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D1 Spring > Perio 1 Final (2nd half) > Flashcards

Perio 1 Final (2nd half) Flashcards

1
Q

CAL

A

Measured pocket (probe depth) + visible recession below CEJ

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2
Q

Fuchsia-colored erythrosine sodium solution

A

Plaque disclosing agents

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3
Q

Visual aid for patients to see plaque build up

A

Plaque disclosing agents

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4
Q

What drugs are associated with gingival enlargements (hyperplasia)?

A
  1. Calcium channel blackers (Nifedipine & Diltazem)
  2. Anticonvulsants (phenytoin)
  3. Immunosuppressants (cyclosporin)
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5
Q

A tooth brush should have a ______ ______ head (about ________ in size for adults).

It should have ____, _______, ________ bristles, usually in ____ rows.

A

relatively small; 1-1.25 inches

soft nylon, multitufted, polished; 3

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6
Q

The force of which bristles are applied to the tooth should not exceed

A

300-400g

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7
Q

Effective toothbrush technique, ESPECIALLY for patients with ginigivitis & periodontitis

A

Modified Bass technique

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8
Q

Describe the Modified Bass technique

A

Bristles at 45 degree angle, small vibratory/circular motions (known as sulcular brushing).

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9
Q

Natural vs. Synthetic toothbrush bristles

A

Natural bristles = contain gaps that bacteria can colonize; don’t have rounded ends, which can cause lesions to the gingiva.

Synthetic bristles = have end-round filaments that reduce the damage to gingiva.

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10
Q

Describe the Modified Stillman method

A

Vertical, Rotary brushing

A series of brush movements repeated 5-10 times in the same area

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11
Q

When is vertical brushing indicated?

A
  1. Overlapped teeth
  2. Open interproximal areas
  3. Areas of recession
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12
Q

Describe the Fones method of brushing

A

Max teeth closed, circular motion from max gingiva to mand gingiva

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13
Q

Where is toothbrush trauma most frequently seen?

A

Facial surfaces of canines & premolars

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14
Q

What is the purpose of interdental care?

A

Remove plaque, NOT food debris.

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15
Q

Where does disease originate in the mouth?

A

Interproximal areas

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16
Q

What dictates the effectiveness of dental floss?

A

The anatomy of the tooth (areas might be missed due to shape of the tooth)

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17
Q

Which classification of gingival disease?

  1. Older classification system of gingivitis vs. periodontits based on probing depth (NOT attachment loss)
  2. Didn’t account for many systemic health considerations
  3. Had the term “refractory periodontitis”
A

Pre-Armitage

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18
Q

Which classification of gingival disease?

  1. Gingival disease classification system that is based primarily on attachment level/loss
  2. Didn’t account for many systemic health considerations
A

Armitage

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19
Q

Which classification of gingival disease?

  1. Oncology model
  2. Has stage and grade
A

Current

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20
Q

In the new periodonal classification system, does the stage or grade improve with periodontal treatments?

A

The grade can improve with treatment and better oral hygiene, but the stage will never improve (can get worse).

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21
Q

What does periodontal staging classify? What is it based off of?

A

Severity/extent of disease

Based off measurable data (helps assess complexity)

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22
Q

How many stages are there in periodontal staging?

A

4

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23
Q

What are the 4 stages of periodontal staging based on?

A

Severity, complexity, and extent/distribution

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24
Q

What do “interdental CAL”, “RBL”, and “tooth loss” fall under for staging of perio?

A

Severity

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25
Q

What does “local” fall under for staging of perio?

A

Complexity

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26
Q

What does “add to stage as descriptor” fall under for staging of perio?

A

Extent/distribution

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27
Q

Interdental CAL, RBL, tooth loss of Stage I perio

A

Interdental CAL = 1-2 mm

RBL = coronal third (<15%)

Tooth loss = none

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28
Q

Local effects (complexity) of Stage I perio

A

Max probing depth < than or = to 4mm

Mostly horizontal bone loss

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29
Q

Interdental CAL, RBL, tooth loss of Stage II perio

A

Interdental CAL = 3-4mm

RBL = coronal third (15-33%)

