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Periodontics > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What are the 4 modifying factors of furcation involvement

A

Anatomic, Supervised neglect, difficult cleansibility, restorations

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2
Q

What are 5 examples for anatomic modifying factors of furcation involvement

A

Cervical enamel projections, enamel pearls, accessory canals, root anatomy, root trunk length

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3
Q

What factors affect root anatomy 4

A

Form proximity grooves and concavities bifurcation ridges

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4
Q

exposed roots are more or less sussectable to caries

A

more

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5
Q

Longer trunks roots are harder to clean but are less or more susceptible to caries

A

less

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6
Q

Short root trunks are easy to clean but are more or less susceptible to carries

A

more

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7
Q

Root trunk distances for the facial maxillary molar and Mandibular molar

A

Facial molar is 4mm long while the mandibular is 3 mm

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8
Q

Root trunk distances for the mesial surfaces of maxillary bicuspid, molar

A

3mm for maxillary molar

7mm for maxillary bicusbid

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9
Q

Root trunk distances for distal surfaces of maxillary molar and bicusbid

A

5mm

7mm

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10
Q

What is the lingual distance of a mandibular molar

A

4mm

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11
Q

Premolars have a good prognoses with furcation involvement because of the root trunk length T of F

A

false the have a poor prognosis

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12
Q

Bifurcating ridges within the furcations are present 73% of what molars

A

mandibular and they are convex on both sides

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13
Q

entry of probe for maxillary teeth are from what angles

A

Mesial palatal, distal and facial right angled.

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14
Q

What type of probe is used for maxillary molars

A

naber’s probe

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15
Q

Glinkmans classifications go to what number

A

1-4

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16
Q

What describes Glinkmans class 1 furcation

A

not evident on radio graph, incipient bone loss

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17
Q

Hamp classification involves 3 classes but are different than the Glinkmans classifications.

A

false they are the same

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18
Q

Where is the incipient bone loss for class 1

A

opening of the furcation, detectable upon examination but not by radiograph

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19
Q

Glinkmans class 2 furcation involvement is

A

partial bone loss, with a culdelsac like appearnce, not through and through and may or may not show up on a radiograph

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20
Q

Class two of glinkmans can either be what or what

A

deep or shallow, deep may go all the way to the middle and stop at the mesial root

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21
Q

Class 3 glinmans furcation involvement is

A

through and through and will definitively show up on a radiograph, inter radicular bone is completely absent

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22
Q

Class 4 glinkmans furcations involve a

A

through and through with a furcation exposure due to gingival recession

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23
Q

Hamp classes go to what number and explain each number

A

1 2mm

3 through hand through

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24
Q

What is the average width of a currette

A

1.25

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25
Q

58% of fucations are less than

A

.75mm

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26
Q

81% of furcations are

A

1.0mm

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27
Q

untreated furcations progress to the next stage every

A

class one year 1
Class two year 4
Class three year 6

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28
Q

Enamel projections are separated into 3 grades what is grade one

A

Distinct change in to the CEJ tha tprojects toward the furca

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29
Q

Enamel projections are separated into 3 grades what is grade two

A

CEP approaching the furcation

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30
Q

Enamel projections are separated into 3 grades what is grade 3

A

CEP at the roof of or into the furcation

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31
Q

T or F gingiva will not bind to the enamel and will cause a deep PD,

A

T

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32
Q

The commonality of cervical enamel projects are

A

28.6% of mandibullar molars

17% of maxillary molars

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33
Q

CEPs in ____ of isolated mandibular molars with furcation involvement

A

> 90% and usually 50% of all CEP involves the furcation

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34
Q

If you get a random deep pocket depth you should associate that with CEP

A

TRUE

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35
Q

what is the likely hood of getting a enamel pearl

A

1.1% to 5.7% of permanent molars

74% of 3rd molars

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36
Q

Accessory canals that exit in the roof of furcation

A

36% of maxillary 1st molars
32% of mandibular 1st molars
24% of mandibular 2nd molars
12% of maxillary 2nd molars

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37
Q

In non vital teeth or those with pulpits accessory canals are often associated with

A

abscess blow outs of furcal bone

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38
Q

What were the percentages of advanced disease in 600 patients in Hirshfeld L Wasserman study

A

76%

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39
Q

What was the percentage of those who lost 0-3 teeth 4-9 teeth and 10-23 teeth

A

0-3 teeth were 83%
4-9 teeth was 13%
10-23 teeth were 4%

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40
Q

What teeth are less likely to be lost to perio

A

single rooted teeth

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41
Q

What trends of lost teeth do you find with teeth loss

A

Maxillary are lost before mandibular except for central incisors

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42
Q

the pushback procedure is used to establish a wider

A

keratinized tissue

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43
Q

what were some reasons for stopping the pushback proceedure

A 
exposure of denuded bone during healing
resorption of crestal bone
stormy post surgery healing
poor esthetic results
poor long term results of infra-bony lesion are not adequately treated
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44
Q

