Periodontology Handbook Mixture Flashcards
what is gingivitis?
- inflammation that is confined to the gingival tissue
- redness and swelling of marginal gingiva
- swelling leads to formation of gingival pocket (this manifests as an increased probing depth)
what is a cardinal sign of inflammation in the marginal periodontium?
bleeding on (gentle) probing
what are “false” pockets?
pockets caused by gingival enlargement (no permanent destruction of the connective tissue attachment to the root surface)
what is periodontitis?
- apical extension of inflammation
- destruction of connective tissue attachment
- apical migration of junctional epithelium
- loss of alveolar bone
when is a “true” pocket formed?
in patient with periodontitis where actual loss of attachment occurs
what would the diagnosis be for:
- inflammation in the mucosa at an implant
- no signs of loss of supporting bone
- bleeding on probing
peri-implant mucositis
what would the diagnosis be:
- presence of inflammation in the mucosa at an implant
- loss of supporting bone
- increased probing pocket depth
- BOP
peri-implantitis
what are the signs of peri-implantitis?
- inflammation in mucosa at the implant
- increased probing pocket depth
- BOP
- suppuration (sometimes)
- loss of supporting bone (evidenced radiographically)
- implant mobility (occasionally)
what are the causes of peri-implantitis?
- microbial plaque (patients immune response to said plaque)
- excess cement
- poorly fitting superstructures
- poorly positioned implants
what is a BPE?
- screening tool
- does not provide a diagnosis
- provides guidance as to further investigations required
what are some limitations of a BPE?
- pocket depth inaccuracies (due to gingival enlargement, incomplete eruption, recession/furcation involvement)
- does not indicate extent of disease (e.g a code 4 in a sextant may indicate that only one site has a pocket of 6mm or that many sites
what probe is used for a BPE? what does it look like?
CPITN/WHO/BPE probe
- black band starts at 3.5mm to 5.5mm
a new patient enters the surgery, what topics would be covered in your initial conversation with them?
- complaining of
- HPC
- PDH
- PMH
- SH
- FH
when an image of the whole root length is necessary, what type of radiograph should be taken?
- periapical
- panoramic view
when should radiographs be taken in periodontitis patients?
all code 3 and code 4 sextants
what should a radiographic report include?
should include description of periodontal bone loss including:
- distribution (localised, generalised)
- shape (horizontal or vertical)
- severity (mild, moderate, severe)
any furcation lesions, perio-endo lesions, periapical pathology, caries and any other pathology should also be recorded
what is meant by mild periodontal bone loss?
bone loss equivalent to < 30% of root length
what is meant by moderate periodontal bone loss?
bone loss equivalent to 30%-50% of root length
what is meant by severe periodontal bone loss?
bone loss equivalent to >50% of root length
what is meant by the STAGE of periodontitis?
a measure of the disease severity (assessed by amount of bone loss at the worst affected site)
what is meant by the GRADE of periodontitis?
a measure of susceptibility and speed of progression (calculated using the patients age & amount of bone loss)
what is the disease STABILITY assessed by?
the presence of inflammation (BOP)
what systemic factors may cause gingivitis?
endocrine system
- pregnancy gingivitis
- diabetes mellitus
blood dyscrasis
- leukaemia
what medications can modify gingival disease?
- phenytoin
- calcium channel blockers
- cyclosporins
malnutrition of what vitamin may cause gingival disease?
Vitamin C deficiency (scurvy)
what is meant by localised chronic periodontitis?
affects < 30% of teeth
what is meant by generalised chronic periodontitis?
affects > 30% of teeth
what are the stages of treatment of periodontitis?
- relief of acute symptoms
- systemic phase (consideration of general health and relationship with periodontal disease & periodontal treatment)
- infection control
- re-evaluation
- corrective/reconstructive treatment
- supportive periodontal care (maintenance)
what may infection control of periodontitis include?
- extraction of hopeless teeth
- hygiene phase therapy
- treatment of caries
- endodontic therapy
- provisional prosthesis
what mat hygiene phase therapy include?
- dental health education and motivation
- oral hygiene instruction
- scaling and root surface debridement
- removal of overhanging restoration margins
what probe is used for completion of periodontal pocket chart? what does it look like?
PCP12 probe
- black bands at 3mm increments
- 2 black bands
- goes from 3mm to 12mm
how is loss of attachment measured in periodontology?
- the position of the gingival margin in relation to the ACJ is recorded at 6 points around each tooth (disto-buccal, mid-buccal, mesial-buccal, mesio-palatal, mid-palatal, disto-palatal)
- the PCP12 probe must be positioned as closed as possible to the contact point while keeping the probe parallel to the long axis of tooth
- when the gingival margin lies above the ACJ it is given a positive value, when it lies apical to the ACJ it is given a negative value
- record the pocket depth for the same buccal & palatal aspects
- LOA is calculated by adding together the score for the gingival margin level and the pocket depth
how can tooth mobility be graded?
mobility is graded by observing the displacement of the crown of the tooth when an attempt is made to move it buccal-lingually (using an index finger on one side of crown and an instrument handle on the other)
- grade 1 = <1mm
- grade 2 = 1-2mm
- grade 3 = >2mm and/or rotation or depression
how is furcation involvement graded?
grade 1 = up to 3mm horizontal attachment loss
grade 2 = >3mm horizontal attachment loss but not through and through
grade 3 = a through and through lesion
