week 7 Flashcards
Define Gingival and periodontal health
absence or minimal levels of clinical inflammation in periodontium with normal support
what is healthy mobility
0-2mm
what is healthy bop
less than 10%
define gingivitis
infalmmatory condition of gingiva
retained dental plaque without bone loss
how much BOP in gingivitus
more than 10%
what are the probing depths in gingivitus
0-3mm
what is the mobility in gingivitus
up to 0.2mm
define periodontitis
inflammatory disease of supporting tissues around teeth - can cause irreversable loss of periodontal ligament, bone, toothe mobility and loss of tooth
how much bop in periodontitis
more than 10%
what are the probing depths of periodontitis
more than 3/4mm
what is a reduced periodontium in a stable perio patient
pre-existing loss of periodontal tissue
less than 10% bop
0-3mm probing
up to 0.2mm mobility
what is attachment loss not caused by periodontitis
recession caused by abrasion
tissue damage - eg tooth that has been surgically removed
what are the systemic risk factors that can modify gingivitis
smoking
hyperglycaemia
nutritional factors
pharmacological agents
sex steroid hormones
haematological conditions
what are the local risk factors that can modify gingivitis
dental plaque biofilm retention factors
oral dryness
what are the three medications that are associated with drug induced gingival overgrowth
calcium channel blockers
cyclosporine
phenytoin
what are the three forms of periodontitis in classification in 2017
necrotising
manifestation of systemic disease
periodontitis
what is necrotising gingivitis
necrosis of papilla
what is necrotising periodontitis
bleeding
what is necrotising stomatitis
sudden onset of pain
what are the features of periodontitis as a manifestation of systemic disease
- genetic conditions
- severe, aggressive, periodontal destruction in children and adolescents
- severe gingival inflammation and rapid bone loss
- tooth loss in both primary and permanent dentition
- generally neutrophils or CT disorders
what are the neutrophil disorders causing periodontitis as a manifestation of systemic disease
- severe neutropenia
- congenital neutropenia
- cyclic neutropenia
what are the connective tissue disorders causing periodontitis as a manifestation of systemic disease
ehlers-danlos syndrome
angioedema
systemic lupus erthematosus
what are the 5 steps required to compile a diagnosis statement
1 - determine if the patient is a periodontitis case
2- stage the patient (severity)
3 - Grading (rate of bone loss)
4 - Systemic risk assessment
5 - Assesment of periodontal status
what determines whether a patient is a periodontitis case
interdental attachment loss is detectable at more or equal than 2 non adjacent teeth
OR
buccal clinical attachment loos of more or equal to 3mm with pocketing over 3mm due to periodontitis at two or more non adjacent teeth
are periodontal defects cause by endo perio lesions, root resorption, impacted wisdom teeth included as attachment loss due to periodontitis in the current classification
no
what is staging
extent + severity + complexity of disease management
what is the extent of disease presentation
localised = less than 30% of teeth
Generalised more than or equal to 30% of teeth
“molar, incisor” pattern
what are the features of complexity of disease management
probing depths
furcations
pattern of bone loss
tooth loss
mobility
what is the maximum probing depth for stage 1 (mild)
less than or equal to 4mm
what is the maximum probing depth for stage 2 (moderate)
less than or equal to 5mm
what is the maximum probing depth for stage 3 (severe)
greater or equal to 6mm
what is the radiographic bone loss of stage 1
less than 15%
what is the radiographic bone loss of stage 2
15-33%
what is the radiographic bone loss of stage 3
vertical bone loss
furcation involvment
what is the radiographic bone loss of stage 4
extends to middle third of the root or beyond
what is the CAL of stage 1 at site of greatest loss
greater or equal to 2mm
what is the CAL of stage 2 at site of greatest loss
3-4mm
what is the CAL of stage 3 and 4 at site of greatest loss
greater or equal to 5mm
what is the difference between stage 3 and 4
stage 3 involves the loss of 4 or less teeth
stage 4 is at risk of losing dentition - more than 5 teeth lost
there is also mobility and occlusal collapse in stage 4
what outcomes are stage 1 and 2
predictable
what outcomes are stage 3 and 4
non predictable
what is grading
estimates the rate or speed of attachment loss
how do u calculate grading
% of bone loss at worst site divided by age
what is grading made up of
information on biological features of disease + rate of progression + risk assessment
what is the ratio for grade A
less than 0.5
what is the ratio for grade B
0.5-1
what is the ratio for grade C
greater than 1
what grades involve systemic risk factors
B and C
what is the diabetic and smoking features of grade B
HbA1c less than 7
smoke less than 10 cigarettes a day
what is the diabetic and smoking features of grade C
HbA1c greater or equal to 7
Smoke 10 or more cigarettes a day
what is currently stable
BOP less than 10%
PD less than or equal to 4mm
No BOP at 4mm sites
what is in remission
BOP greater than 10%
PD less than or equal to 4mm
No BOP at 4mm sites
What is currently unstable
PD greater or equal to 5mm
or PD greater or equal to 4mm and BOP
what are the two systemic risk factors for periodontitis
diabetes and smoking
can these risk factors alter a patients grade
yes
what are healthy probing depths
0-3mm