Tooth loss = none

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30
Q

Local effects (complexity) of Stage II perio

A

Max probing depth < than or = to 5mm

Mostly horizontal bone loss

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31
Q

Interdental CAL, RBL, tooth loss of Stage III perio

A

Interdental CAL = > than or = to 5mm

RBL = extending to middle third of root & beyond

Tooth loss = < than or = to 4 teeth

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32
Q

Local effects (complexity) of Stage III perio

A

Probing depths > than or =to 6mm

Vertical bone loss > than or = to 3mm

Furcation involvement (class II/III)

Moderate ridge defects

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33
Q

Interdental CAL, RBL, tooth loss of Stage IV perio

A

Interdental CAL = > than or = to 5mm

RBL = extending to middle third of root & beyond

Tooth loss = > than or = to 5 teeth

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34
Q

Local effects (complexity) of Stage IV perio

A

Complex rehab needed

Masticatory dysfunction

Secondary occlusal trauma (tooth mobility degree >2)

Severe ridge defects

Bite collapse, drifting, flaring

<20 remaining teeth

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35
Q

What are things you would add to the stage of perio as a descriptor?

A

For each stage, describe extent as one of the following:

Localized (<30% of teeth involved)
Generalized
Molar/incisor pattern

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36
Q

What is periodontal staging used to indicate?

A

The rate of periodontitis progression, responsiveness to therapy, and potential impact on systemic health.

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37
Q

How many grades are there in periodontal staging?

A

3 (A-C)

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38
Q

Describe the 3 grades of periodontal staging

A

Grade A = slow
Grade B = moderate
Grade C = rapid

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39
Q

What are the 2 things grading for perio is based on?

A

Primary criteria
Grade modifiers

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40
Q

What does “direct and indirect evidence of progression” fall under when grading for perio?

A

Primary criteria

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41
Q

What is included under “direct and indirect evidence of progression”?

A

Direct = RBL or CAL

Indirect = % bone loss and case phenotype

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42
Q

What does “risk factors” fall under when grading for perio?

A

Grade modifiers

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43
Q

What is included under “risk factors”?

A

Smoking
Diabetes

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44
Q

What is the RBL/CAL, % bone loss, and case phenotype for Grade A perio?

A

RBL/CAL = no loss over 5 yrs

% bone loss = <0.25

Case phenotype = heavy biofilm w/ low levels of destruction

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45
Q

What are the smoking and diabetes risk factors for Grade A perio?

A

Smoking = non-smoker

Diabetes = normoglycemic (no diagnosis of diabetes)

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46
Q

What is the RBL/CAL, % bone loss, and case phenotype for Grade B perio?

A

RBL/CAL = <2mm over 5 yrs

% bone loss = 0.25 - 1.0

Case phenotype = destruction commensurate w/ biofilm

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47
Q

What are the smoking and diabetes risk factors for Grade B perio?

A

Smoking = <10 cigs/day

Diabetes = HbA1c < 7.0%

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48
Q

What is the RBL/CAL, % bone loss, and case phenotype for Grade C perio?

A

RBL/CAL = greater than or equal to 2mm over 5 yrs

% bone loss = >1.0

Case phenotype = destruction exceeds expectations given biofilm; specific clinical patterns suggestive of periods of rapid progression/early onset disease

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49
Q

What are the smoking and diabetes risk factors for Grade C perio?

A

Smoking = greater than or equal to 10 cigs/day

Diabetes = HbA1c greater than or equal to 7%

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50
Q

What does the initial exam determine?

A

Diagnosis
Tx plan
Prognosis

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51
Q

What is included in the exam/data collection of the initial exam? (6)

A
  1. Medical hx
  2. Chief complaint
  3. Dental hx
  4. Radiographs
  5. Extra-oral exam
  6. Intra-oral exam
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52
Q

What % of pateints at dental schools require medical consultation?

A

25%

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53
Q

What are the 4 categories of periodontal health?

A
  1. Pristine periodontal health
  2. Clinical periodontal health
  3. Periodontal disease stability
  4. Periodontal disease remission/control
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54
Q

How would you describe this patient?

-absence/minimal levels of clinical inflammation

-normal osseous support

-CAL exists, but due to predisposting factors (recession, fenestrations, toothbrush abrasion)

-NOT due to active periodontal disease activity

A

Clinical periodontal health

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55
Q

How would you describe this patient?

-absence of inflammation & infection (reduction in predisposing factors and control of modifying factors)

-reduced periodontium

-the goal of perio patients

A

Periodontal disease stability

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56
Q

How would you describe this patient?

