SEVERE AND IMMUNE MEDIATED PERIODONTAL DISEASE

Question 1

periodontitis

Answer 1

inflammatory condition affecting the supporting structure of the teeth

Question 2

aetiology of periodontitis

Answer 2

associated with dysbiotic biofilms
progressive destruction of tooth supporting structures
clinical attachment loss, alveolar bone loss, presence of periodontal pocketing and gingival bleeding

Question 3

presentation sof periodotntisi

Answer 3

necrotising periodonttis
periodontitis as a direct manifestation of systemic diseases
periodontitis - molar incisors, localised and gfenrealised

Question 4

for perio disease … is needed

Answer 4

host response(genetic, environmental and behavioural)
bacteia

Question 5

host repsonce is influence by

Answer 5

stress
diet
exercise
illness
sleep
smoking

Question 6

common features of patients with rapidly progressive periodontitis

Answer 6

patient otherwise clinically healthy
rapid attachment loss and bone destruction
familial aggregation

2ndary features
- microbial deposits not consistent
elevated levels of P gingival and AA
phagocyte abnormalties

Question 7

how to separate diagnosis of gingivitis and mild periodontisis

Answer 7

require assessment of interdental CAL to separate diagnosis

Question 8

clinical attachment loss

Answer 8

periodontal probe

- measured from CEJ

Question 9

what is the diagnosis of periodontitis characterised by

Answer 9

loss of periodontal support, manifested through CAL and radiographically alveolar one loss
PP and BOP

Question 10

necrotising periodontitis characterised by

Answer 10

history of pain
presence of ulceration at gingival margin
fibrin deposits at sites with decapitated papillae
may be exposure of alveolar bone

Question 11

importance of diagnosis

Answer 11

medico legal
early management priority
treatment modality
early referral

Question 12

antibiotic indication and regime

Answer 12

rapidly progressing peripdntits
amociilicin 500mg + metronidazole 400mg TDS 7 days
or azithromycin 500mg 3 dyas

Question 13

tx strategy for periodontitis

Answer 13

cause related therapy

corrective therapy

Question 14

factors which influence complete calculus removal

Answer 14

extent of the disease
anatomic factors
skills of operator
instruments used

Question 15

how can calculus contribute to PDD

Answer 15

barrier to sub gingival cleaning
may allow conolosation of bacteria
may lead to endotoxins
falsify probing depth measurements

Question 16

what would non surgical intervention fail

Answer 16

patient failure (poor motivation, cooperation, patient circumstances)
operator failure (incorrect diagnosis, inadequate therapy)
anatomical failure (multiple intra bony defects, furcation etc)

Question 17

aims of surgery if reqrueid

Answer 17

pocket reduction
pocket elimination
regernation

Question 18

what is an intrabony defect

Answer 18

where pattern of bone destruction around tooth forms a trough with base of defect apical to the surrounding crestal bone

Question 19

stable perio disease qualificaiton

Answer 19

pockets less than 4mm
no BOP
BOP less than 10%