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ODDR- e lecs > Role of local factors > Flashcards

Role of local factors Flashcards

1
Q

Define periodontal diseases

A

A group of diseases that can affect single or multiple sites in the oral cavity and may lead to damage and loss supporting periodontal tissue

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2
Q

What are the 2 broad groups all periodontal diseases fall under?

A
  1. Gingival diseases

2. Periodontitis

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3
Q

What is the primary aetiological factor that causes periodontal diseases?

A

Microbial plaque and its products that colonises the gingival crevice and root surface and

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4
Q

What is a risk factor?

A

A factor that increases the probability of disease developing and progressing but not necessary causing the disease

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5
Q

What do risk factors in disease progression comprise of?

A

1, Local (intra-oral) factors

2. Systemic factors which affect the appropriateness and magnitude of the host repose

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6
Q

What are the local (intra oral) factors sometimes called?

A

Plaque retention factors

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7
Q

Describe plaque retention factors

A

They may influence the accumulation of plaque and can allow certain bacterial species to flourish

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8
Q

What can plaque retention factors prevent?

A

May prevent effective plaque removal

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9
Q

Changes in what can lead to periodontal destruction?

A
  1. Change in the local environment

2. Change in the systemic condition

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10
Q

What can happen if there is a change in the patients systemic condition?

A

Can predispose the plaque to become more problematic resulting in disease formation and progression

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11
Q

State some local factors that increase chances of getting periodontal disease

A
  1. Anatomic factors
  2. Patient’s habits
  3. Iatrogenic factors
  4. Microbiological factors
  5. Pre-exisitng deposits and disease
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12
Q

What do anatomic factors include?

A
  1. Tooth malalignment

2. Idiosyncrasy of tooth and root morphology

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13
Q

How does tooth malalignment increase a persons chance of getting periodontal disease?

A

As plaque retention can occur from sites due to crowding spacing, rotation, tilting and drifting
May be due to deep overbites and increased over jets

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14
Q

Name some of the idiosyncrasies of tooth and root morphology

A
  1. General morphology
  2. Enamel projections / pearls
  3. Root grooves
  4. Cemental tears
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15
Q

What are Enamel projections / pearls?

A

They are ectopic deposits of enamel

They are normally found apical to the normal cement enamel junction

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16
Q

What percentage of lower molars have Enamel projections / pearls?

A

Up to 34%

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17
Q

What percentage of upper molars have Enamel projections / pearls?

A

Up to 25%

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18
Q

What are Enamel projections / pearls associated with?

A

Gingivitis and attachment loss

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19
Q

Where are root grooves usually located?

A

Palatally especially on upper lateral incisors

Are also found on lower incisors and upper premolars proximally

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20
Q

How many root grooves extend more than 5mm apically from the CEJ?

A

58%

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21
Q

What are root grooves associated with?

A

Increased plaque and pocketing

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22
Q

Where do cement tears occur?

A

Where there is separation along the cemento-dentinal junction

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23
Q

What can cemental tears initiate?

A

Could initiate rapid ,non infected breakdown in isolates sites

24
Q

What to cemental tears disrupt?

A

Periodontal attachment

25
Q

What are some patients habits that can influence periodontal diseases?

A

Mouth breathing

Smoking

26
Q

How can mouth breathing lead to periodontal disease?

A

Mouth breathing results in lack of saliva flow
Decreased salivary cleansing
Dehydration of tissues
Hyperplasia of gingival cells

27
Q

Which area is mostly affects if patients mouth breath?

A

The upper anterior gingiva

28
Q

What are the clinical effects of smoking?

A

1, Increased attachment loss

  1. Increased bone loss
  2. Increased pocket depths
  3. Increased recession anteriorly
  4. Increased staining
  5. Increased fibrous gingival tissues
  6. Decreased bleeding on probing
29
Q

What are the local effects of smoking?

