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BDS Finals > Periodontology > Flashcards

Periodontology Flashcards

1
Q

BPE 0 (3)

A

Black band completely visible
No calculus/overhangs
No bleeding on probing

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2
Q

BPE 1 (3)

A

Black band completely visible
No calculus/overhangs
Bleeding after probing

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3
Q

BPE 2 (2)

A

Black band completely visible
Supra- or sub gingival calculus/overhangs present

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4
Q

BPE 3 (2)

A

Black band partially visible
Probing depths of 3.5-5.5mm

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5
Q

BPE 4 (2)

A

Black band entirely within the pocket
Probing depths of 6mm or more

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6
Q

BPE *

A

Furcation involvement

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7
Q

BPE 0 Treatment

A

No need for periodontal treatment

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8
Q

BPE 1 Treatment

A

OHI

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9
Q

BPE 2 Treatment (2)

A

OHI
Removal of plaque retentive factors including supra- and sub- gingival calculus

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10
Q

BPE 3 Treatment (2)

A

OHI
Root surface debridement

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11
Q

BPE 4 Treatment (3)

A

OHI
RSD Assess need for more complex treatment and referral to a specialist

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12
Q

When should radiographs be taken to assess bone levels

A

When a BPE of 3 or 4 is found

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13
Q

Which part of a hand scalar should be parallel to the long axis of the tooth

A

Lower terminal shank

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14
Q

When should a 6 point pocket chart be carried out

A

When a BPE of 3, 4 or * is found
If BPE 3 in 1 sextant, carry it out only in that sextant

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15
Q

What is recorded on a 6PPC (6)

A
  1. Gingival margin
  2. Probing depth
  3. Loss of attachment
  4. Bleeding on probing
  5. Mobility
  6. Furcation involvement
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16
Q

What probe is used for a 6PPC

A

PCP 12 Probe

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17
Q

How is loss of attachment calculated

A

Probing depth + recession

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18
Q

Mobility Grade 1

A

<1mm movement

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19
Q

Mobility Grade 2

A

1-2mm movement

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20
Q

Mobility Grade 3

A

> 2mm movement
Or rotation or depression

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21
Q

When does recession have a negative value

A

If the gingival margin is above the ACJ
i.e. coronal to the ACJ

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22
Q

Furcation Grade 1 (2)

A

Initial furcation involvement
Furcation opening can be felt on probing but involvement is less than one third of the tooth width

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23
Q

Furcation Grade 2 (2)

A

Partial furcation involvement
Loss of support exceeds one third of the tooth width but does not include the total width of the furcation

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24
Q

Furcation Grade 3 (2)

A

Through and through involvement
Probe can pass through the entire furcation

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25
Q

What do the black bands mean on a PCP 12 probe when carrying out a 6 point pocket chart

A

3, 6, 9, 12

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26
Q

How much more likely are periodontal patients to lose teeth off they don’t return for regular visits

A

5.6

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27
Q

What should be established when a patients periodontitis keeps recurring

A

Why there has been recurrence

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28
Q

Periodontitis Stage 1

A

Less then 15% or 2mm bone loss at worst site

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29
Q

Periodontitis Stage 2

A

Coronal third of root of bone loss

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30
Q

Periodontitis Stage 3

A

Mid two thirds of root of bone loss

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31
Q

Periodontitis Stage 4

A

Apical third of root of bone loss

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32
Q

If they patient has lost teeth due to periodontitis what stage should they be assigned

A

Stage 4

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33
Q

How is the grade for periodontal bone loss calculated

A

Percentage of bone loss divided by age

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34
Q

Periodontitis Grade A (3)

A

<0.5
Bone loss less than half the patients age
Slow

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35
Q

Periodontitis Grade B (2)

A

0.5-1.0
Moderate

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36
Q

Periodontitis Grade C (3)

A

> 1
Rapid
Max bone loss more than the patients age

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37
Q

How is localised periodontitis defined

A

Effects less then 30% of teeth

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38
Q

How is generalised periodontitis defined

A

Effects more than 30% of teeth

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39
Q

What are the components of a full periodontal diagnosis (5)

A
  1. Stage
  2. Grade
  3. Periodontitis status/stability
  4. Risk factors
  5. Generalised/Localised
40
Q

Currently stable periodontitis (3)

A
  1. BoP less than 10%
  2. PPD less than 4mm
  3. No BoP at 4mm sites
41
Q

Currently in remission periodontitis (3)

A
  1. BoP 10% or more
  2. PPD 4mm or more
  3. No NoP at 4mm sites
42
Q

Currently unstable periodontitis (2)

A

PPD 5mm or more
BoP at 4mm sites

43
Q

Non-plaque induced gingivitis

A

Uncommon and will need a specialist to help diagnose

44
Q

What can cause periodontitis without plaque

A

Squamous cell carcinoma
Langerhans cell histiocytosis

45
Q

How can you assess patient engagement with periodontal services

A

Modified plaque and bleeding scores

46
Q

What surfaces are used for modified plaque scores

A

Interproximal
Buccal
Lingual

47
Q

What surfaces are used for modified bleeding scores

A

Buccal
Lingual
Mesial
Distal

48
Q

Modified plaque scores (3)

A

0 - No plaque
1 - No visible plaque but a probe reveals plaque
2 - Visible plaque

49
Q

Modified bleeding scores

A

0 - No bleeding
1 - Bleeding

50
Q

How do you calculate modified plaque score

A

Add up the score for each surface and divide by max possible score (36)

51
Q

What does modified bleeding score measure

A

Marginal bleeding which indicates how well the patient is able to carry out effective plaque control daily

