Diagnosis and Microbiology Flashcards
(60 cards)
How can you classification the severity of bone loss?
Mild: 25% of root length (1-2mm CAL)
Moderate: 25-50%(3-4mm CAL)
Severe: more than 50% (6+mm CAL)
How can you categorise distribution?
Generalised : PPD or more than 3mm in more than 30% of sites
Localised : PPD. Of less than 3mm in less than 30% of sites
How can you assess the shape of bone loss?
Horizontal or vertical
Horizontal is entire width of interdental bone loss
Vertical : adjacent to tooth surface
What is the host response to perio antigens?
PMN complement and in Late stages you see T cels B cells and very late is plasma infiltrate
What is the purpose of neutrophil in pDl?
They act as surveillance and maintains integrity of PDL
Adhere, chemo taxis, phagocytosis, generate super oxide
What is the PDL like in health?
Very little plaque
Minimal GCF
Few PMN
What happens in the initial gingival lesion?
2-14 days
Early plaque: gram pos bacteria
Increases PMN
Vasculitis with appearance of IGs and complement
JE begins to proliferate and FEW Plasma cels
Wat happens in the established gingival lesion?
Grame neg and pos bactera
PLASMA CELLS. IGs predominate
What happens in the advanced gingival lesion?
Connective tissue attachment loss
> 50% PLASMA cells
What is he microbial aetiology of perio?
Non specific vs specific vs ecological plaque
Non specific : caused by mixed microbial bass of bactera
Specific: one group or a single organism causes perio
Ecological: changes in environmental conditions lead to an ecological shift favouring pathogenic organisms
How does tissue destruction occur in perio?
Directly by bacteria eg collagenases,muster oxide, toxins
Indirectly via host response; humoral immunity and cellular
Which interleukin is key in perio destruction for bone manage?
IL1 released by macrophages and CT cell
Which factors make you a susceptible host?
Smoking:
Syestmic condition eg HIV, diabetes have four fold increased risk since they have decreased neutrophils
Genetic familial
Stress
Leukaemia
Overhangs, crowding, dentures, weak contacts, enamel pearls
Which OH indices are there?
Greene and Vermillion
Quigley and Hein 1962 mod Turesky 1970
What does the Green and vermillion show?
Soft and hard depsotos
0: nothing
1: soft debris 2/3 band of calculus sub
What did the Turesky show?
0: nothing
1: flecks
2: continuous band of 1mm
3: less than 1/3
4. Less than 2/3
5: >2/3
Which gingival index is there?
Loe 1967
0: no inflam
1: change in colour and texture
2: inflam and bleeding from probing
3: overt inflam and spon bleeding
Muhlemann and Son 1971
1: no bleeding on probing
2: bleeding within 15seconds
How can we screen for perio?
BPE
3: 6PPC that sextand
4: whole mouth
Each sextand must have 2 teeth or add to next sextant
- furcation but must be added to score
What are the scores for BPE?
1: healthy
2: BOP/calculus/overhand : OHI and scale
3: part black band gone 3.5-5.5 pocket depth :.OHI scale, RSD
4: black band gone: OHI Scale, consider surgery
What factors will affect picket depth?
Size of probe Force applied Contour of tooth Angulation of probe Presence of calcius Presence of inflammation
Which mobility is normal?
<0.2mm
What are mobility indices?
Grace and smales
Miller
What is the grace and smales mobility index?
0: no apparent mobility
1: single tooth where mobility is les than 1
2: mobility 1-2
3: >2 horizontal /vertical movement
What is the miller index?
1: 1mm
3: >1 and axial
