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Perio > 3rd Section > Flashcards

3rd Section Flashcards

(68 cards)

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1
Q

T/F patient’s old radiographs and perio charts are important

A

True

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2
Q

Fremitus:

A

Movement in occlusion

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3
Q

Diagnosis is affected by what 9 things

A 
Probing depth
Gingival recession
CAL
Keratinized gingiva
BOP
Furcation involvement
Mobility
Fremitus
Bone defects

Casey
Kariya
Gets
More
For
Five
Bucks
By
Playing
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4
Q

CPITN probe increments

A
  1. 5 (Ball)
  2. 5
  3. 5
  4. 5
  5. 5
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5
Q

Williams probe increments

A 
1.2
3
5
7
8
9
10
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6
Q

Mucogingival defect

A

When probe is at or past MGJ

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7
Q

Furcation involvement I-III

A

I - indent into furcation
II- most of the way through furcation
III - through and through

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8
Q

Furcation involvement is measured using

A

Nabers probe

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9
Q

Classic two walled defect

A

Crater

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10
Q

3 clinical signs that indicate health

A

Probing depth 1 to 3 mm
No history of attachment loss
No clinical signs of inflammation

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11
Q

Dental plaque induced gingivitis requirements (4)

A

≤3 mm probing depth
BoP
No gingival recession
Red/edematous soft tissue

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12
Q

3 things to have periodontitis

A

≥ 4 mm probing depth
Attachment loss
Clinical signs of inflammation

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13
Q

What determines if perio is slight, moderate or severe

A

How much CAL

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14
Q

Incidental attachment loss is also called

A

Gingival recession

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15
Q

Order of general perio treatment

A 
Exam
Diagnosis
Risk factors for future
Prognosis
Treatment alternatives
Informed consent
Therapy (non-surgical)
Re-evaluation
Maintenance
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16
Q

Osseointegration:

How is rigid fixation different:

A

Direct attachment of bone to implant

It is just the clinical term to define osseointegration

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17
Q

T/F 100% bone to implant connection exists

A

FALSE - more like 60%

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18
Q

Important factors for osseointegration

A 
Biocomp. Of implant
Design of implant
Surface of implant
Status of host bed
Surgical technique at insertion
Loading conditions
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19
Q

4 steps of implant insertion procedure

A

Incision
Mucoperiosteal flap elevation
Preparation of a bed in bone
Insertion of titanium device

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20
Q

3 ways to surgically manipulate alveolar bone for implants

A

Anatomical location
Augmentation techniques
Condensation

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21
Q

Bone healing at 24 hrs vs 1 week

A

24 - resorption at cortical bone, woven bone formation, blood clot, proliferation of vasculature into newly forming granulation tissue

1 week - reparative macrophage and undifferentiated mesenchymal cells. Modeling at the apical trabecular region and at the Furcation sites of a screw shaped implant

