Brainscape's Knowledge GenomeTM

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


See full index

Periodontics > Written Paper > Flashcards

Written Paper Flashcards

1
Q

4 components of the periodontium

A

Gingiva
Periodontal ligament
Alveolar bone
Cementum

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

4 features of healthy gingiva

A

Pink
Stippled in texture
Knife-edged margins
Scalloped profile

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

2 functions of gingiva

A

Attachment between oral mucous membrane and hard tissues
Protects the underlying periodontal tissues from invasion by bacteria

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

3 types of gingival epithelium

A

Junctional epithelium
Sulcular/crevicular epithelium
Oral gingival epithelium

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

5 features of junctional epithelium

A

Stratified squamous non keratinised epithelium
Forms attachment of gingiva to tooth by hemi-desmosomes and internal basal lamina
Epithelial attachment to enamel which terminates apically at cementum-enamel junction
Very high cell turnover
Permeable epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 features of crevicular epithelium

A

Stratified squamous non-keratinised epithelium
Lines gingival crevice, not attached to tooth surface
0.5-2 mm in depth

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

3 features of oral gingival epithelium

A

Stratified squamous, keratinised epithelium
Masticatory mucosa
Rete pegs interdigitate with dermal papillae of the underlying connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 components of gingival connective tissue

A

Collagen fibres embedded in an extra cellular matrix
Fibroblasts
Many blood vessels
Nerve cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2 functions of fibroblasts

A

Secrete all components of the extracellular matrix including collagen fibres
Responsible for degradation of the matrix through secretion of MMPs

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

What is the periodontal ligament

A

A specialised gomphosis fibrous attachment of the tooth to alveolar bone

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

What is alveolar bone

A

The component of the maxilla or mandible which surrounds and support the teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 components of alveolar bone

A

Alveolar bone proper
Cancellous/spongy bone
Cortical plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is cementum

A

Calcified mesenchymal tissue that covers entire root surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2 types of cementum

A

Cellular cementum
Acellular cementum

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

3 functions of cementum

A

Anchorage
Protection
Repair

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

8 plaque retentive factors

A

Calculus
Poor restoration margins
Tooth position/angulation
Developmental anomalies
Oral appliances
Xerostomia
Gingival enlargement
Incompetent lip posture

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

6 stages in classifying periodontal disease

A

Condition
Pattern
Stage
Grade
Stability
Risk factor profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

6 considerations for risk factor status

A

Smoking
Poorly-controlled diabetes
Family history
Poor plaque control
Subgingival deposits of calculus
Local factors: mouth-breathing, crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

4 periodontal indices

A

O’Learys laque index
Periodontal pocket depths
Bleeding on probing
Miller’s mobility index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Choice of radiographs for generalised moderate/advanced periodontal disease

A

OPT plus anterior IOPAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Choice of radiographs for generalised mild periodontal disease

A

Bite-wings plus anterior IOPAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Choice of radiographs for localised advanced periodontal disease

A

Additional IOPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3 methods of mechanical plaque control

A

Bass method of toothbrushing – intrasulcular
Interdental flossing
Interdental brushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Method of chemical plaque control

A

Chlorhexidine mouthwash: 0.2% chlorhexidine gluconate, 10ml rinse (20mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mechanical and hand-instrumentation methods of root surface debridement (RSD)

A

Mechanical: ultrasonic scalers, sonic scalers

Hand instrumentation: site-specific curettes, hoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

4 modes of action of mechanical scalers

A

Mechanical energy
Irrigation
Cavitation
Acoustic microstreaming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Features of piezo–electric ultrasonic scaler

A

Linear movements of tip
Vibrations caused by oscillations of quartz crystals in the handpiece

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Features of magnetostrictive ultrasonic scaler

A

Eliptical movements of tip
Magnetic energy converted to mechanical energy to create vibrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