-Cannot fully control modifying/predisposing factors

-decreased inflammation

-improved clinical parameters

-stabilization of disease progression to low disease activity

-an acceptable alternative threapeuting goal in long-standing perio disease patients

A

Periodontal disease remission/control

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57
Q

Health vs. Stability

A

Health= minimal recession w/out pre-existing active perio disease

Stability= healthy state of a patient with previous perio disease (has attachment loss)

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58
Q

How would you describe this patient?

Absence of :

-attachment loss
-BOP
-Clinical erythma, edema, & pus
-pocket depths greater than 3mm

A

Pristine clinical health

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59
Q

What cells are increased in the initial lesion of healthy gingiva (clinically)?

A

neutrophils

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60
Q

What cells are increased in early lesions of clinically evident early gingivitis?

A

T lymphocytes

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61
Q

What cells are increased in established lesions of established chronic gingivitis?

A

Plasma cells

note, NO appreciable bone loss

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62
Q

What cells are increased in advanced lesions (the transition from gingivits to periodontitis)?

A

Cytopathically altered plasma cells

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63
Q

Gingivitis is associated with ___________ __________.

It is mediated by _______ or ______ factors.

What external factor can influence gingival hypertrophy?

A

dental biofilm

systemic; local

medications

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64
Q

Plaque-induced gingivitis is exacerbated by ______ __________ ____________

A

sex steroid hormones (puberty, menstrual cycle, pregnancy, oral contraceptives)

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65
Q

Vascular epulis (tumor); almost exclusively in pregnant women

A

Pyogenic granuloma

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66
Q

A tiny cluster of WBCs and other tissue; non-cancerous

A

Granulmona

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67
Q

Leukoplakia (often associated w/tobacco use) and Erythroplakia

A

Pre-malignant neoplasms

68
Q

Squameous cell carcinoma, Leukemic cell infiltration, and Lymphoma (Hodgkins & Non-Hodgkins)

A

Malignant neoplasms

69
Q

When probing, when the gingival margin appears at a level between prob marks, do you read the higher or the lower mark as the measurement?

A

The higher mark

70
Q

When charting in axium, if the pocket depth is 3mm and there is no sign of attachment loss, what value should you enter for the gingival margin?

A

-3 (put the negative value of the pocket depth)

71
Q

When charting in axium, if the pocket depth is 5mm but the gingiva is inflamed and the gingival margin is above the CEJ (toward the crown), what value should you enter for the gingival margin?

A

Assume -2mm so that the pocket depth is at 3mm

72
Q

When charting in axium, if the pocket depth is 4mm and the gingiva is located at the CEJ (can see black triangles), what value should you enter for the gingival margin?

A

0mm (reflects 4mm of attachment loss)

73
Q

The instrumentation of the crown & root surfaces to remove plaque, calculus, & stains w/out removing tooth substance

A

Scaling

74
Q

The removal of cementum & surface dentin that’s impregnated w/calculus.

Objective= produce a smooth, hard, clean surface.

A

Root planing

75
Q

Why is root planing necessary?

A

Calculus becomes embeded in the irregularities of the cementum, thus it needs to be removed & a smooth surface established

76
Q

Indications for SRPs (4)

A
  1. Inflamed, bleeding, edematous gingival tissues
  2. Gingival hyperplasia
  3. 4mm+ pockets
  4. Plaque, calculus, diseased cementum, endotoxins
77
Q

SRP results (5)

A
  1. decreased inflammation & edema
  2. decreased pocket depth
  3. improved tissue tone
  4. smoother root surface
  5. decreased bacteria, plaque, and calculus
78
Q

Subgingival calculus vs. Supragingival calculus

A

Subgingival = harder & more tenacious; removed in an open or closed surgical procedure

79
Q

Does gingival curettage add any benefit to healing from SRPs?

A

No

80
Q

For pocket depths >5mm, what is the success in total removal of calculus?

A

Failure of total removal of calculus dominates

81
Q

What are the side effects of SRPs?

A

Increases sensitivity to air, tactile, and thermal stimuli

(It exposed the dentinal tubules, which exposes the dentin to irritants that can cause pain)

82
Q

How long should you wait before scheduling a re-evaluation for SRP patients?

A

4-6 weeks

83
Q

Healing after SRPs:

What happens immediately after (2-8 hrs) root planing?