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22
Q

When can new bone first be detected at furcation sites of implant surface

A

2 weeks

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23
Q

Plateau effect of bone stability happens after when

A

6 weeks

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24
Q

What is jumping distance, what is the ideal range

A

Distance b/t implant and bone that can be filled with new bone

20-40 um

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25
Healing period for max and mand. For osseointegration
Max - 6 months | Mand - 3 months
26
4 types of implant surfaces
Titanium plasma sprayed Sand blasted acid etched hydroxyapatite Tricalcium phosphate
27
Implant needs how much thickness around it
1mm minimum
28
Minimum bone thickness b/t two implants
3mm
29
Minimum bone thickness b/t implant and adjacent tooth
4 mm
30
Coronal part of an implant should be placed _ apical to the adjacent CEJ
~5mm
31
Implant can be placed with max of _˚ angle
20˚
32
On an implant, what is the thickness of barrier epithelium? Zone of connective tissue?
Barrier - 2 mm ZoCT - 1-1.5 mm
33
Collagen fiber bundle run _ to implant surface
Parallel
34
Zone adjacent to implant surface is high in _ Zone lateral to that one _
Fibroblasts Collagen fibers and blood vessels
35
Blood supply to bone around implants comes from _
Supraperiosteal blood vessels
36
Submerged vs. non-submerged tech
Sub - two stage implant placement Non-submerged - one stage
37
Micro gap b/t implant and abutment is usually located at _
Alveolar crest
38
Biologic width exists around what type of implants? How thick?
Around unloaded and loaded NON-SUBMERGED one-part titanium implants 3 mm
39
Clinical parameters to evaluate peri-implant health
1. No mobility 2. Radiograph 3. Absence of bone loss (≥0.2 mm/yr) after first year 4. Absence of pain, complain, infection 5. Functional and esthetic acceptance by pt and dr. 6. Success rate of 94-98% (5 yr), 90-94% (10 yr)
40
3 techniques to evaluate dental implants
Peri-implant probing Mobility Radiographs
41
Conditions associated with Ailing implant: Failing implant: Failed implant
A: peri-implant mucositis Peri-implantitis Fing: peri-implantitis Fed: peri-implantitis w/ mobility and complete loss of osseointegration
42
Peri-implant mucositis vs. peri-implantitis
Mucositis: reversible inflammation of the mucosa around the implant implantitis: inflamm. Associated w/ loss of supporting bone around an implant IN FUNCTION
43
Peri-implantitis vs. periodontitis
PI - neutrophils surrounding implant, direct contact b/t plaque on implant and inflamed connective tissue Both not seen in periodontitis
44
Bacterial plaque is a _ in PI and mucositis
Primary etiologic factor
45
Main type of bacteria that cause PI and mucositis
Gram - anaerobic
46
T/F implants and teeth can have a different microbiota
TRUE
47
Occlusal trauma is a _ etiological factor for periodontal disease, and can be a _ etiological factor for peri-implant disease
2˚ for perio 1˚ for peri-implant
48
What does bruxism do to implants
Complicates implant healing
49
Class 1-4 peri-implantitis
1. Slight horizontal bone loss, minimal peri-implant defects 2. Moderate horizontal bone loss, isolated vertical defects 3. Moderate to advanced horizontal bone loss, broad circular bony defects 4. Advanced horizontal bone loss, broad, circumferential vertical defects, loss of oral and/or vestibular bony wall
50
Treatment for class 1-4 peri-implantitis
1. Surgical reduction of pocket depth, cleaning 2. Repositioning more apically, implantoplasty, bone defects restored by GTR if necessary 3. GTR
51
T/F BOP shows risk for future disease
FALSE, indicates inflammation now
52
Goal after scaling/root planing
No Probe depths >5 mm
53
Treatment goal for Furcation involvement is _
≤3mm
54
4 phases of therapy (what they contain too)
``` Systemic -eliminate/decrease influence of systemic conditions -protection from infectious hazards Initial hygiene phase -removal or retentive factors -removal of deposits -patient motivation Corrective phase -perio/implant surgery -endo, restorative, prosthetic therapy Maintenance phase -supportive periodontal therapy -prevention/caries control ```
55
How long to wait to re-evaluate after scaling/root planing
4-6 weeks, takes around 6 weeks to regenerate collagen
56
When is prognosis established
After diagnosis is made, before treatment plan is established
57
Prognosis determinants are divided into 4 categories:
Overall clinical factors (age, compliance) Systemic/environmental factors (smoking, systemic disease) Local Factors (plaque, anatomic factors) Prosthetic/Restorative Factors (abutment, caries, root resorption)
58
Overall vs. individual tooth prognosis
O: age, severity of disease, systemic factors, smoking, compliance I: mobility, probe depth, bone loss, Furcation inv., local factors
59
BBB vs McGuire and Nunn classification
BBB: good, questionable, hopeless MN: Very good, good, fair, poor, hopeless
60
Criteria of the McGuire and Nunn classification for: Good Fair Poor Hopeless (Including: Aloss, Furcation, mobility, maintenance/pt cooperation, systemic factors)
Good: - 25% Aloss and/or Class I Furcation - adequate remaining bone support - can control etiologic factors - patient cooperation - no systemic environmental factors OR well controlled systemic factors Fair: - 25-50% Aloss - grade I or easily accessible grade II Furcation - adequate maintenance possible - few systemic complications Poor - >50% Aloss - Bad II or III Furcation - Class 2 mobility - difficult to maintain areas/ low pt compliance - systemic/environmental factors Hopeless - >75% Aloss - Tooth mobility 2+ - II and III Furcation - difficult maintenance/ doubtful pt compliance - root proximity
61
Disease severity is classified according to what 2 parameters
Level of clinical attachment Radiographic examination
62
Which is more important: pocket depth or attachment level, why?
Attachment level, pocket depth isn’t necessarily related to bone loss, but attachment loss is
63
_ is the primary etiologic factor associated with perio
Bacterial plaque
64
Which tooth anatomy usually causes a poor prognosis
Short, tapered roots and large crowns
65
3 main causes of tooth mobility
Loss of alv. bone Inflammation in PDL Trauma from occlusion
66
If inflammation can be controlled, slight to moderate perio prognosis is:
Good
67
Hypophosphatasia:
Decreased levels of alkaline phosphatase, severe alveolar bone loss, premature loss of teeth and connective tissue disorder
68
NUG: Reversible? Prognosis? Difference in NUP Who gets NUP
Tissue destruction is not reversible Good except in repeated episodes which is fair NUP extends to periodontal ligament and alveolar bone Immunocompromised get NUP, have to treat systemic conditions too

Perio (3 decks)

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