5 principles of ultrasonic instrumentation

A

0 -15 degrees to tooth
Insertion at gingival margin
“Exploring” pressure
Keep tip in motion
Bidirectional stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

4 advantages of ultrasonic scaling

A

Irrigation with water clears the field of debris and blood
Allow quick removal of gross deposits
Less tiring for the operator
Can be used to remove overhanging margins on amalgam restorations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

4 disadvantages of ultrasonic scaling

A

Generate contaminated aerosols
Water/aerosol can obscure vision
Can damage teeth and restorations
Cause significant sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the types of Graceys curettes and what surfaces of which teeth are they used for

A

1, 2: all surfaces of anterior teeth

5, 6: all surfaces of anterior teeth

11, 12: buccal, lingual, mesial surfaces of posterior teeth

13, 14: distal surface of posterior teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

4 advantages of hand scaling

A

Hand instruments allows the operator tactile sensitivity
No aerosol is generated
May provide better access, especially deeper sites (>5mm)
Patients report less sensitivity and less discomfort during the procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

3 disadvantages of hand scaling

A

Can cause more operator fatigue
Are more time consuming compared to ultrasonics
Are more difficult to use effectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

5A’s of smoking cessation

A

Ask
Assess
Advise
Assist
Arrange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

4 host defence mechanisms against periodontal disease pathogens

A

Saliva
Epithelial barrier
Inflammatory response
Immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

2 functions of inflammation

A

Isolate, neutralise and remove cause
Initiate healing and repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Red complex organisms

A

Porphyromonas Gingivalis
Treponema Denticola
Tannerella Forsythia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

2 Porphyromonas gingivalis virulence factors

A

Production of proteases
Polysaccharide capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

2 Tannerella forsythia virulence factors

A

Production of trypsin-like proteases Production of glycosidase enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Treponema denticola virulence factor

A

Production of potent hydrolytic enzymes including collagenases and proteases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

3 patients who would benefit from being prescribed high fluoride toothpaste

A

High caries risk
Xerostomia
Orthodontic appliances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

2 concentrations of high fluoride toothpaste

A

2800ppm
5000ppm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Describe the Bass technique of toothbrushing

A

45 ̊ angle to the tooth surface
Bristles below the gum margin
Circular motion
Firm yet gentle pressure
At least 2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Concentration of the active ingredient in Chlorhexidine mouthwash

A

0.2% chlorhexidine gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

3 important properties of Chlorhexidine mouthwash

A

Antibacterial
Antiseptic
Substantivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

3 possible side effects of Chlorhexidine mouthwash

A

Staining
Altered taste sensation
Hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

4 signs of inflamed gingiva

A

Red colour
Bleeding on brushing/probing
Bad breath
Receding gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

4 areas early plaque formation occurs faster in

A

Lower jaw
Molar areas
Buccal tooth surfaces
Interdental regions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

5 bacterial pathogens associated with periodontal disease

A

Porphyromonas Gingivalis
Tannerella Forsythia
Treponema Denticola
Fusobacterium Nucleatum
Prevotella Intermedia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Define the periodontium

A

Supporting apparatus of the tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Describe the variation in width of attached gingiva

A

Wider in incisor regions
Narrower over canines and 1st premolars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Describe the role of collagen fibres in withstanding occlusal loading during tooth function

A

Capable of remodelling and stretching during occlusal loads whilst maintaining their overall structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Describe the role of GAGs in withstanding occlusal loading during tooth function

A

Bind water and act as a hydraulic cushion to allow the PDL to resist compressive forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

4 antibacterial effects of saliva

A

Washing effects
Inhibition of attachment of bacteria (sIgA)
Killing bacteria by peroxidase system
Killing bacteria by lysozyme, lactoferrin, histatins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

3 causes of xerostomia

A

Drug-induced: antihypertensives, antidepressants
Head and neck radiation
Salivary disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