A
  1. Blood clot fills the gingival sulcus
  2. Hemorrhagine within tissue
  3. Appearance of PMNs leukocytes on the wound surface
84
Q

Healing after SRPs:

8-24 hours after, what is the clinical appearance?

A

Gingiva appears hemorrhagic & bright red

85
Q

Healing after SRPs:

2-7 days after what occurs?

A
  1. Restoration & epithelialization of the sulcus (note, this is keratinized epithelium).
  2. Reduction in the height of the gingival margin.
  3. Gingiva is slightly redder than normal, but less so than the previous days.
86
Q

Healing after SRPs:

After 2 weeks:

A
  1. Gingiva regains normal color, consistency, surface texture, and contour
  2. Gingival margin is well adapted to the tooth
  3. Appearance of immature collagen
87
Q

Healing from SRPs results in the formation of what?

A

Long junctional epithelium

(sometimes the long JE is interrupted by islands of CT attachment)

88
Q

Antiseptic mouthwash that kills germs & destroys their protective coverings; can be used to prevent plaque; can be used prior to using a Cavitron

A

Chlorhexidine/Peridex

89
Q

Side effects of Chlorhexidine/Peridex

A

Increased calculus formation
Staining
Altered taste

90
Q

Chlorhexidine/Peridex works due to

A

Substantivity (it remains on the pellicle & works for an extended period of time)

91
Q

When is periodontal surgical intervention indicated after SRPs?

A
  1. Consistently acceptable levels of oral hygiene
  2. A number of gingival sites are still BOP
  3. Significant reduction in probing depths has NOT been achieved
92
Q

When should a patient NOT be considered an acceptable candidate for periodontal surgery after SRPs?

A
  1. Poor oral hygiene
  2. Lack of motivation/ability to exercise proper home care
93
Q

When does a patient NOT require further perio treatment (other than routine maintenance)? (4)

A
  1. Acceptable oral hygiene
  2. No gingival inflammation or BOP
  3. Probing depths significantly reduced
  4. Clinical attachment levels have improved
94
Q

Any patient with probing depths of ______ or greater should be referred to a periodontist

A

6mm

95
Q

In private practice, Stage ____ or _____ and Grade ___ perio patients should be IMMEDIATELY referred to a periodontitis.

A

III; IV; C

96
Q

Which phase?

  1. Elimination of active disease
  2. Goal is to reduce gingival inflammation and reduction of pocket depth through reduction of swelling
A

Phase I therapy
(aka Hygienic Phase)

97
Q

Which phase of therapy includes the following?

  1. OH instructions
  2. Prophy or SRP
  3. Antimicrobial agents
  4. Extraction of hopeless teeth
  5. Caries control
  6. Endo tx
A

Phase I therapy

98
Q

Ideal goals of treatment of periodontitis

A
  1. Form new attachment
  2. Regeneration of lost structures (alveolar bone, PDL, cementum, surrounding tissues)

note that there isn’t “regeneration” after an SRP, but there is healing with the long junction epithelium

99
Q

Healing of a wound by tissue that does not fully restore architecture or function of the part

A

Repair

100
Q

Reproduction or reconstitution of lost or injured part

A

Regeneration

101
Q

The union of CT and epithelium w/root surface that was deprived of its original attachment

A

New attachment

102
Q

Reunion of epithelium w/root surface & bone after incision/injury

A

Reattachment

103
Q

What instruments are used for SRPs?

A

Hand instruments and ultrasonic instruments

104
Q

What are the actions of ultrasonic scalers?

A
  1. Allows for rapid removal of calculus
  2. Mechanical
  3. Cavitation (formation & collapse of bubbles by high-frequency waves surrounding ultrasonic tip)
  4. Irrigation (therapeutic washing of the pocket & root surface)
105
Q

________ are released from Gram negative bacterial cell walls and is toxic to humans.

Release from bacteria covering the cementum triggers the _______ ________.

______ penetrated deeply into the cementum and are held w/in calculus not removed during instrumentation.

A

Lipopolysaccharides

Immune response

Endotoxins

106
Q

Prior to instrumentation of subgingival area, what microorganisms dominate?

What microorganisms dominate after SRPs?

A

Before: gram -, anaerobic, motile bacteria

After: gram +, aerobic, non-motile bacteria

107
Q

Why are perio maintenance recall exams every 3-4 months?

