Sweep 2.1 Flashcards

1
Q

Volpe-Manhold Index

A

Determines the quantity of supragingival calculus
Lingual surfaces of lower anteriors (#22-27)
Quantity is determined in mm of calculus along the 2 diagonal and the central lines drawn over the lingual surface of each tooth
Index, expressed in mm, is computed for tooth, subject, population
Most frequently used calculus index in longitudinal studies
Published by Volpe & Manhold (1962)

A periodontal probe graduated in millimeter divisions is used to measure the deposits of calculus on the lingual surfaces of the six mandibular anterior teeth.

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2
Q

Papillary-Marginal-Attachment (PMA)-Index

A

Background: “The number of units affected correlates with the severity of gingival inflammation”
Facial gingival surface is divided in 3 scoring units P - M - A
Gingival units affected with gingivitis are counted. Presence or absence of inflammation is counted as {1} and {0}, respectively
Severity component can be considered
Score computed for tooth subject population
First published by Schour & Massler (1947)

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3
Q

Gingival Index (GI)

A

The severity of inflammation is assessed in 4 distinct gingival areas: distofacial papilla, facial margin, mesiofacial papilla, lingual gingival margin.
Scores: 0 to 3; bleeding is considered. Presence of bleeding automatically leads to a score ≥2
Score for tooth subject population
Useful for the calculation of prevalence and severity in population and individual
Frequently used index in clinical trials
First published by Löe (1961) and Löe & Silness (1963)

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4
Q

B-o-P is a valid indicator for ————-. However, it is a poor indicator of ————–

A

periodontal stability

periodontal breakdown.

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5
Q

The Extent and Severity Index (ESI)

A

Agreement
Disease is defined as attachment loss >1mm
Extent
Proportion of tooth sites in a patient showing signs of destructive periodontitis
Severity
Amount of attachment loss at the diseased sites, expressed as a mean value

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6
Q

The Periodontal Index System (PI)

A

Score 0: Negative.
Score 1, 2: Gingivitis
Score 6: Gingivitis with pocket formation
Score 8: Advanced destruction with loss of masticatory function
All teeth are examined. The circumference of each tooth is inspected visually, and given a score.
Index computed for subject, population

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7
Q

The Periodontal Disease Index System

This system includes several components:

A
Gingival status
Crevicular measurements
Periodontal Disease Index
Plaque criteria
Calculus Criteria
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8
Q

The Periodontal Disease Index System

A

Score 1, 2, 3: Severity of gingivitis
Score 4: Initial attachment loss (£3 mm)
Score 5: Moderate attachment loss (>3 mm and
£6 mm)
Score 6: Advanced attachment loss (>6 mm)

4 areas per tooth are examined using a probe. The most severe score is tabulated and used for the calculation of the subject’s PDI
Index computed for subject, population

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9
Q

Community Periodontal Index of Treatment Needs (CPITN)

A

Primarily designed to assess periodontal treatment needs in under served parts of the world
Uses a specially designed probe
Epidemiology: 10 index teeth are examined and worst finding is recorded per sextant
For individual subjects: worst finding of all teeth in a sextant is recorded, resulting in 6 scores per subject. The worst score determines the treatment needs score
Published and promoted by the World Health Organization (1982).

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10
Q

Community Periodontal Index of Treatment Needs (CPITN)

Periodontal Status

A

Score 1: Bleeding on gentle probing
Score 2: Calculus felt during probing,crevicular depth £3 mm
Score 3: Probing depth 4 mm or 5 mm
Score 4: Probing depth ³6 mm

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11
Q

Community Periodontal Index of Treatment Needs (CPITN)

Treatment Needs

A

Code 0: No treatment
Code I: Improved oral hygiene
Code II: I + professional scaling
Code III: I + II + complex treatment

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12
Q

Periodontal Screening & Recording® (PSR)

Purpose:

A

Purpose:
Periodontal Screening and Recording® (PSR®) is a rapid and effective way to screen patients for periodontal diseases and summarizes necessary information with minimum documentation.

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13
Q

Periodontal Screening & Recording® (PSR)

Endorsement:

A

The ADA and the AAP support the use of PSR® by dentists as a part of oral examinations.

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14
Q

PSR - Benefits:

Early detection:

A

PSR® includes evaluation of all sites. For this reason, it is a highly sensitive technique for detecting deviations from periodontal health and a uniquely appropriate screening tool for periodontal diseases that are, by nature, site specific and episodic.

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15
Q

PSR - Benefits:

Speed:

A

Once learned, PSR® takes only a few minutes to conduct for each patient. It can be readily incorporated into routine oral examinations.

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16
Q

PSR - Benefits:

Simplicity:

A

PSR® is easy to administer and comprehend. The simplicity of the scoring system aids in monitoring a patient’s periodontal status.

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17
Q

PSR - Benefits: Cost-effectiveness:

A

PSR® utilizes a simple periodontal probe designed specifically for use with this screening system. It does not require the use of expensive equipment.

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18
Q

PSR - Benefits:

Recording ease:

A

Documentation for PSR® requires the recording of six numerical scores, one for each sextant of the mouth. It does not require extensive charting or lengthy narrative explanation.

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19
Q

PSR - Benefits:

Risk management:

A

Proper, consistent, and documented use of PSR® shows that the dentist is evaluating a patient’s periodontal status

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20
Q

PSR - Limitations

A

PSR® is a screening system designed to detect periodontal diseases. It is not intended to replace a comprehensive periodontal examination when indicated.
Patients who have been treated for periodontal diseases and are in a maintenance phase of therapy require periodic comprehensive periodontal examinations.
In addition, PSR® is designed primarily for use with adult patients and has limited utility in screening children and adolescents.

