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Periodontics > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Define the process of patient care

A
  • Assessment
  • Diagnosis
  • Planning
  • Implementation
  • Evaluation

ADPIE

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2
Q

What are the objectives of a periodontal assessment?

A
  • Provides a comprehensive picture of patients periodontal health status
  • Determine health status
  • Look for signs of inflammation and damage to periodontium
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3
Q

What are the fact gathering process?

A
  • Baseline data for long term monitoring of periodontal disease activity
  • Evaluate the success of periodontal treatment
  • Accompanied by documentation of all clinical findings
  • Needs to be performed on all patients
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4
Q

Reasons for periodontal documentation?

A
  • Reference tool
  • Record
  • Educational resources
  • Medical and legal document
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5
Q

What are the assessments in the clinical examination?

A
  • Interview
  • Extraoral/Intraoral
  • Oral Hygiene
  • Periodontal
  • Dentition
  • Radiographic
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6
Q

Describe the component of interview assessment

A

Medical History:
* Ensures safety of patient
* Aids clinician
* Verified with interview ans signature

Dental History:
* Chief complaint
* Acquire details necessary for diagnosis
* Past and present dental treatment
* Current oral hygiene practices
* Behavorial habits
* Attitude towards dentistry

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7
Q

Describe the component of Extra/Intra Oral assessment

A

Extroral
* Presence of pathology: Look, Feel, Listen, Smell

Intraoral
* Presence of Pathology: Oral mucosa, gingiva characterisitcs

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8
Q

Describe the component of Oral Hygiene assessment

A
  • Plaque biofilm
  • Calculus
  • Tooth Surface topography
  • Stain
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9
Q

Describe the component of Periodontal assessment

A
  • Probe depth
  • Clinical attachment level (CAL)
  • Bleeding and suppuration
  • Furcation detection and measurement
  • Mucogingival considerations
  • Tooth mobility and migration
  • Fremitus
  • Implications of implants
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10
Q

Describe the component of Dentition assessment

A
  • Caries
  • Restorations
  • Overhanging margins
  • Proximal contact relationships
  • Tooth abnormalities
  • Parafunctional habits
  • Tooth wear
  • Sensitivity or hypersensitivity
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11
Q

Describe the component of Radiographic assessment

A
  • Interdental septa
  • Bone destruction
  • Furcation areas
  • Dental implants
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12
Q

What are intrinsic stains

A

Fluorosis: too much fluoride over a period of time
Tetracycline: Medication
Minocycline: Medication

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13
Q

What are extrinsic stains and their associated causes?

A

Brown: Poor hygiene, Tannins and tobacco, Chlorhexidine, Stannous Fluoride
Green: Poor Hygiene, Enamel cuticle, Fluorescent bacteria and fungi
Black: Chromogenic bacteria, Ferric sulfide
Orange: Poor Hygiene, Chromogenic bacteria

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14
Q

What are the limitations of probing?

A
  • Junctional Epithelium(JE) penetration/ puncture
  • Probing Force
  • Placement and Angulation variations
  • Accuracy of depth
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15
Q

What are the etiology of recession?

A
  • Multifactorial
  • Anatomic variations
  • Occlusal trauma
  • Smoking or chewing tobacco
  • Inflammatory periodontal disease
  • Trauma induced by tooth brushing
  • Ortho
  • Crown margins
  • RPD clasps
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16
Q

Describe normal and abnormal clinical presentation of the periodontium

17
Q

Describe the normal and abnormal clinical presentation of the dentition.

18
Q

How do you calculate Clinical attachment level (CAL)?

A

Overgrowth: Subtract overgrowth amount coronal to CEJ from probing depth

Recession: add the probe depth and recession measurement

19
Q

How do you calculate attached ginigva?

A

1) record width of keratinized gingiva
2) Amount of keratinized gingiva minus probing depth
** You calculate on the outside*

20
Q

How do you chart recession/FGM and Probing depth

21
Q

How do you chart mobility

A

Mobility: Grade 0-3
0- Physiologic Mobility only (Not charted)
1- Slight pathology 1mm BL (Not charted)
2- Moderate pathology 1-2mm BL
3-Severe pathology greater than 2mm BL or MD vertical displacement

22
Q

What type of instrument is specifically designed for measuring furcation involvement?