A

Anaerobic bacteria will become more active and need to be removed

108
Q

Contraindications of Ultrasonic instruments (10)

A
  1. Certain pacemakers
  2. Communicable diseases
  3. Medically compromised patients
  4. Patients at respiratory risk
  5. Patients with swallowing difficulty
  6. Titanium implants
  7. Some restorative materials (porcelain, composite, laminate veneers)
  8. Areas of demineralization
  9. Hypersensitive teeth
  10. Kids w/mixed dentition
109
Q

Which ultrasonic tip?

Reaches all accessible surfaces

MOST effective on buccal & lingual surfaces of all teeth and interproximal surfaces of anteriors

A

Universal (Straight) tip for ultrasonic scalers

110
Q

This ultrasonic tip is used for:
1. Interproximal surfaces of posteriors
2. Furcations
3. Mispositioned molars
4. Concave surfaces

A

Curved tips for ultrasonic scalers

111
Q

Instrumentation fundamentals

A

Use light lateral pressure
Keep tip moving at all times
Let the tip do the work

112
Q

If there’s a 1mm loss of an instruments tip, what % efficiency is lost? If there’s 2mm loss?

A

25% for 1 mm loss

50% for 2 mm loss

113
Q

Manual curette vs. Sonic/Ultrasonic

A

Manual = more efficient but requires increased time, effort, and expertise

Ultrasonic = insert designs are an adjunct to hand instrumentation.

The difference is clinically insignificant as long as you have achieved your goal of total debridement

Best results usually from starting with sonic/ultrasonic instruments followed by hand scaling

114
Q

From the end of the working end to the first bend

A

Terminal shank

115
Q

From the working end to the handle

A

Functional shank

116
Q

Hand instrument used to treat subgingival surfaces; it has a blade with an unbroken cutting edge that curves around the toe and a flat face set at a 90-degree angle to the lower shank

A

Universal curette

117
Q

Curette with one cutting edge, “area specific”; it is designed to adapt to specific tooth surfaces (mesial or distal)

A

Gracey curette

118
Q

Used to remove large amounts of deposits from supragingival surfaces

A

Curved sickle scaler
Straight sickle scaler

119
Q

Excessive protrusion of the maxillary incisors; horizontal overlap

A

Overjet

120
Q

No incisal contact; posterior teeth in normal occlusion

A

Open bite

121
Q

Maxillary teeth are lingual to mandibular teeth

A

Underjet

122
Q

Incisal edge to incisal edge of anterior teeth

A

Edge-to-edge

123
Q

Maxillary incisors are lingual to the mandibular incisors

A

Anterior crossbite

124
Q

Incisal edge of maxillary tooth is at the level of the cervical third of the facial surface of the mandibular anterior tooth

A

Deep (severe) anterior overbite

125
Q

Pathologic alteration/adaptive changes which develop in the periodontium as a result of undue force

A

Trauma from occlusion

126
Q

What can excessive occlusal force cause?

A

TMJ, injury to masticatory muscles, injury to pulp tissue

127
Q

Traumatizing forces may act on an _______ tooth or groups of teeth in _______ _________.

This can occur in conjugation with ___________ _________ (like clenching/bruxing) or ______________ of premolars/molars.

A

individual; premature contact

parafunctional habits; loss/migration

128
Q

A reaction that’s elicited around a tooth w/normal height of the periodontium

A

Primary trauma from occlusion

129
Q

Occlusal forces cause injury in a periodontium of reduced height

A

Secondary trauma from occlusion

130
Q

Regardless of primary or secondary trauma from occlusion, the alterations which occur in the periodontium as a consequence of trauma from occlusion are __________ and _____________ of the height of periodontium.

A

similar; independent

131
Q

Subjective symptoms of trauma from occlusion may develop only in situation when ___________ of the load elicited by occlusion is so high that the periodontium around the exposed tooth cannot properly withstand and distribute the resulting __________ with unalter position & stability of the tooth involved

A

magnitude; force

132
Q

Causes of primary occlusal trauma (4)

A
  1. High fillings
  2. Prosthetic replacements that create excessive forces on abutments and antagonistic teeth
  3. Drifting/extrusion of teeth into space created by unreplaced teeth
  4. Ortho movement into fx unacceptable positions
133
Q

Effect of occlusal forces on the periodontium is influenced by what 4 things?