6 methods of bacterial pathogenic synergy in periodontal disease

A

Bacterial signalling relays information about the biofilm environment
Bacterial gene transfer
Co-adhesion between bacteria allows organisation of the biofilm architecture
Protection provided by extracellular polymeric matrix and other bacteria
Provision of essential nutrients
Adherence to the enamel pedicle to resist the removal forces of GCF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Describe how to measure probing pocket depth

A

Gingival margin – base of pocket

58
Q

Describe how to measure clinical attachment loss

A

Cementum-enamel junction – base of pocket

59
Q

When does clinical attachment loss > probing pocket depth

A

Gingival recession

60
Q

When does probing pocket depth > clinical attachment loss

A

Gingival swelling

61
Q

Define Miller’s index score 0

A

No, or physiological movement

62
Q

Define Miller’s index score 1

A

Buccal-lingual movement <1 mm

63
Q

Define Miller’s index score 2

A

Buccal-lingual movement ≥1mm

64
Q

Define Miller’s index score 3

A

Buccal-lingual movement ≥1mm and vertical movement

65
Q

Describe Miller’s index

A

Used to assess the mobility of teeth by using the ends of a dental instrument e.g mirror

66
Q

3 things accurate probing depends on

A

Probing force
Probe placement
Probe angulation

67
Q

4 potential problems that may affect your ability to complete an accurate probing record

A

False pocketing
Subgingival calculus
Overcrowding
Orthodontic appliances

68
Q

Define gingivitis

A

Inflammatory response of the marginal gingiva, reversible condition

69
Q

Define periodontitis

A

Inflammatory condition resulting in the irreversible loss of the tooth supporting structures, periodontal ligament and alveolar bone

70
Q

5 features of supra-gingival calculus

A

Attached to tooth
Creamy-yellow
Brittle
Easily removed from tooth
Visible

71
Q

5 features of sub-gingival calculus

A

Attached to root surfaces
Brown/Black
Very hard
Tenacious
Detected by gentle probing/ radiograph

72
Q

6 clinical presentations of periodontitis

A

Formation of periodontal pockets
Bleeding on probing
Gingival inflammation
Drifting of teeth
Tooth mobility
Gingival recession

73
Q

Radiographic presentation of periodontitis

A

Loss of alveolar bone - >1.5mm apical to CEJ

74
Q

Classify the pattern of periodontitis

A

Localised: ≤ 30% teeth involved
Generalised: > 30% teeth involved
Molar-incisor distribution: only molar and incisor teeth involved

75
Q

Classify the staging of periodontitis

A

Stage I : < 15% or < 2mm attachment loss from CEJ
Stage II : coronal third of the root
Stage III : middle third of the root
Stage IV : apical third of the root

76
Q

Classify the grading of periodontitis

A

Grade A: < 0.5
Grade B: 0.5-1
Grade C: > 1

77
Q

Classify the current disease status of periodontitis

A

Stable: BoP<10%; PPD≤4mm, no BoP at 4mm sites
Remission: BoP≥10%; PPD≤4mm; no BoP at 4mm sites
Unstable: PPD≥5mm or PPD≥4mm with BoP

78
Q

3 types of hand scalers

A

Gracey curettes
Periodontal hoes
Sickle scaler

79
Q

2 types of mechanical scalers

A

UItrasonic scalers
Sonic scalers

80
Q

2 types of ultra-sonic scalers

A

Piezo-electric
Magnetostrictive

81
Q

3 histological changes following successful non-surgical therapy

A

Decreased vasodilation and number of inflammatory cells
Remodelling of alveolar bone
Deposition of collagen fibres

82
Q

5 clinical changes following successful non-surgical therapy

A

Decreased inflammation and swelling
Decreased redness
Decreased bleeding
Decreased probing depths
Reduction in subgingival calculus

83
Q

4 important factors for successful non-surgical treatment

A

High standard of plaque control
Smoking cessation
Good quality root surface debridement
Good quality restorative treatment