Wennstrom is described as how attached gingiva

A

at least 2 mm of attached keratinized

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45
Q

What is the Etiology of Gingival recession

A 
Chewing tobacco use
Malposed teeth
Factitial injury
Eruption patterns
Frenulum attachment
Parafunctional habits
Chronic inflammation
toothbrushing technique
thin biotype
Iatrogenic
Discrepancy in facial-lingual width of tooth vs that of the alveolus
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46
Q

Fenistratins and dishissence may have pathology yes or no

A

no

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47
Q

Tooth osition relative to ______or_______ may result in bony fenestration and dehiscence

A

facial or lingual

48
Q

_______ when combined with bony dehiscence or fenestration is likely to result in gingival recession

A

Biotype for thin gingiva

49
Q

Other causes for recession include

A 
plaque
malposed tooth, calculus
frenulum
trauma
toothbrushing
piercings
50
Q

what equals attached gingiva

A

the width of keratinized tissue - PD

51
Q

to determine the keratinized tissue one can use what two things

A

a probe, disclosing solution

52
Q

tissue fenestration is when you have a hole in what

A

mucosa

53
Q

why would you want to treat recession

A

To increase the width of keratinized tissue and attached gingiva
For root coverage

54
Q

Why increase the keratinized and attached gingiva

A

prosthetic concerns
Orthodontic concerns
prevent progressive recession

55
Q

Root coverage is important in order

A

help esthetics
dentinal sensitivity
prevention of root caries

56
Q

How to increase the width of attached gingiva

A

APF Apically positined flap, full thickness flap
Free autogenous gingival graft FGG
Subepitheilial connective tissue great CTG

57
Q

What are the options for obtaining root coverate

A

CTG,
semilunar incision+ coronal positioning Tarnow procedure
Lateral pedicle flap LPF

58
Q

APF need to check on

A

Thickness of the alveolar bone
amount of pocket reduction required
length of the root run average 3mm
Clinical crown length

59
Q

APF is used to increase what and how is it done

A

It is used to increase the karitinized tissue, and is done by cutting the tissue and moving it up, used for multiple teeth

60
Q

the FGG is importantt to use for

A 
increase attached gingiva
remove abnormal frenulum
deepen oral vestibule
ridge augmentation procedures
rarely to cover exposed roots
61
Q

What are the advantages of using a FGG

A

Not technically demanding

may be accomplished with partial or full thickness flap reflections

62
Q

FGG disadvantages

A

poor ability to provide blood supply to graft for root coverage
esthetic results are compromised due to scarring during healing resulting in poor color match
surgery required at two intramural sites
Donor site may present problems with bleeding pain and slow healing

63
Q

CTG, more often used for

A

for covering exposed root surface

64
Q

What advantages are there to using a CTG technique

A

High predictability
graft receives abundant blood supply
palatal wound can be surgically closed for rapid healing
Good color match
applicable for recession on multiple teeth

65
Q

Disadvantages for CTG

A

The subepitheilial connective tissue graft is technically demanding, gingivoplasty may be necessary after healing to obtain better tissue contours and to decrease thickness

66
Q

Semilunar incision with coronal positioning requires what

A

Maxillary anterior teeth with no more than 2 mm of recession and 3-5 mm of remaining keratinized gingiva

A complimentary procedure for small areas of gingival recession remaining after other procedures were used for root coverage

67
Q

Advantages to Tarnow procedure aka semi-lunar incision with coronal positioning are

A 
no tension on coronal positioned flap
no narrowing of oral vestibule
good esthetics due to color match
papillary height is preserved
simple surgical procedure
minimal post operative discomfort
applicable to minimal gingival recession across multiple teeth
68
Q

disadvantages of Tarnow procedure is

A

Not applicable in cases of moderate to advanced gingival recession greater than 2mm

requires 3-5 mm of thick keratinized tissue

Healing is by secondary intention and therefore some contraction may occur

may require a second procedure depending on occurrence of tissue contraction

osseous dehiscence or fenestration exists apical to the gingival recession area a FGG or CTG should be performed after coronal positioning of the semi lunar flap

69
Q

Trauma from occlusion is considered to be

A

pathologic

70
Q

forces of occlusion that exceed the adaptive capacity of the periodontium is considered to be what type of trauma

A

occlusal trauma

71
Q

what are the variables of force in occlusal trauma

A

direction of force
magnitude of force
duration of force
frequency of occurrence

72
Q

What re the effected sections of the periodontium affected by occlusal forces

A

cementum
PDL
Alveolar Bone Proper
The gingiva and junctional epithelium are not affected by occlusal forces

73
Q

What are the clinical symptoms of occlusal trauma

A

mobility of affected teeth
radiographic evidence of PDL
positive HX of clenching or bruxism

74
Q

What are some more clinical symptoms of occlusal trauma

A

evidence of working on occlusal interferences
evidence of occlusal slide in centric relation or centric occlusion
evidence of occlusal inter terence in protrusive mandibular movement

