6. Periodontal Pocket Formation and Bone Loss

Question 1

5

What kind of radiograph is needed for all patients in periodontal clinic?

Question 2

5

What do periapical radiographs do?

Question 3

5

What technique is used for periapical radiographs?

Question 4

5

What is a horizontal bitewing used for?

Question 5

5

What is a vertical bitewing used for?

Question 6

5

What are bitewings best used to evaluate?

Question 7

5

What type of radiograph has the least interproximal bone distortion?

Question 8

6

What are the two definitions for periodontal pockets?

Question 9

7

What is another name for a Gingival Pocket?

Question 10

7

How is a gingival pocket formed?

Question 11

7

When does a periodontal pocket form?

Question 12

8

What are the three classifications of pockets?

Question 13

9

What are the 2 types of periodontal pockets?

Question 14

9

Where is the bottom of the pocket of a suprabony pocket relative to the alveolar bone?

Question 15

9

Where is the bottom of an intrabony pocket relative to the alveolar bone?

Question 16

9

For an intrabony periodontal pocket, the pocket wall lies between the ______ and the ______.

Question 17

10

What is the initial lesion in the development of periodontitis?

Question 18

11

What is the first step of pocket formation?

Question 19

11

What fibers are destroyed when there is inflammation in the connective tissue wall of the gingival sulcus?

Question 20

11

What does the junctional epithelium do as a result of loss of gingival collagen fibers?

Question 21

13

What happens to the cementum facing the pocket wall when there is pocket formation?

Question 22

13

What two things do bacteria penetrate when the cementum facing the pocket wall becomes exposed to the oral environment?

Question 23

14

Scaling an root planing should remove _____ of the cementum to _______.

Question 24

14

Bacteria may evade the host defense and scaling and root planing efforts by ________.

Question 25

16 What is the formula for Clinical Attachment Loss?

Question 26

19 Gingival margin position is relative to the _____.

Question 27

21 What is it called when the gingival margin is apical to the CEJ?

Question 28

21 Is the number for gingival margin when there is recession negative or positive?

Question 29

21 Is the number for the gingival margin when the gingival margin is coronal to the CEJ negative or positive?

Question 30

21 What is the number for the gingival margin when the gingival margin is at the CEJ?

Question 31

24 What instrument do you use to detect a subgingival CEJ?

Question 32

24 Detecting Subgingival CEJs: 1. Insert pribe into the ____ to feel for the CEJ. 2. Hold the probe at a ____ angle when detecting CEJs. 3. Measure where the gingival margin _____. 4. Record gingival margin as a _____ number.

Question 33

25 What is the gingival margin a negative or positive number when the interdental papilla fills the interproximal space?

Question 34

26 Is the interproximal gingival margin negative or positive when there is gingival recession and there is an open interproximal space?

Question 35

27 What is the clinical attachment loss value when the probe depth is 6 mm and the GM is -2mm?

Question 36

32 Clinical attachment loss tells you how much attachment loss there is from the _____. It is the distance from the ____ to the ______.

Question 37

33 Periodontal disease activity goes through periods of ______ and ______.

Question 38

33 Does periodontal destruction occur in all areas of the mouth at the same time?

Question 39

35 What marks the transition from gingivitis to periodontitis?

Question 40

36 The mechanism of bone destruction is ____ and ____ mediated.

Question 41

36 Bacterial products such as ____ induce the differentiation of osteoclasts in the mechanism of bone destruction.

Question 42

36 What are three host factors released by inflammatory cells that induce bone resorption?

Question 43

37 What is the critical distance for the radius of action where there is locally produced bone resorption? What if the radius is greater than this distance?

Question 44

38 Alveolar bone responds to inflammation by ____ and ____. Periodontal bone loss occurs when ____ dominates ____.

Question 45

39 What are 6 factors that increase the risk for periodontal bone loss?

Question 46

40 Smoking Effects on Periodontitis: 1. ______ risk for periodontitis 2. _____ dependent 3. _____ important 4. ____ Years

Question 47

41 What is the formula for Pack Years for smokers?

Question 48

42 What is the most common bone destruction pattern?

Question 49

42 In which dimension is bone lost in horizontal bone loss?

Question 50

42 In horizontal bone loss, the bone margin remains ____ to the root.

Question 51

42 In which direction is bone lost in verticular (angular) bone loss?

Question 52

42 Vertical bone loss leads to the formation of which type of periodontal pockets?

Question 53

What is this an image of?

Answer 53

Horizontal Bone Loss

Question 54

What is the slanted line an image of?

Answer 54

Vertical Bone Loss

Question 55

48 Radiographs underestimate bone loss by up to ____ mm.

Question 56

48 Normal bone levels are ____ mm from the CEJ to the osseous crest.

Question 57

48 What two tissues are attached in normal bone levels? What is the name for these attached tissues?

Question 58

48 How do you determine bone loss using a bitewing radiograph? (2 bullet points under "To determine bone loss")

Question 59

50 What percentage and mm measurement represents slight bone loss?

Question 60

50 What percentage and mm measurement represents moderate bone loss?

Question 61

50 What percentage and mm measurement represents severe bone loss?

Question 62

51 Are facial and lingual bone loss easy or difficult to visualize on radiographs?

Question 63

51 What should you look for when analyzing facial and lingual bone loss?

Question 64

53 What is an early radiographic change in periodontitis?

Question 65

55 What effect will occlusal trauma have on the PDL?

Question 66

55 What type of defects will there be in bone due to occlusal trauma?

Question 67

55 What effect will occlusal trauma have on the lamina dura?

Question 68

55 Will Fremitus occur as a result of occlusal trauma?

Question 69

58 A vertical defect can only occur if the interproximal space is wider than ____ mm.

Question 70

58 Interproximal spaces less than 2.5 mm have ____ bone loss.

Question 71

60 Close root proximity is measured from ____ to ____ of adjacent teeth.

Question 72

60 What is the measurement for close root proximity?

Question 73

60 What type of bone loss will result from close root proximity?

Question 74

61 Classifications of vertical defects are based on the number of _______.

Question 75

61 What are the three classifications of vertical defects?

Question 76

66 Why do narrow vertical defects have a better prognosis than wide vertical defects?

Question 77

66 Vertical defects must be how deep for a bone graft to be placed?

Question 78

66 Can vertical defects be grafted?

Question 79

66 Can horizontal defects be grafted?

Question 80

67 What are osseous craters?

Question 81

68 What is a positive osseous architecture?

Question 82

68 What is a negative osseous architecture?

Question 83

68 What is a flat osseous architecture?

Question 84

71 What is the 3-4-5 rule for the location of furcations on the maxillary 1st molar?

Question 85

71 What is the root trunk length?

Question 86

72 What is the 3-4 rule for the location of furcations of the mandibular 1st molar?

Question 87

73 When would you suspect furcation involvement for a maxillary 1st molar?

Question 88

74 Where are the two furcations on a maxillary 1st premolar?

Question 89

74 In what percent of cases does the maxillary first premolar have a bifurcation?

Question 90

74 How far apical to the CEJ is the bifurcation of a maxillary 1st premolar?

Question 91

74 What is the clinical implication of the bifurcation of a maxillary 1st premolar being 8 mm apical to the CEJ?

Question 92

75 What is exostosis?

Question 93

75 What may exostosis be related to?