A
  1. Inhibits neutrophils
  2. Increases keratinisation
  3. Decreased vascular repose to inflammation
  4. Alters gingival perfusion
30
Q

What are iatrogenic factors?

A

Factors that are injurious and that could have been prevented

31
Q

Name some iatrogenic factors

A
  1. Orthodontic appliances and retainer
  2. Poorly designed partial dentures
  3. Poor restoration margins/ contours
  4. Initiation of roughness / grooves by instrumentation
32
Q

What are the 2 types of orthodontic appliances?

A
  1. Removable

2. Fixed

33
Q

What are removable orthodontic appliances made up of?

A

Acrylic base with a wire clasp that keeps the appliance in place

34
Q

What are fixed orthodontic appliances made up of?

A

Brackets bands and arched wires

35
Q

What problems to orthodontic appliances cause?

A

Make it difficult for patients to clean inter proximal making it more likely for plaque to accumulate around the orthodontic appliance

36
Q

What must be checked when making a partial denture

A

The dentures stability
Must follow the rules of gingival clearance
Placement of class, rests and connectors should be done appropriately

37
Q

What must be avoided when designer dentures?

A

Gum strippers design must be avoided

38
Q

What is a gum stripper design

A

A denture that has no gingival clearance and no clasps so nothing preventing the denture from slipping into the mucosa

39
Q

What are some effects of

A

Tremendous gingival inflammation
Hypoplastic gingival
Gingival have been stripped from the surfaces of the palatal aspects of teeth
High plaque retention

40
Q

What is important when carrying out a class 2 restoration

A

Make sure margins of there restoration are flushed and smooth with the tooth surface

41
Q

What must be used When making a class 2 restoration?

A

Matrix bands and tissue management to avoid overhangs and ledges

42
Q

What must crown margins not be when a restoration is made?

A

Crown margins must not be to sub gingival

43
Q

Which instruments are commonly used when undertaking periodontal root surface debridement?

A

Hoes and curettes

44
Q

What is consequence of using hoes?

A

They can leave grooves in the root surface dentine

45
Q

What can the precess on grooves in root surface dentine promote?

A

Promotes the retention of sub gingival plaque

46
Q

What can we use to try and smooth over grooves made by hoes?

A

Use a curettes to finish to ensure any slight grooves are covered
Also use ultrasonics with a light grip and in a painting motion

47
Q

Colonisation of what area of the mouth can lead t increase risk of periodontal breakdown?

A

Colonisation of the ginigival crevice and root surface by particular microbes can increase risk of periodontal breakdown

48
Q

Name some species of bacteria implicated in periodontal diseases

A
  1. Action actinomycetemcomitans
  2. P ginigivalis
  3. B. Forsythus
49
Q

The presence on what can increase the chances of getting periodontal disease?

A
  1. Carious cavities
  2. Existing periodontal disease
  3. Calculus
50
Q

Which type of caries can increase you chances of getting periodontal diseases?

A

Carious lesion on the enamel and dentine at the gingival margin or below
Root caries

51
Q

Why can root caries increase your chances of getting periodontal disease

A

These lesions can isolate and held periodontal pathogenic bacteria by acting as a plaque trap

52
Q

How can the existence of deep pockets increase your chances of getting periodontal disease?

A
  1. Can lead to further destruction
  2. Pocket physiology allows a toxic milieu to arise
  3. Exposed furcations also collect plaque and make it harder for patients to properly clean their teeth
53
Q

What does calculus act as?

A

A plaque retention factor

54
Q

Describe supraginigival calculus

A

Lingual surface of lower anterior teeth

Cream yellow appearance

55
Q

What link is there between subginigival calculus and teeth?

A

Teeth with subgnigval calculus had a higher rate of attachment loss

56
Q

Colonisation of the ginigival crevice and root surface can lead to what?

A

increased risk of periodontal breakdown

57
Q

58% of root grooves extend more than how many mm apically from the CEJ?

A

5mm

ODDR- e lecs (5 decks)

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