75
Q

What is Fremitus

A

A movement of tooth when teeth come into functional contact

76
Q

Trauma from compression side causes

A

initial decrease in PDL space
loss of fiber orientation
rupture of capillaries and hemorrhage into PDL perivascular spaces
Resorption of alveolar bone proper to widen PDL
Root resorption may occur

77
Q

What are two symptoms of trauma seen on a slide for compression side

A

Surface resorption of bone and compacting of PDL at compression side of tooth

78
Q

Tension side trauma of occlusion creates

A

stretching of fibers increase PDL
Rupture of PDL fiber bundles
compression of PDL capillaries and hemorrhage
Apposition of new alveolar bone proper follwwed by decrease PDL
Cemental tearing

79
Q

Primary occlusal forces are Increased and excessive the bone support is

A

normal

80
Q

Forces are or are not on the long axis of the tooth during excursive primary occlusal truama

A

not on the long axis

81
Q

Secondary occlusal trauma occur ______ and the amount of alveolar bone support is _______

A

normal or excessive

reduced

82
Q

Occlusal hyperfuncion is caused by

A

slight increase in occlusal force

considered to be a physiologic adaptation and not a pathologic entity

83
Q

What clinically will you see with occlusal hyperfunction

A

Increase in number and diameter of collagen fire bundles in PDL
increased width of PDL
Increased density and thickness of alveolar bone proper Lamina dura
Radiographic evidence of oseosclerosis of alveolar bone with PDL insertions
slight or undetectable tooth mobility

84
Q

Occlusal Hypofunction

A

a mild weakening of tooth supporting structures due to lack of physiologic stimulation
Considered to be physiologic adaptation and not a pathologic entity
can only be dianosed by histology
decrease in number of PDL fiber bundles Normal orientation
decreased physiologic turnover and remodeling of alveolar bone
narrowing of PDL space
no change in tooth mobility

85
Q

Difuse atrophy

A

total removal of occlusal forces resulting in lack of the level of physiologic stimulation required to maintain mnormal form and function, consderd to by physiologic not patholgic

86
Q

Difuse atrophy can be seen with

A

decreased width of PDL
increased tooth mobility is always present
absence of occlusal antagonist
loss of orientation of the principle bundle
Significant decrease in number of bony trabecular

87
Q

Trauma from occlusal forces do no cause

A

gingivitis
increased PD
Periodontitis

88
Q

Even though there is occlusal trauma with perio, it doesn’t mean that

A

the removal of the occlusal trauma will make it better

89
Q

Occlusal trauma with perio does produce more bone loss than with perio alone t or f

A

true

90
Q

iatrogenic disease

A

the creation of additional problems or complications as a result of treatment

91
Q

Contour of crowns and gingival margins of crowns and restorations are important determinants of what

A

periodontal health

92
Q

Gingival margin overhangs of inter proximal restorations

A

are associated with periodontal pockets that are significantly deeper

93
Q

Gingival inflammation and plaque retention scores show significant decreases following removal of the overhang

A

significant decreases following removal of the overhang

94
Q

Gingival margin overhangs are associated with

A

gingival inflammation
bone loss and
microbial plaque and caluculus accumulation

95
Q

X-rays can show

A

periodontal ligament
trabecular of cancellous bone
lamina dura

96
Q

What are causes of alveolar bone loss

A

Chronic periodontitis
aggressive periodontitis
Necrotizing ulcerative periodontitis

97
Q

Interproximal caries will typically

A

occur below the contact point
follow direction of the enamel odds
cone shaped radiolucency
spreads along the DEJ

98
Q

BW radiographs check for , what is important not to do in order to find this

A

have overlap on the BW

1/2 enamel penitration,

99
Q

A incipeint lesion

A

does no pass more than half way of the enamel

100
Q

a moderate lesion

A

passses mor than half way

101
Q

what is most likely penitrated the dentin incipient or moderate

A

moderate

102
Q

How much of the actual decay can be seen on a radiograph,

A

70%

103
Q

Through and through lesion has penitrated

A

past the DEJ and visualized in the dentinal layer

104
Q

Base of triangle on enamel then

A

base of triangle at dej

105
Q

Root caries involves what

A

dentin and cementum

106
Q

generally root caries are initiated in areas of

A

food impaction

107
Q

Root caries commonly are found in

A

surgical patients for periodontal disease

108
Q

Root caries are what shaped

A

saucer shaped

109
Q

Is enamel envolved in root caries

A

no

110
Q

Interpretation or root caries must be what before diagnosis

A

confirmed clinically due to cervical brunout

111
Q

How efficient are our diagnostic tools

A

they are good at only seeing changes and not good at early preventive detection, best is home hygiene

112
Q

half of what go undetected by explorers

A

proximal lesions

113
Q

X-rays are ____ senisitive in the diagnosis of proximal caries

A

60%

114
Q

Caris detection by radiographic examination requires

A

very through clinical examination
flawless radiographic technique
experience in radiographic interpretation

115
Q

Why have root coverage

A

esthetic concerns
dentinal sensitivity
prevention of root caries

Periodontics (4 decks)

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