Recognising Periodontal Disease

Question 1

How does severe imbalance lead to periodontal disease

Answer 1

Bacteria load increases and bacteria biofilm in sulcus thickens, leading to severe imbalance. Host immune response mounts exaggerated hyper inflammatory response to contain bacteria, destroying host tissues. Chronic non resolving and destructive inflammation, resulting in bone and connective tissue loss

Question 2

Describe healthy gingiva

Answer 2

Coral pink. Firm, resilient papilla. Complete papilla fill, gingival margins above CEJ. Knife edge, scalloped margins, keratinised, smooth, stippling

(Colour, consistency, contour, surface texture)

Question 3

What is clinical attachment loss

Answer 3

Measure of accumulated past disease at a site. CAL = CEJ to base of pocket

Question 4

What is the primary parameter to monitor health and inflammation of periodontal tissues

Answer 4

Bop. Lang et al 1986 show that clinical evidence of inflammation is the most useful indicator of disease

Question 5

Pressure for probing

Answer 5

0.25N

Question 6

Relate radiographic findings to bone loss

Answer 6

Clinical bone loss precedes radiographic bone loss by 6-8 months Goodson et al JCP 1984

Radiographs reveal changes in bone after 30-50% of minerals are lost, there is extensive cal loss before detected on radiograph jeffcoat et al kpr 1991