84
Q

Features of alveolar bone proper

A

Consists of thin lamella of bone that surrounds the root of the tooth
Gives attachment to the principal fibres of the periodontal ligament
Perforated due to ingress of vessels/nerves

85
Q

Features of cancellous/spongy bone

A

Surrounds the alveolar bone proper and gives support to the socket
Widely spaced concentric or tranverse lamella enclosing the marrow spaces

86
Q

Features of cortical plates

A

Forms the outer and inner plates of the alveolar bone

87
Q

Cells responsible for alveolar bone resorption

A

Osteoclasts

88
Q

Cells responsible for alveolar bone deposition

A

Osteoblasts

89
Q

Features of cementum

A

It is avascular and not innervated
Formed slowly throughout life
Thicker at root apices
Resistant to resorption

90
Q

Features of cellular cementum

A

Contains cementocytes in lacunae which resorb cementum
Communicate with each other through a network of canaliculi

91
Q

Features of acellular cementum

A

Forms a thin surface layer which is often confined to cervical portions of the root
Cementoblasts are found on its surface

92
Q

Define hypercementosis

A

Excessive deposition of cementum usually at apical area of roots

93
Q

Features of inflammatory response

A

Rapid
Relatively non-specific

94
Q

Cellular exudate of inflammatory response

A

Neutrophils
Macrophages

95
Q

2 disorders which affect inflammatory response in periodontal disease

A

Leucocyte adhesion deficiency
Cyclic neutropenia

96
Q

Features of adaptive immune response

A

Exhibits memory
Highly specific

97
Q

Histology of healthy gingiva

A

Few neutrophils migrating through JE

98
Q

Histopathology of early lesion (4-7 days)

A

Increased neutrophil migration
Macrophage and lymphocytic infiltrate
Localised collagen degradation
Localised fibroblast degeneration

99
Q

Histopathology of established lesion (14-21 days)

A

Neutrophils walling off plaque
Increased lymphocytic infiltrate
60-70% collagen destruction
Lateral proliferation of JE with micro-ulceration

100
Q

Histopathology of periodontitis

A

Apical migration of JE
Loss of periodontal ligament attachment
Loss of alveolar bone
Micro-ulceration of JE

101
Q

When do you get false pocket formation

A

Gingivitis

102
Q

5 stages of development of a plaque biofilm on a clean tooth surface

A
  1. The pellicle derived from saliva forms on a clean tooth surface
  2. Initially gram-positive cocci predominate in oral biofilms
  3. After a few hours the plaque bulk increases by bacterial division
  4. As plaque matures, gram positive bacteria are gradually replaced by gram negative species
  5. Gram negative filamentous forms such as fusiforms and spirochaetes appear in the later stages of plaque maturation
103
Q

Composition of dental plaque

A

80-90% water

104
Q

Composition of calculus

A

70-80% inorganic salts

105
Q

Bacteria found in supra-gingival plaque

A

Mostly gram positive, aerobic bacteria

106
Q

Bacterial composition of sub-gingival plaque

A

Gram negative rods and spirochetes, anaerobic bacteria

107
Q

Describe the ecological plaque hypothesis for the development of periodontal disease

A

Organisms associated with disease may be found at healthy sites but at levels that are too low to be clinically relevant

Disease occurs as a result of a shift in the balance of the resident microflora due to a change in the local environmental conditions

The amount of dental plaque and the specific microbial composition of the plaque contribute to the transition from health to disease

The destruction in periodontal disease is the outcome of interactions between the host and the microbial challenge

108
Q

Important message of the Ecological plaque hypothesis

A

Periodontal disease can be prevented, not only be targeting the putative pathogens, but also by interfering with the environmental factors which drive the changes in the balance of microflora

109
Q

Calculation to determine plaque score

A

Number of surfaces exhibiting plaque divided by the number of available surfaces x 100

