Unit 9 - Other Conditions Affecting the Periodontium

Question 1

What are the six other conditions affecting the periodontium?

Answer 1

1. Necrotizing periodontal diseases
2. Mucogingival deformaties and conditions around the teeth
3. Tooth and prosthesis related predisposing factors
4. Periodontal abscesses and endodontic-periodontal lesions
5. Traumatic occlusal forces
6. Local risk factors

Question 2

What is necrosis?

Answer 2

Tissue death

Question 3

What is included in necrotizing periodontal disease?

Answer 3

Necrotizing gingivitis
Necrotizing periodontitis
Necrotizing stomatitis

Question 4

All necrotizing periodontal diseases have three clinical freatures including:

Answer 4

Tissue necrosis
Spontaneous bleeding
Pain

Question 5

True or False: necrotizing periodontal diseases are associated with impairment of the host immune system and found in clients who are severely immunocompromised.

Answer 5

True

Question 6

Is necrotizing periodontal disease painful?

Answer 6

Yes, very painful

Question 7

Clients with necrotizing periodontal disease will present with ulcerated, necrotic papillae and gingival marings with some areas being covered by a whitish/grayish slough which is called:

Answer 7

A pseudo membrane

Question 8

What will it look like under the pseuo membrane with necrotizing periodontal disease?

Answer 8

Very red, shiny tissue that can bleed spontaneously

Question 9

What are other signs of necrotizing periodontal disease?

Answer 9

Swollen lymph nodes
Fever
Malaise

Question 10

What are the necrotizing periodontal disease predisposing factors?

Answer 10

Severe biofilm related condition
Impaired immune response
Associated with immunosuppression in conditions such as HIV infection/AIDS
Highest prevalance between ages 20-30
Malnutrition/poor nutrition, fatigue, alchohol/drug abuse, smoking

Question 11

What is necrotizing gingivitis?

Answer 11

Tissue necrosis confined to the gingival tissues

Question 12

What are the signs and symptoms of necrotizing gingivitis?

Answer 12

Ulcerations or necrosis of the interdental papillae
Gingival bleeding
Pain

Question 13

What is necrotizing periodontitis?

Answer 13

Tissue necrosis of the gingival tissues and loss of attachment and alveolar bone

Question 14

What are the signs and symptoms of necrotizing periodontitis?

Answer 14

Necrosis of the gingiva, PDL and bone that can happen very rapidly and is very painful

Question 15

What is necrotizing stomatitis?

Answer 15

The most severe condition with severe tissue necrosis that extends beyond the gingival tissues in the cheeks, tongue and palate along with bone destruction and osteitis (inflammation of the bone).

Question 16

What is the treatment for necrotizing gingivitis?

Answer 16

Anti-inflammatory for pain
Chlorhexidine or hydrogen peroxide rinse
Removal of pseudo membrane
Debridement
Avoid alcohol, drugs, smoking
OHI and nutrition counselling
Antibiotics may be prescribed

Question 17

Treatment for necrotizing periodontitis

Answer 17

Referral to peridontist

Question 18

Treatment for necrotizing stomatitis

Answer 18

Immediate referral to an oral pathologist and/or oral surgeon

Question 19

What are examples of systemic diseases affecting the periodontium?

Answer 19

Rare disorders (down symdrome)
Oral cancer
Diabetes
Osetoporosis

Question 20

What are the mucogingival deformaties and conditions around the teeth?

Answer 20

Gingival recession
Lack of keratinized gingiva
Decreased vestibular depth
Absent frenum/muscle position
Gingival excess
Abnormal colour

Question 21

What is the most common of the mucoingival deformaties and conditions around the teeth?

Answer 21

Gingival recession

Question 22

What was the most commonly used classification system for recession of the margin but has recently been replaced?

Answer 22

Miller Classifcation System for Recession of Gingival Margin

Question 23

What is the current classification system for recession?

Answer 23

Cairo Classification System for Recession of Gingival Margin

Question 24

How does the Cairo classification system for recession work?

Answer 24

It is based on CAL measurements at buccal and interproximal sites

Question 25

What is RT1?

Answer 25

Gingival recession with no loss of interproximal attachment

Question 26

What is RT2?

Answer 26

Gingival recession associated with interproximal attachment loss (interproximal loss is less than or equal to the buccal loss). Periodontitis horizontal bone loss.

Question 27

What is RT3?

Answer 27

Gingival recession associated with interproximal attachment loss (interproximal loss is greater than buccal loss). Periodontitis infrabony defect.

Question 28

What are the localized dental prosetheses-related factors?

Answer 28

Partial denture
Crown/bridge

Question 29

What is the space occupied by the JE and CT attachment fibers?

Answer 29

Supracrestal Tissue Attachement (Biological Width)

Question 30

Impingement on the supracrestal tissues attachment will cause

Answer 30

Chronic gingival inflammation and bone loss

Question 31

A crown placement of ___mm coronal to alveolar crest is paramount in maintaining gingival health.

Answer 31

2mm

Question 32

What can happen if the crown margin is closer than 2mm to the alveolar crest?

Answer 32

Bone resorption

Question 33

What occurs if margins of restorations encroach upon the zone of soft tissue occupied by the JE and conntective tissue attachment fibers?

Answer 33

Supracrestal tissue attachment violation

Question 34

What is a localized accumulation of pus in a peridontal pocket?

Answer 34

A periodontal abscess

Question 35

What can trigger an endo-periodontal lesion?

Answer 35

Carious or traumatic lesion that affects both the pulp and periodontium

Question 36

What is traumatic occlusal force or excessive occlusal trauma?

Answer 36

Force that exceeds that adaptive capacity of the periodontium or teeth

Question 37

True or False: Local risk factors can be either acquired or anatomical

Answer 37

True

Question 38

What are some aquired local risk factors?

Answer 38

Calculus
Restoration overhangs
Poorly contoured restorations

Question 39

What are some anatomical local risk factors?

Answer 39

Malpositioned teeth
Root grooves
Concavities
Furcations