A

Magnitude
Direction
Duration
Frequency

134
Q

Tissue responses to increased occlusal forces (3 stages):

A

Stage I= Tissue Injury (produced by excessive occlusal forces)

Stage II= Repair

Stage III= Adaptive remodeling of the periodontium

135
Q

Stage II (repair) of tissue responses to increased occlusal forces includes what?

A

Damaged tissues removed, new CT & fibers, bone, & cementum formed in attempt to restore the injured periodontium

Force remain traumatic ONLY as long as the damage produced exceeds the reparative capacity of the tissue.

136
Q

Stage III (adaptive remodeling of the periodontium) of tissue responses to increased occlusal forces includes what?

A

Results in thickened PDL
Involved teeth can become loose
NO ATTACHMENT LOSS

137
Q

Radiographic signs of occlusal trauma

A

Wide PDL w/thick lamina dura
Vertical appearance of destruction
Root resorption

138
Q

T/F- Trauma from occlusion is reversible when the traumatic force is removed

A

True

139
Q

Result of periodontal infection; tooth moves up and down w/in socket

A

Pathological migration of teeth

140
Q

What happens with increasing the magnitude of occlusal forces?

A

The PDL thickens (increase in # and width of fibers)

141
Q

What happens with changing the direction of occlusal forces?

A
  1. Reorientation of the stresses & strains.
  2. Note that principal fibers of the PDL are arranged to accommodated forces along the long axis of the tooth.
  3. Lateral & rotational forces can injure the periodontium.
142
Q

Constant pressure on the bone is more injurious than intermittent forces

A

Duration of occlusal forces

143
Q

The more frequent the application of an intermittent force, the more injurious the force is to the periodontium

A

Frequency of occlusal forces

144
Q

Within physiological limits

A

Tooth Mobility= 0

145
Q

Less than 1mm movement in a BL/MD direction

A

Tooth Mobility= 1

146
Q

1mm + movement in a BL/MD direction

A

Tooth Mobility= 2

147
Q

Exceeds 1mm movement in a BL/MD direction AND depressible occluso-apical direction

A

Tooth Mobility= 3

148
Q

Tipping movements occur when there are excessive forces directed _______.

A

horizontally

149
Q

______ and _______ zones will develop within the _____ and _____ parts of the periodontium.

_________ _________ occur within theses zones, allowing the tooth to tilt in the direction of the force.

A

Pressure; tension; marginal; apical

Tissue alterations

150
Q

When the tooth has escaped the trauma, __________ __________ of the periodontial tissues takes place.

A

complete regeneration

151
Q

In the absence of inflammation, there is NO apical down-growth of the _____

A

JE

152
Q

Movement of the tooth due to pressure & tension over the entire tooth surface; no inflammatory rx in gingiva of down-growth of JE (in the absence of inflammation)

A

Bodily movement

153
Q

The bone formation that occurs to repair trauma from occlusion; attempt to reinforce weakened trabeculae; may produce a bulbous/ridge-like distortion (lamellar bone with osteoclasts & osteoblasts)

A

Buttressing bone

154
Q

T/F- Trauma from occlusion, without inflammation, can induce periodontal tissue breakdown

A

FALSE

155
Q

Which tooth has the worst prognosis in the mouth?

A

Maxillary 2nd molar

156
Q

What bacterium can be found in hidden pockets of localized aggressive periodontitis?

A

Actinobacillus actinomycetemcomitans

157
Q

Prophylaxis code in axium

(for healthy/gingivitis patients; 6mo recall)

A

D1110

158
Q

Periodontal maintenance (STP) code in axium

(for patients who have completed SRPs; 3 month recall)

A

D4910

159
Q

T/F- Metal instrumentation is used for calculus removal on implants

A

FALSE, plastic instruments ONLY

160
Q

T/F- Acidic fluoride prophylactic agents are avoided for patients with implants

A

True, acidity damages the titanium abutments

161
Q

Gingivitis around implant

A

Peri-implant mucositis

162
Q

Periodontal disease around implants

A

Peri-implantitis

163
Q

Attached gingiva equation

A

Attached gingiva = length of marginal gingiva to mucogingival junction - pocket depth

164
Q

Attachment loss equation with deep pocket (4+) and nothing entered in axium

A

Attachment loss = pocket depth (4,5,6) + -2

165
Q

Attachment loss equation and nothing entered in axium

A

Attachment loss = pocket depth (1,2,3) + reciprocal (-1, -2, -3)

D1 Spring (47 decks)

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