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21
Q

Reliability of gingival indices

A

(Reliability of an index to measure a condition in the same subject repeatedly and obtain the same score results each time)

22
Q

Validity of a diagnostic test

A

(Sensitivity and specificity of various diagnostic tools used to create an index)

23
Q

Calibration involves:

A
  • Several examiners at different experience levels
    - Subjects with various disease extend and severity
    - Follow-up appointments
    Main goal is to determine inter/intra-examiner variations
24
Q

Predictive Value Positive (PVP)

A

The probability of disease in a subject with a positive test result
PVP = Pr(D+/T+)

25
Q

Predictive Value Negative (PVN)

A

The probability of not having the disease when the test is negative
PVN = Pr(D-/T-)

26
Q

CPITN Coding

A

Mouth divided into sextants defined by tooth numbers:
1–5, 6–11, 12–16, 17–21, 22–27, 28–32

Index teeth in each sextant probed and pocket depth, subgingival calculus and bleeding response determined

27
Q

CHRONIC

A

Adult (20 – 64 yrs)
Prevalence
% moderate = ~20

Senior (65 and older)
Prevalence
% moderate = ~50

28
Q

AGGRESSIVE

A

Localized
Prevalence
0.2 % (Caucasian)
2.6% (African-American)

Generalized
Prevalence
0.13%

29
Q

Mild

Bone Loss

A

≤ 20%

30
Q

Moderate

Bone Loss

A

21% to 49%

31
Q

Severe

Bone loss

A

≥ 50%

32
Q

The integrity of the crestal lamina dura, evaluated on either PA or bite-wing radiographs, does not seem to be related to the

A

presence or absence of visual inflammation, BOP, periodontal pocketing, or loss of connective tissue attachment in the corresponding interdental area.

33
Q

Using integrity of crestal lamina dura as an indicator for the need of periodontal treatment is

A

not appropriate.

34
Q

The crestal bone is a continuation of the

A

lamina dura of the teeth, and is continuous from tooth to tooth.

35
Q

Hemiseptal defect:

A

a vertical defect in the presence
of adjacent roots; thus half of a septum remains on
one tooth, AKA one-walled defect

36
Q

Osseous Crater:

A

Buccal and Lingual Wall(Two walled defect)

37
Q

Detect Furcation Involvement by

A

Gutta-Purcha Point on X-ray Film

38
Q

Thickened Radicular Lamina Dura

A

widened pdl space

39
Q

Root proximity: If the roots are less than

A

2.5 mm apart

Periodontal bone loss will affect the entire interproximal

40
Q

Gingival lesions of specific bacterial origin

Infective gingivitis and stomatitis.

A

The lesions may be due to bacteria.

The lesions may or may not be accompanied by lesions elsewhere in the body.

Bacteria involved:
Neisseria gonorrhea, Treponema pallidum, Streptococci, Mycobacterium chelonae or other org.s
41
Q

Gingival lesions of specific bacterial origins

Clinical presentation … Variations

A

Fiery red edematous painful ulcerations
Asymptomatic chancres
Mucous patches
Atypical non-ulcerated, highly inflamed gingivitis.

Diagnosis:
Biopsy
Microbiologic examination
42
Q

Primary herpetic gingivostomatitis-

A

[Through oral mucosal epithelium, virus penetrates a neural ending and travels to the trigeminal ganglion.]

43
Q

Primary herpetic gingivostomatitis-

Symptoms:

A
  • painful severe gingivitis with redness
    • ulcerations with serofibrinous exudate
    • edema accompanied by stomatitis
44
Q

Primary herpetic gingivostomatitis-

Characteristics:

A
  • Incubation period is one week.
    • Formation of vesicles, which rupture, coalesce
      and leave fibrin-coated ulcers.
    • Healing within 10 to 14 days.
45
Q

Recurrent herpetic infections

A

herpes labialis (more than once per year)

Vermilion border and/or the skin adjacent to it.

20-40% of individuals with primary infection.

Trauma, UV light exposure, fever, menstruation 

Diagnosis:

- generally considered an aphtous ulceration.
- ulcers in attached gingiva and hard palate.
46
Q

Viral gingival lesions:

If sampling is needed,

A

Lifethreaten in immunocompromised patients.

aspiration from vesicle is
the best way !!!

47
Q

Viral gingival lesions: Blood samples to determine

A

increase antibody
titer against virus [works better for primary infection].
Histopathology is not specific.

48
Q

Viral gingival lesions: Treatment:

A
  • Careful plaque removal to limit bacterial superinfection
    of the ulcerations
  • Systemic uptake of a antiviral medication such as a
    acyclovir
49
Q

Herpes zoster-

A
  • Virocella-zoster virus causes varicella (chicken pox).
    [in later life… Shingles]
    • Small ulcers usually on the tongue, palatal and gingiva.
    • Latent in the dorsal root ganglion.
    • Unilateral lesions.
    • 2nd and 3rd branch of the trigeminal ganglion.

Herpes zoster-
Skin lesions may be associated with intraoral lesions,
or intraoral lesions may occur alone.

Initial symptoms are pain and paresthesia.

Diagnosis:
Usually obvious due to the unilateral occurrence of
lesions associated with severe pain.

Treatment:
Soft diet, rest, atraumatic removal of plaque, and diluted
chlorhexidine rinses.
This may be supplemented with antiviral drug therapy.

50
Q

Most common fungal infections that may affect oral cavity:

A

Candidosis
Linear gingival erythema
Histoplasmosis