Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Periodontics I > Week 5- Periodontal Staging and Grading > Flashcards

Week 5- Periodontal Staging and Grading Flashcards

1
Q

what are the stages of severity of disease based on clinical attachment level

A
  • slightL 1-2mm
  • moderate: 3-4mm
  • severe: greater than or equal to 5 mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the gold standard for categorizing the severity of disease

A

clinical attachment level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AAP formed a task force in 2015 to identify alternative criteria including:

A
  • radiographic bone loss
  • probing depth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why is probing depth not considered diagnostic

A
  • inflammation has effect on penetration of probe into tissue
  • inflammation may move gingival margin coronally - psuedopocket
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the recommendation for using these factors to measure severity of disease

A
  • use interproximal attachment los - 2 or more non-adjacent teeth
  • use probing depth as a complexity factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the 2017 classification of periodontal and peri-implant diseases and conditions

A

-3 dimensional adaptive system:
- severity/extent: number of teeth affected rather than sites
- prognosis: affects no teeth up to 4 teeth, 5 or more teeth
- progression: grading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the 2017 AAP classification’s rationale for change is to:

A
  • recognize and monitor systemic influences inflowing to periodontal disease such as smoking and diabetes
  • control inflammatory and microbial influences from periodontal disease outflowing to systemic targets to decrease the co-morbid effect of the periodontal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the periodontal diseases and condition

A
  • necrotizing diseases
  • periodontitis as a manifestation of systemic diseases
  • periodontitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

according to the CDC and prevention approximately _____ of adults over 30 years old have periodontitis

A

47%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the primary cause of tooth loss in adults over 30 years old

A

periodontitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the goal of new system of staging and grading

A
  • easy to use
  • should promote better communication with patient, referring dentists, hygienists, other health care professionals
  • identify response to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the 3 steps to staging and grading a patient

A
  • step 1: initial case overview to assess disease
  • step 2: establish stage
  • step 3: establish grade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do you screen in step 1 of staging and grading in a patient

A
  • full mouth probing depths
  • full mouth radiographs
  • missing teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

mild to moderate periodontitis will either be:

A

stage I or stage II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

severe to very severe periodontitis will be:

A

stage III or Stage IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

for staging and grading every patient categorized based on:

A

the worst periodontal site and specific factors that may impact long term management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

staging is divided into

A
  • severity
  • complexity
  • extend and distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

staging considers:

A
  • CAL using the worst site
  • amount and % of bone loss
  • probing depth
  • presence/extent of ridge defects and furcation involvement
  • tooth mobility
  • tooth loss due to periodontitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the criteria for defining periodontitis

A
  • interdental CAL at 2 or more non adjacent teeth OR
  • buccal or oral CAL greater than or equal to 3mm with pocketing greater than 3mm on 2 or more teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the interproximal CAL for each stage of the new system

A
  • stage I: 1-2mm
  • stage II: 3-4mm
  • stage III: greater than or equal to 5mm
  • stage IV: greater than or equal to 5mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ensure the problem cannot be attributed to non-periodontal causes such as:

A
  • gingival recession due to trauma- toothbrush trauma/toothpaste abrasion
  • dental caries extending to or below the gingival margin
  • defect on distal on 2nd molars caused by malposition or extraction of a 3rd molar
  • endodontic lesion draining through marginal periodontium - deep probing depth
  • vertical root fracture- isolated deep probing depth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does the staging and grading system also take into consideration

A
  • overall probing depths
  • evaluates radiographic bone loss, horizontal and vertical
  • evaluates furcation involvements, number of missing teeth, function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

describe stage I with complexity factors

A
  • max probing depth less than 4mm
  • mostly horizontal bone loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe stage II with complexity factors

A
  • max probing depth less than 5mm
  • mostly horizontal bone loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe stage III with complexity factors

A
  • in addition to stage II complexity:
  • probing depths greater than or equal to 6mm
  • vertical bone loss greater than or equal to 3mm
  • class II or III furcation involvements
  • moderate ridge defects
26
Q

describe stage IV with complexity factors

A
  • in addition to stage III complexity need for complex rehabilitation due to:
  • masticatory dysfunction
  • secondary occlusal trauma greater than or equal to 2 mobility
  • bite collapse, drifting, flaring less than 10 opposing pairs remaining teeth
  • severe ridge defects
27
Q

what is the prognosis of each stage

A
  • stage I or II: no tooth loss likely
  • stage III: risk of tooth loss up to 4
  • stage IV: risk of loss of arch or dentition (greater than 5 teeth_
28
Q

describe stage 1

A

1-2mm CAL
- less than 15% bone loss around root
- no tooth loss due to periodontal disease
- probing depth 4mm or less
- mostly horizontal BL

