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Operative Dentistry Y2 > Primary Care > Flashcards

Primary Care Flashcards

1
Q

What percentage of the adult population is affected by periodontitis, severe periodontitis, and how common is the disease in the world ?

A

50%
11%
6 th most common

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2
Q

What is the prevalence of peri implant mucositis and peri implantitis ?

A

Mucositis is 43%

Implantitis is 22%

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3
Q

What factor causes progression of periodontitis ?

A

Sub gingival bacteria which are derived from supra gingival plaque

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4
Q

What is a predictor of tooth loss ?

A

Continued gingivitis

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5
Q

What is the best method for treating and preventing gingivitis and peri implant mucositis ?

A

Mechanical plaque control

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6
Q

What does mechanical plaque control involve ?

A

Self care

Professional mechanical plaque removal

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7
Q

What does chemical plaque control involve ?

A

Self care

Professional

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8
Q

How many hours does it take to produce gingival inflammation ?

A

48

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9
Q

What level of mechanical plaque control is sufficient to maintain gingival health ?

A

Tooth brushing and interdental cleaning once daily

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10
Q

What interventions are effective in improving oral hygiene behaviour in patients with periodontal disease ?

A

Goal setting , self monitoring, planning, understanding seriousness of disease

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11
Q

How effective is a manual toothbrush at plaque removal ?

A

Ineffective 42%

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12
Q

What force should be exerted on a mainsail toothbrush ?

A

Up to 4 N

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13
Q

What is the plaque score reduction for a toothbrush with flat trim, multi level and crisscross bristles ?

A

Flat trim is 24-47%
Multi level is 35-54%
Crisscross is 39-61%

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14
Q

How effective are electric toothbrushes at plaque removal ?

A

Effective 46%

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15
Q

In which area of the tooth surface are electric toothbrushes shown to be superior ?

A

Approximal surfaces

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16
Q

By how much do electric toothbrushes reduce plaque and gingivitis compared to Manual brushes ?

A

Plaque 11-21%

Gingivitis 6-11%

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17
Q

By how much does interproximal cleaning reduce plaque on the approximal surfaces ?

A

50%

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18
Q

Where should pmpr be concentrated ?

A

Tooth surfaces normally neglected by the patient ie Buccaneers lingual and interproximal

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19
Q

How long should be spent on each tooth surface when polishing ?

A

3-7 seconds, complete plaque removal takes 5 minutes using rubber cup and pumice

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20
Q

What effect does frequent pmpr have on diseased periodontal pockets ?

A

Quantitative reduction of sub gingival micro flora and qualitative shift to less pathogenic micro organisms

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21
Q

What is the standard care for peri implant mucositis ?

A

Professionally and patient administered plaque control

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22
Q

What evidence is there that tooth paste reduces gingivitis ?

A

Standouts fluoride
Triclosan/ copolymer
Chlorhexidine

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23
Q

What a evidence is there that mouthwash reduces gingivitis ?

A

Amine fluoride
Cpc
Essential oils
Chlorhexidine

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24
Q

What percentage of a population suffers from severe periodontitis ?

A

5-20%

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25
Q

Why may treatment of control of periodontal disease be deferred or declined ?

A

Poor general health
Lack of compliance
Patients or operators own choice

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26
Q

First what purpose were indicies first developed ?

A

Epidemiology studies

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27
Q

What factors do indicies reflect?

A

The pattern of aetiology, pathogens is and treatment concepts

28
Q

What categories are periodontal index systems classified into ?

A 
Inflammatory changes
Loss of periodontal tissues 
Oral hygiene 
Bone loss / mobility 
Treatment needs
29
Q

What so the definition of an index ?

A

A numerical value describing the relative status of a population on a a scale with an upper and lower level

30
Q

What are the qualities of a good index ?

A

Reliable and valid
Allows comparison of disease severity between groups
Subject to examiner variability depending on training and experience

31
Q

Why should caution be taken when interpreting data from clinical indicies ?

A

Most indices follow an ordinal scale eg turesky

But most subsequent analyses are non parametric

32
Q

Describe a nominal measurement scale

A

Lowest statistical power

No ranking or structure

33
Q

Describe an ordinal measurement scale

A

Describes difference of gross order but not differences in degree of order

34
Q

Describe an interval scale

A

Eg pain scale

35
Q

Why is a ratio the highest power of measurement ?

A

There is a true 0 eg measurement of pocket depth

36
Q

What determines the development of a classification system ?

A

Consensus if international group of experts

37
Q

What type of inflammation is seen in most periodontal diseases ?

A

Chronic

38
Q

What is chronic periodontal disease and what is it characterised by ?

A

Plaque related periodontal disease characterised by extent and severity in relation to the patients age

39
Q

How is the extent of chronic periodontal disease measured ?

A

Extent is number of sites involved :
Localised up to 30% of sites affected
Generalised more than 30% of sites affected

40
Q

How is the severity of chronic periodontal disease classified ?

A

According to clinical attachment loss
Mild 1-2 mm cal with 0-25% bone loss
Moderate 3-4 mm cal with 25-50% bone loss
Severe 5 or more mm cal with more than 50% bone loss

41
Q

What is the aim of periodontal therapy ?

A

To achieve a pocket depth of 3 mm or less

42
Q

What is the significance of bop for disease ?

A

Presence is 30 % predictor for disease

Absence in 98% indicator of periodontal a stability

43
Q

How is clinical attachment loss measured ?

A

From amelo cemental junction to base of pocket

44
Q

What is cal a measure of ?

A

Sum of total periodontal destruction since eruption

45
Q

What is used to diagnose periodontal disease ?

A

1999 classification of periodontal disease

46
Q

What are the additional signs of gingivitis ?

A

Bad or metallic taste
Halitosis
False pocketing
Fibrous tissue reaction

47
Q

Describe the Loe and Silness 1963 gingival index

A

Subjective assessment of gingivitis based on colour consistency and bleeding
0 is normal
1 is mild colour change, slight inflammation, oedema, no bleeding
2 is moderate inflammation, redness, oedema, bleeds on probing
3 is severe inflammation, very red, ulceration, spontaneous bleeding
4 sites on each tooth examined and divided by number of sites to give average

48
Q

Which systemic factors can modify plaque induced gingival disease ?

A

Diabetes, puberty, pregnancy, menstrual cycle (endocrine)

Leukaemia ( blood dyscrasias)

49
Q

What can cause non plaque induced gingival lesions ?

A 
Bacteria eg neisseria gonorrhea 
Fungi eg candida 
viral eg herpes 
Genetic 
Trauma
Foreign body reactions 
Systemic conditions eg mucocutabeous disorder, allergy
50
Q

What bacteria are associated with necrotising ulcerative gingivitis?

A

Spirochaetes and fusiform

51
Q

What systemic factors contribute to necrotising ulcerative gingivitis?

A 
Smoking 
Severe malnutrition 
Stress
Compromised immune system hiv or aids 
Blood dyscrasias eg acute leukaemia
52
Q

Describe the histology of nug

A

Necrotic surface epithelium and underlying connective tissue
Dense acute inflammatory infiltration
Increased plasma cells lymphocytes and macrophages

53
Q

What is the most common site of ulceration in nug?

A

Interdental papilla

54
Q

Describe the character of the ulcers in nug

A

Crater like, pseudomembranous, covered by yellow or white or grey Slough

55
Q

What a re the symptoms of nug?

A

Slight fever, malaise, painful gums, dead feeling teeth, swollen submandibular and cervical lymph nodes

56
Q

How is the acute phase of nug managed ?

A

Irrigate with ultrasonic
Use oxygen releasing mouthwash
Metronidazole is antibiotic of choice
Chlorhexidien mouthwash

57
Q

How is nug managed following initial treatment ?

A

Supra and sub gingival debridement
Remove local predisposing factors
If cause unexplained consider medical examination and blood screening

58
Q

What is cancrum oris ?

A

Associated with poverty, immunosuppressive therapy

59
Q

What diseases commonly precede noma cancrum oris ?

A

Measles , malaria , severe diarrhoea, nug

60
Q

What are the early features of cancrum oris ?m

A

Soreness of mouth, pronounced halitosis, foetid taste, blue black discolouration of skin

61
Q

How is acute noma managed ?

A

Correct dehydration and electrolyte balance
Nutritional rehabilitation
Treat predisposing disease
Antibiotics
Antiseptic
Physiotherapy to reduce fibrous scarring
Serological test for HIV

62
Q

How is a peri apical abscess diagnosed ?

A

No pupal response
Apical lesion on radiograph
No increased probing depth

63
Q

How is a peri coronal abscess diagnosed ?

A

Partially erupted tooth

Adjacent vital teeth with no increased pocket depths

64
Q

Describe the classification of combined perio endo lesions

A

Class 1 - primary endodontic lesion draining through pdl
Class 2 - primary endodontic lesion with secondary periodontal involvement
Class 3 - primary periodontal lesion
Class 4 - primary periodontal lesion with secondary endodontic involvement

65
Q

What are the treatment options for a combined perio endo lesion ?

A

If class 1 endodontic treatment and reassessment
If class 3 periodontal treatment and reassessment
Root resection
Extraction

Operative Dentistry Y2 (7 decks)

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