SG Flashcards
Primary cause of perio ds is
Plaque not calculus
Perio ds is bacterial plaque in a
susceptible host
Dental plaque is
Structurally and functionally organized, species rich, microbial biofilms that form on teeth
Calculus
mineralized plaque that forms hard deposits
Materia alba
soft accumulation of salivary proteins, bacteria, desquamated epithelial cells and food debris
Predominant cells of early lesion
PMNs, macrophages, T-lymphocytes
Predominant cells of established lesions
PNMs, macrophages, T-lymphocytes, B-lymphocytes, plasma cells
Stage 1
1-2mm CAL, <15% BL, no tooth loss, probing depth=4mm or less, mostly horizontal BL
Stage 2
3-4mm CAL, 15-33% BL, no tooth loss, probing depths=5mm or less, mostly horizontal BL
Stage 3
5mm or more CAL, BL >33%, 4 or less teeth, probing depths of 6mm or more, vertical BL 3mm more more, Class 3-4 furcation, moderate ridge defects
Stage 4
5mm or more CAL, BL >33%, 4 or less teeth, probing depths of 6mm or more, vertical BL 3mm more more, Class 3-4 furcation, severe ridge defects, secondary occlusal trauma, bite collapse, pathological migration of teeth, <20 remaining teeth (10 opposing pairs)
Grade A
Slow rate = nonsmoker and nondiabetic
Grade B
Moderate rate, <10 cig/day, diabetic with HbA1c <7
Grade C
Rapid rate, >10cig/day, diabetic HbA1c >7%
Mobility
Use 2 rigid instruments, not fingers. (may show thickened PDL, clenched/bruxism, missing tilted teeth, evidence of working/balancing occlusal interferences
Mobility Grade 1
First distinguishable sign of movement more than normal (physiologic)
Mobility Grade 2
Movement which allows crown to move 1 mm from its normal position in any direction
Mobility Grade 3
Tooth may be rotated or depressed in alveoli
Furca: Glickman Grade 1
Pocket formation into the flute of the fucra, but the inter-radicular bone is intact
Furca: Glickman Grade 2
Loss of inter-radicular bone with pocket formation of varying depths into the furca, but not completely through to the other side (can be shallow or deep)
Furca: Glickman Grade 3
Complete loss of inter-radicular bone with pocket formation completely probable to the other side B/L
Furca: Glickman Grade 4
Loss of attachment and gingival recession that has made the furcation clearly visible
Hamp
Classification of horizontal component of the furca involvement.
Hamp Degree 1
<3mm
Hamp Degree 2
> 3mm but not the total width of furca area
Hamp Degree 3
Through and through
Tarnow
Classification of the vertical component
Tarnow Class A
Up to 1/3 of furca (1-3mm)
Tarnow Class B
Up to 2/3 of the furca (4-6mm)
Tarnow Class C
Into apical third (>7mm)
Components of biological width
1 mm of Junctional Epithelium and 1mm of Connective tissue
Stippling
A form of adaptive specialization or reinforcement of function. Indicates health, pt may not have stippling and still be health
Bundle Bone
Attachment for PDL fibers into the bone (Lamina Dura is just a radiographic term for it)
Cortical/cancellous bone
Spongy bone btw teeth
Rests of Malassez
Remnants of Hertwigs tooth sheath (cells form in the cervical part of the enamel organ, can persist and embed in the PDL)
Cervical Enamel Projections
Enamel extending into the furcation
CEP Stage 1:
Extends from the CEJ toward the furcation entrance
CEP Stage 2:
Approaches the entrance to the furcation, does not enter the furcation, no horizontal component is present
CEP Stage 3
Extends horizontally into the furcation
Palatal gingival groove
Groove that extends down the root which can be a highway for bacteria. 4-6 % of lateral MI
Short Root trunk
Less attachment to be lost before furcation involvement, easier access to tx
Long root trunk
More attachment to be lost before furcation involvement, less accessible to tx plaque control
Free Gingival groove
Demarcation btw attached gingiva and mucosa (50% incidence)
Attachment of JE
attaches to the tooth via hemidesmosomes and non-collagenous proteins (proteoglycans and glycosaminoglycans)
Alveolar crest PDL fibers
Cementum -> crest of alveolar bone prevents extrusion
Horizontal PDL fibers
Cementum -> alveolar bone at 90 degree to surface (opposes lateral forces)
Oblique PDL Fibers
Cementum -> Alveolar bone in slight coronal direction (largest group resisting vertical masticatory forces)
Apical PDL fibers
Cementum -> apical alveolar bone resisting luxation and tipping
Interradicular PDL fibers
Cementum -> furcation bone resists laxation and tipping
PDL fibers main fxn
support, nutrition, formative sensory (shock absorbers)
PDL fibers contain
Blood vessels, collagen type 1, 3, 4, proprioceptive nerve endings (transmits pressure and pain via trigeminal nerve)
Acellular cementum is
coronal 1/3
Cellular cementum is
apical 1/3
Cementum is
calcified mesenchymal tissue (45-50% hydroxyapatite), non-vascularized, no nerves, no lymph, grows by apposition