A

Nabers probe, curved with blunt tip and calibrated

23
Q

List and describe the indices used to report furcation involvement

A
  • Mandibular molars= bifurcated= Facial and Lingual involvements
  • Maxillary Molars= Trifurcated= Facial Mesial and distal
  • Maxillary 1st Premolars= Bifurcated= Mesial and distal
24
Q

List and describe the indices used to report tooth mobility and dental caries.

A

Tooth mobility:
-Loss of support
-Rotation
-Elongation/extrusion
Dental Caries
G.V Black Cavity Classification:
Class 1- Pits and Fissures
Class 2- Proximal Spaces on Posterior teeth
Class 3- Proximal Spaces on Anterior teeth (no angle)
Class 4- Proximal Spaces on Anterior teeth with angle
Class 5- Cervical Third
Class 6- Edge and cusp

25
List and describe the indices used to report tooth wear
Attrition- parafunction, reduced salivary Erosion- chemical, gastric, diet Abrasion- excessive abrasion by foreign object Abfraction- occlusal stress
26
Identify radiographic changes seen in periodontal diseases
**Interdental Septa**- break down of the lamina dura, loss of radiopacity, breaks in the crestal plate **Bone loss**- Horizontal or vertical , Furcations
27
State the characteristics of ginigval epithelium
- Protection of underlying structures - Selective interchange with oral environment (absorption of drugs) - Avascular (relies on lamina propria for blood supply and nutrients - has serveral layers
28
What are the 4 layers of ginigival epithelium?
Stratum Corneum (cornified) Stratum Granulosum (Granular) Stratum Spinosum (Spinous/prickle) Stratum Germinativum/basale (Basal)
29
What are the different characteristics of the 4 layers of ginigval epithelium ?
Stratum Corneum (cornified) (TOP) - Keratinized, para and non - barrier membrane Stratum Granulosum (Granular) -Keratin Formation -Flatten cells -Shrinking nuclei Stratum Spinosum (Spinous/prickle) - 8-12 layers thick - Langerhans cells Stratum Germinativum/basale (Basal) - Mitotic - Keratinocytes (Touch cell) - Melanocytes (Touch Cell) - Merkel Cells (Touch Cell)
30
Differentitate among the three types of gingival epithelium: Oral Sulcular Junctional
Oral (OE): - Covers=crest of gingiva, outer surface of the free ginigva and attached gingiva. - Keratinized or parakeratinized stratified squamous epithelium (masticatory mucosa) - Keratinized Tissue: hard palate and dorsum of tongue Sulcuar (SE): - lines the gingival sulcus, thin and non keratinized - DOES NOT have rete pegs - Maybe parakeratinized near oral cavity opening - goes from the coronal area of JE to crest of MG - It forms the gingival wall of sulcus - DOESNOT have granulosum or corneum - Acts as a semipermeable membrane Junctional (JE): - nonkeratinized - Two cell layers: basale and spinosum - Thickness from coronal to apically - Length ranges from .71 to 1.35mm - Attaches to tooth by epithelial attachment (basement lamina and hemidesmosomes from enamel or cementum
31
Explain the renewal of gingival epithelium and its keratinization process
GE renews constantly - Thickness maintained by the balance between cell formation and shedding of old surfcae cells During the keratinization process - process by epithelial cells differentiating or mature - Different types of differentiating reflects functional demand and stimulus placed on tissue - Entire thickness is replaced
32
Define Fenestrations
A window of bone loss on the facial of the mandible Bone defect
33
Define Dehiscences
V shaped defects apical to the cementoenamel junctions extending through marginal bone Bone defect
34
What is the difference between fenestrations and dehiscences?
Fenestration is not commonly associated with ginigval recession, unlike dehiscence. *Both can affect either a natural tooth or dental implant*
35
How do you chart Furcation grade
by grade I-IV (FITS) I- early involvement=bone is intact (Feel It) II- Moderate= bone is destroyed but probe cannot pass through it (In it) III-Severe= Probe can pass through the roots (Through it) IV- Severe severe= Visible due to recession (See It)
36
How do you chart bleeding on probe?
during probing- presence or absence on chart Detailed description to include amount and rate Ex: Gen light BOP, loc mod molars Light= delayed Mod= @ the time of probing Severe=@ time and excessive
37
Where is the fremitus tested?
Only maxillary anterior teeth
38
Cell turn over time
* Palate, tongue and cheek is 5-6 days * Ginigiva is 10-12 days * JE is 4-7 days

Periodontics (9 decks)

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