery
used to increase the apposition of incision edges and decrease the distance that cells need to migrate in the wound healing process
sutures
minimally invasive procedure designed to treat recession. a small pinhole is created by piercing the mucosa apical to the mucogingival junction in the area of recession.
pinhole surgical technique PST
the main reason people receive regenerative procedures is to treat
infrabony defects
the more walls the
the better the prognosis
a one wall defect is
difficult to tx
perio packs containing —- are irritating to gingival tissue
eugenol
what maintains tissue contour
periodontal dressing
fibroblasts synthesize and deposit fibronectin collagen and prteoglycans the resulting tissue is cellular, red and highly vascular it is termed
granulation tissue
what causes swelling pain and inflammation
prostaglandins
causes inflammation bronchoconstriction air way obstruction and increase cellular infiltration and cytokine relase
leukotrienes
leukotrienes are derived from leukocytes like neutrophils basophils macrophages eosinphils and
mast cells
loss of alveolar bone, gingival recession, 1-2 mm long root exposure
dehiscence
window of bone loss, bordered by alveolar bone along its coronal aspect
fenestration
which of the following types of sutures would not require a follow up visit for removal
catgut
which periodontal ligament fiber bundle is most involved in orthodontic movement of teeth
transeptal fiber group
when you examine your patients gingiva you notice the interdental papillae are swollen and appear to be squeezed out of the embrasure space
a. clefted
b. blunted
c. bulbous
d. festooned
bulbous
what effect does tobacco use have on gingival tissue
a. increase cal
b. increase edema
c. increase bleeding
d. increase caries risk
a
leukotrienes are derived from
a. t cells
b. mast cells
c. complement
d. prostoglandins
b
what is the best indicator that damage to the periodontium is progressing.
a. increased fibrosis
b. increase in probe depths
c. increase in cal
d. coronal migration of the je
c
your patient presents with a history of a kidney transplants. she states that she currently takes cyclosporine on a daily basis. when examining her gingival tissues, you notice generalized tissue enlargement with probing depths ranging from 5-7 mm. additonally the pocket bases are coronal to the alveolar crest. radiographically the crest of the alveolar bone is `-1 mm apical to the cej what type of periodontal defect is this
suprabony defect
a common minimally invasive surgical technique used to treat areas of recession is known as
a. bone grafting
b. soft tissue curettage
c. pinhole surgical technique
d. internal flap augmentation
c
your patient presents with diffuse marginal gingival red that has been non responsive to home care and in office tx. in reviewing the health history you notice that this patient is taking nucleoside reverse transcriptase inhibitors NRTi’s what is likely condition causing gingival presentation
a. aggressive gingivitis
b. NRTIS associated edema
c. linear gingival ertytmea
d. NUG
c
what is the term that describes the process by which neutrophils squeeze between the endothilial cells to relocate into the tissue from the blood vessel
emigration
at what stage of histopathology does a periodontal lesion become irreversibe.
stage 4