110
Q

2 probes for measuring periodontal disease

A

Williams probe
WHO probe

111
Q

Light probing force

A

20-25g

112
Q

Features of WHO probe

A

Ball end is 0.5mm in diameter
First black band is found at 3.5mm to 5.5mm

113
Q

5 things radiographic periodontal assessment allow us to determine

A

Bone loss: severity, pattern
Presence of sub-gingival calculus
Restoration margins
Presence of furcation
Peri-apical radiolucencies

114
Q

4 components of periodontal disease prevention

A

OHI
Diet advice
Smoking cessation advice
Medication advice

115
Q

What does non-surgical management of periodontal disease involve

A

Removal and control of plaque bacteria and their products
Removal of plaque-retentive factors

116
Q

Uses for a WHO probe

A

Detect developing periodontal pockets
Measure the depths of the pockets and any loss of attachment to periodontal structures
Detect calculus and measure furcation involvement

117
Q

Describe BPE 0 score

A

Pockets <3.5mm (black band entirely visible)
No calculus/overhangs, no bleeding on probing

118
Q

Describe BPE 1 score

A

Pockets <3.5mm (black band entirely visible)
No calculus/overhangs, bleeding on probing

119
Q

Describe BPE score 2

A

Pockets <3.5mm (black band entirely visible)
Supra or subgingival calculus/overhangs

120
Q

Describe BPE score 3

A

Probing depth 3.5-5.5mm (black band partially visible)
Indicating pocket of 4-5mm

121
Q

Describe BPE score 4

A

Probing depth >5.5mm (black band disappears)
Indicating a pocket of 6mm or more

122
Q

Describe * BPE

A

Furcation involvement

123
Q

Management of BPE score 0

A

No need for periodontal treatment

124
Q

Management of BPE score 1

A

OHI

125
Q

Management of BPE score 2

A

OHI
Removal of plaque retentive factors

126
Q

Management of BPE score 3

A

OHI
Removal of plaque retentive factors
Root surface debrivement if required

127
Q

Management of BPE score 4

A

OHI
Removal of plaque retentive factors
Root surface debridement
Referral to specialist if indicated

128
Q

Define chemotaxis

A

The movement of an organism in response to a chemical stimulus

129
Q

Define cytokine

A

Small protein produced mainly by macrophages that facilitate cell-cell communication via paracrine/autocrine signalling

130
Q

Define phagocytosis

A

Process initiated by innate immune response, where pathogens are engulfed, neutralised and degraded

131
Q

Recall for periodontal review

A

6/8 weeks

132
Q

Define cross infection

A

Transmission of a pathogenic organism from one person to another

133
Q

6 measures to prevent cross infection control

A

Dress code
PPE
Hand hygiene
Zoning
Decontamination
Segregation of waste

134
Q

How will Amiodipine therapy affect treatment

A

Calcium channel blocker
Risk of gingival overgrowth
Increased risk of gingivitis and periodontitis therefore need to emphasise good OHI

135
Q

How will Warfarin therapy affect treatment

A

Anticoagulant
Increased bleeding time
Need to check INR is below 4.0

136
Q

How is stage of periodontal disease determined

A

Extent of interproximal bone loss recorded in the site with the most bone loss

137
Q

How is grade of periodontal disease determined

A

Percentage bone loss at worst site divided by patients age

138
Q

3 effects of protease release

A

Collagen breakdown
Extracellular matrix breakdown
Loss of attachment

139
Q

2 effects of IL-1, IL-6 and prostaglandins activation

A

Osteoclast activation
Bone loss

140
Q

6 cells found in periodontal ligament

A

Fibroblasts
Osteoblasts
Cementoblasts
Osteoclasts
Nerve cells
Vascular cells

141
Q

Define virulence factors

A

Microbial determinants of pathogens that mediate host damage

142
Q

6 surface associated virulence factors

A

Adhesion pili
Capsule
Adhesins
LPS
Flagella
Surface proteins

143
Q

3 secreted virulence factors

A

Exotoxin
Enzymes
Iron binding proteins

Periodontics (1 decks)

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