52
Q

How should you carry out a modified bleeding score (3)

A

Use ramfjords teeth
Run a probe around margins in continuous sweep at 45 degree angle
Check for bleeding up to 30 seconds after

53
Q

How do you calculate modified bleeding score

A

Score / 24
Or max possible score

54
Q

What should you do if one or Ramfjords teeth is missing

A

Use a similar alternative tooth

55
Q

When should you calculate plaque and bleeding scores

A

Not needed at initial session
Every subsequent session

56
Q

Goals for modified plaque and bleeding scores (3)

A

Plaque <30%
Bleeding <35%
Or more than a 50% improvement

57
Q

What is the length of biological width

A

Connective tissue + junctional epithelium
2mm

58
Q

Supportive Periodontal Care Tx (3)

A
  1. OH reinforcement
  2. Scaling
  3. Polishing
59
Q

Oral Hygiene TIPPS

A

Talk
Instruct
Practice
Plan
Support

60
Q

Periodontal - Teeth in right/left

A

7-4

61
Q

Periodontal - Teeth in anterior sextant

A

3-3

62
Q

How many teeth should be in a sextant to qualify it for recording BPE?

A

2+

63
Q

When should third molars be included in BPE?

A

When first and second molars are missing

64
Q

What do vertical defects in bone loss indicate

A

More rapid progression of disease process

65
Q

How long after step 1 should you re-evaluate

A

8 weeks

66
Q

How long after step 2 should you re-evaulate

A

12 weeks

67
Q

How often should a review chart be carried out

A

Yearly

68
Q

Before starting perio tx as a GDP

A

Record all costs involved at start prior to commencing tx and give estimate

69
Q

What should the patient be informed of for perio tx (2)

A
  1. Potential side effects during and after tx
  2. If there is any difficulties during tx
70
Q

Indications for mucogingival surgery (5)

A
  1. Lesions requiring regenerative tx
  2. Poor aesthetics
  3. Short clinical crown height
  4. Frenal pull causing recession defect
  5. Socket preservation for future implant tx
71
Q

Mucogingival surgery - common procedures (3)

A
  1. Free gingival graft
  2. Pedicle graft
  3. Connective tissue graft
72
Q

Free Gingival Graft (2)

A

Partial thickness flap
Connective tissue exposed which heals to graft

73
Q

Pedicle sliding graft (3)

A

Partial thickness flap
Flap rotated to cover defect
Good blood supply

74
Q

How does the donor site heal in mucogingival surgery

A

Secondary inention

75
Q

Connective Tissue Graft (2)

A
  1. Doesn’t leave an exposed donor site as flap as closed again after connective tissue removed
  2. Can also use coronally advanced flap
76
Q

GBR

A

Guided Bone Regeneration

77
Q

Infrabony Defects

A

1 wall, 2 wall, 3 wall
3 wall responds better to treatment

78
Q

DBBM

A

Deproteinised bovine bone matrix

79
Q

EMD

A

Enamel matrix derivative

80
Q

Biomaterials used in GBR (3)

A
  1. Barrier membrane (collagen)
  2. DBBM
  3. EMD
81
Q

Long junctional epithelium (2)

A

Weaker than normal anatomy
OH must be excellent

82
Q

Gingival Recession Classification (2)

A
  1. Cario 2012
  2. RT1 RT2 RT3
83
Q

RT1 (2)

A

No inter proximal tissue loss
Full root coverage may be achievable

84
Q

RT2 (2)

A

Interproximal tissue loss not as significant as mid-buccal
Partial root coverage may be expected

85
Q

RT3 (3)

A
  1. Gingival recession associated with loss of inter proximal attachment
  2. Interproximal tissue loss worse than mid buccal
  3. No root coverage expected
86
Q

Gingival Recession Tx (7)

A
  1. Record magnitude
  2. Eliminate etiological factors (habits/peircings)
  3. OHI
  4. Topical desensitisation
  5. Gingival veneer
  6. Crowns
  7. Mucogingival surgery
87
Q

What is crown lengthening

A

Apically repositioning the entire periodontal attachment, usually including bone

88
Q

Crown lengthening indications (4)

A
  1. Increase for restorations
  2. Increase ferrule
  3. Expose subgingival margins/caries/fractures
  4. Uneven gingival contour compromising aesthetics
89
Q

Crown Lengthening Procedure (2)

A
  1. 3-4mm bone removed
  2. Hand bone chisels used close to tooth so no iatrogenic damage
90
Q

When is a collagen membrane used

A

Over bone regeneration treatment under the epithelium

91
Q

Suitable patient for referral for mucogingival surgery (4)

A
  1. After thorough non-surgical
  2. Highly motivated/engaged with optimal plaque control
  3. Non-smoker and no contraindications in MH
  4. Reasonable prognosis of teeth
92
Q

Periodontitis systemic links (5)

A
  1. Diabetes
  2. CV
  3. Pregnancy
  4. Rheumatoid arthritis
  5. Alzheimers
93
Q

Aims of Step 3 (2)

A

Tx non-responding sites
Regenerating or resecting lesions that add complexity

94
Q

What might regenerative/resecting procedures be (3)

A
  1. Access flap surgery
  2. Resective flap surgery
  3. Regenerative flap surgery
95
Q

Step 3 options (3)

A

Repeated sub gingival instrumentation
With or without tx adjuncts
Regenerative options

96
Q

Drawback of 6PPC

A

Assumes everyones roots are same length
Can show worse prognosis if short roots

BDS Finals (23 decks)

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