Topic 6: Periodontal Disease Flashcards
What composes the periodontium
the alveolar bone
periodontal ligament
cementum
gingiva
what does the gingiva cover
Gingiva covers the alveolar bone of the maxilla and mandible, and surrounds the tooth itself.
what is found around the teeth
sulcus
where is junctional epithelium located
Junctional epithelium is where at the bottom of the sulcus, the cells are attached to the enamel surface.
describe the gingiva coronal to the CEJ
free gingiva
describe the gingiva below the CEJ
attached gingiva
where is the attached gingiva differentiated from alveolar mucosa at
the mucogingival junction
what is cementum
is the bony-like tissue covering the root
describe cementum
Less calcified than dentin and enamel
Denser than bone
Deposition occurs throughout life
Involved in both resorptive and reparative processes
What is the periodontal ligament composed of and what does it do
it is composed of collagen fibres and anchor the tooth to the alveolar bone. It also has many blood and lymphatic vessels, nerves, elastic fibres and cells
what do alveolar sockets contain
the roots of the teeth
what is the cribriform plate called
the lamina dura or white line
describe oral microbiology
About 100 billion bacteria from all oral surfaces are shed daily in the saliva
Total plaque flora constitutes about 5% of the salivary flora
About 300 species from dental plaque alone
what is the flora of the healthy gingiva
Flora of healthy gingiva: AEROBIC + FACULTATIVE ANAEROBIC
What is periodontal disease
A disease process that affects one or more of the periodontal tissues…eventually leading to tooth loss.
what is a biofilm
A microscopic layer of glycoprotein molecules found on all moist surfaces. Bacteria live in this “slime” layer that helps them adhere to surfaces.
What is plaque
Plaque: A soft material found on tooth surfaces which is made of bacteria and protein. It is not easy to see, but it is easy to remove with toothbrushing; but returns quickly.
what is calculus
hardened plaque formed from saliva and food debris. It adheres to teeth and is difficult to remove; requires professional treatment under anesthesia for complete removal.
what is gingivitis
Gingivitis: Inflammation of the gingiva; leads to redness and/or bleeding gums.
what is the periodontitis
The active form of periodontal disease. Bacterial infection and inflammation cause destruction of the periodontal tissues, leading to attachment loss around the teeth.
what is the main cause of periodontal disease
plaque - without plaque the periodontal disease does not develop
describe the flora of a diseased mouth
gram - rods motile anaerobic spirochete
what can occur with chronic gingival inflammation
gingival enlargement: hyperplasia, pseudopocket
What happens if gingivitis is left untreated
→ extends subgingivally →more inflammation →more plaque accumulate → more tissue is destroyed by bacteria & host inflammatory response
what are the main sub gingival bacteria
faculative aerobic since there is less 02
how is calculus created
Mixture of bacteria, enzymes, toxins, by-products alter the host defense mechanism = induce calculus.
describe calculus
Itself : non-irritant
But serves as an ideal surface for more plaque!
what are some factors that increase plaque accumulation
tight lips
excess salivation
teeth crowding
what are the factors that decrease resistance to infection
- Metabolic, organic disease
- Nutritional disturbances
- Immunodeficiency
What are the changes to the radiographs in stage 4 periodontal disease
Marked bone loss
+/- tooth fracture
Periapical lucency consistent with a periapical granuloma (“abscess”)
How do you manage periodontal disease
PROFESSIONAL periodontal therapy
- Cleaning versus treatment
Plaque control measured (homecare)
How do you encourage owners to manage periodontal disease
Educate owners to understand disease progression (at the clinic, website, facebook…etc)
Train & motivate owner to perform daily homecare (demo, videos, data information sheet…)
Do back up phone calls, with regular checkups
Perform regular professional periodontal therapy
How do you treat gingivitis
when you remove plaque and calculus the gingivitis will heal.
effective homecare is critical
how do you treat periodontitis
Aim is to prevent new lesions at other sites, and prevent further tissue destructions at sites already affected
Same as gingivitis, but perform periodontal therapy, and may require periodontal sx
what are the goals of professional periodontal therapy
remove calculus above and below gingiva
restore tooth to a smooth plaque attractant surface
what is sub gingival scaling
removal of plaque, calculus and other debris from the tooth surface below the gingival margin
what is root planning
is the removal of the calculus from the cementum from the root surfaces: produces a smooth root surface which is less likely to accumulate plaque and more likely to permit epithelial reattachment.
what instrument do you use to do root planning
the curette
what is the most common reason clients come to us about their dogs mouth
due to halitosis caused by bacteria, plaque and calculus
.what are some of the most common periodontal disease local consequences
Most common ones: 1. Tooth loss 2. Abscess (lateral or periapical) 3- Oronasal fistula (ONF) 4- Pathologic fracture of the mandibule Others: oral cancer, chronic osteomyelitis,
describe a lateral periodontal abcess
Orifice of periodontal pocket is blocked
May drain around tissue or fistulate throught the oral mucosa
where are periapical abcess often seen
often seen at 208 pm4 (with suborbital swelling and draining)
describe a periapical abcess
Pathologic process surrounding the root of the tooth
what causes a periapical abcess
Inflammation or necrosis of the dental pulp from trauma or infection OR
as an extension of PD
describe the radiologic appearance of periodical disease
periapical radiolucency.
what can periapical abscess causes
osteomyelitis, cellulitis, bacteraemia. can fistulate in oral mucosa or nose