29
Q

describe stage II

A
  • moderate
  • 3-4mm CAL
  • 15-33% bone loss
  • no tooth loss due to periodontal disease
  • probing depth 5mm or less
  • mostly horizontal bone loss
30
Q

describe stage III

A
  • severe with potential for additional tooth loss
  • 5mm or more CAL
  • bone loss beyond 33%
  • tooth loss of four teeth or less due to perio disease
  • with complex issues such as probing depth 6mm or more
  • vertical BL 3mm or more
  • class II-III furcations
  • moderate ridge defects
31
Q

describe stage IV

A
  • severe with potential for loss of dentition
  • encompasses all of stage III with additional features that will require the need for complex rehabilitation due to masticatory dysfunction
  • secondary occlusal trauma
  • severe ridge defects
  • bite collapse
  • pathologic migration of teeth
  • less than 20 remaining teeth - 10 opposing pairs
32
Q

what is the purpose of staging of periodontitis

A

classify the severity and extent of a patients disease based on the measureable amount of destroyed and/or damaged tissue as a result of periodontitis and to assess the specific factors that may attribute to the complexity of long-term case management

33
Q

how many complexity factors shift the stage to a higher level

A

one or more

34
Q

what should the initial stage be determined using

A

CAL. if not available use RBL

35
Q

what number of tooth loss is each stage

A
  • no tooth loss= stage I or II
  • less than or equal to 4 teeth: stage III
  • greater than or equal to 5 teeth: stage IV
36
Q

if lost any teeth due to periodontitis then what stage is it automatically

A

stage III or IV

37
Q

what furcation involvement puts patient into periodontitis stage 3 or 4

A

grade 2 or 3

38
Q

what is localized BL

A

BL involved less than 30% of teeth

39
Q

what is generalized bone loss

A

more than 30% of teeth

40
Q

what is molar-incisor BL

A

BL is found around molar - usually first- and anterior incisors

41
Q

molar/incisor pattern generally applies to old classifications of:

A

localized aggressive periodontitis which was known before that as localized juvenile periodontitis

42
Q

what is molar/incisor pattern stage and grade

A

stage III grade C

43
Q

what does grading consider

A
  • rate of disease progression
  • risk of further advancement
  • potential threats to general health - smoking, DM
  • response to standard therapy
44
Q

what are the grades

A
  • A: low risk of progression
  • B: moderate risk of progression
  • C: high risk of progression
45
Q

initially what grade do you assume

A

grade B

46
Q

what group tends to have more rapid attachment loss

A

children

47
Q

what is considered direct evidence for grading

A
  • historical radiographic bone loss
  • CAL
48
Q

what is considered indirect evidence

A
  • % bone loss/patient age
  • case phenotype (soft tissue thickness, bone thickness)
  • heavy plaque accumulation but minimal destruction vs minimal plaque but major destruction
49
Q

what are the grades using direct evidence

A
  • grade A: no loss over 5 years
  • grade B: less than 2mm loss over 5 years
  • grade C: greater than 2mm over 5 years
50
Q

what is the calculation for bone loss

A

percentage / age

51
Q

what are the risk factors smoking and diabetes in grade A

A
  • slow rate
  • nonsmoker
  • nondiabetic
52
Q

what are the risk factors smoking and diabetes in grade B

A
  • moderate rate
  • less than 10 cigs per day
  • diabetic with HBA1c less than 7%
53
Q

what are the risk factors for smoking and diabetes for grade C

A
  • rapid rate
  • greater than or equal to 10 cigs a day
  • diabetic with HBA1C greater than or equal to 7%
54
Q

what is the goal of grading in periodontitis

A

to indicate the rate of periodontitis progression, responsiveness to standard therapy and potential impact on systemic health

55
Q

what are the other names for periodontitis

A
  • chronic periodontits
  • aggressive periodontitis
56
Q

what is another term for periodontal biotype

A

periodontal phenotype

57
Q

what is another term for excessive occlusal force

A

traumatic occlusal force

58
Q

what is another term for biologic width

A

supracrestal attached tissue

59
Q

what is biologic width made of

A

supracrestal connective tissue and JE

60
Q
A

Periodontics I (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions