exam 2 Flashcards

(67 cards)

1
Q

what is a pregnancy tumor?

A

localized area of pyogenic granulation tissue

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2
Q

what bacteria is found in juveline perio?

A

A. Acintomhcetemcomitans

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3
Q

what is the etiologic agent that contributes to disease?

A

bacteria in the biofilm

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4
Q

the gingiva is reddened, may appear blue red, probing depths increase, pus forms and tissue swells…. capillaries proliferate, T and B lymphocytes occur in equal numbers, extensive collagen destruction occurs, junctional epithelium thickens, rete pegs extend into connective tissue, plasma cells infiltrate, edema increases

A

established stage 3 gingivitis

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5
Q

this is unresponsive to treatment, gen or localized, no single bacteria identified, several species, multiple attempts have been made to control, patients harbor organisms that are tenacious and resistant

A

Refractory perio

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6
Q

what is the defining element for classifying perio disease?

A

the level of attachment loss from the CEJ which indicates bone loss

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7
Q

this is a pathologically deepened sulcus

A

periodontal pocket

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8
Q

what does a periodontal pocket contain?

A

subgingival plaque biofilm

metabolic products from biofilm

copious amounts of gingival fluid

calculus

pus

lippopolysacharides

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9
Q

Where is supragingival calculus most abundant?

A

whartons duct and stensons duct

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10
Q

what two reasons can periodontal pocket depths increase?

A

coronal movement of the gingival margin through swelling or deepening of the sulcus (gingival enlargements)

perio pockets reflect a progressive deepening of the sulcus through tissue destruction and associated with bone loss

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11
Q

What are the steps of calculus attaching to the tooth structure?

A
attachment occurs in the relationship with the plaque
pellicle forms 
bacterial plaque begins with gram + cocci
calcification occurs
5 days plaque becomes filamentous
increase tenacity of calculus attachment
mineralization begins 4-8 hrs
50% mineralized in 2 days
90% mineralized in 12 days
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12
Q

what are other names for supragingival calculus?

A

supramarginal, extragingival, coronal calculus, or salivary calculus

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13
Q

what two microbes are associated with NUG?

A

disinformation bacillus

spirochete

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14
Q

The gingiva reddens, stippling appears, pus may appear and BOP.. T lymphocytes increase, cells congregate under sulcular epithelium, gingival fluid flow increases, collagen is defrayed, lengethed junctional ep. is distrusted and fibroblasts destroyed

A

early stage gingivitis stage 2

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15
Q

what are the two mechanisms for the initial of spread of infection?

A

bacteria and products may break down interface between epithelium and cause detachment of junctional epithelium

bacterial products interfere with normal growth and maintenance of the junctional and sulcular epithelium causing a break down

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16
Q

what happens with the sodium content of calculus as the pocket deepens?

A

increases

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17
Q

what is another name for subgingival calculus?

A

submarignal or serumal

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18
Q

how does subgingival calculus attach to the tooth structure?

A

pellicle attachment to cementum is mode of adherence

crystal grow deep into cemental irregularities

appear similar to cementum, termed calculocementus

not site specific

must use xray to detect

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19
Q

this is not a benign substance to the pathogenesis of gingival and periodontal disease, but plays a much smaller part in these disease than bacterial plaque biofilm

A

calculus

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20
Q

what causes the increase of neutrophils with the pathogensis of perio?

A

chemotaxis

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21
Q

this is the loss of crestal alveolar bone through the inflammatory response

A

periodontal bone loss

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22
Q

where does subgingival calculus form from?

A

from mineralized plaque biofilm

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23
Q

what are the trace elements found in supragingival calculus?

A

fluoride,zinc, and stronium

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24
Q

what does calculus provide a reservoir for?

A

bacteria and endotoxins

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25
what is calculus divided into?
supragingival and subgingival
26
this is the extension of inflammation into the attachment apparatus and development of periodontal pockets
pathogenicity
27
what is associated with dark staining and increased calculus deposition?
chlorhexadine
28
what are some plaque retention factors?
dental restorations crown contour and margins (over and undercontoured restorations, margins of cast restorations should be kept away from the gingival ) amalgam overhangs (most common, detected by xray and explorers) removeable partial denture (collect supragingival calculus, shuld be removed from appliance)
29
what is present when perio disease is established?
both plasma and lymphocytes
30
how are periodontal pockets classified?
suprabony (occur above the crest of alveolar bone) infrabony(extend apically from the crest of the alveolar bone)
31
these are calcium channel blockers and cause gingival enlargement
nifedipine and verapamil
32
what inhibits hydroxyapatite growth?
pyrophosphates
33
what do light calculus formers have?
high level of partoid phosphate
34
Inorganic mineral content makes up about 80% of supragingival calculus.. what are the minerals?
calcium phosphate 75.9% calcium carbonate 3.1% and traces of magnesium, sodium, and potassium
35
what is calculus formed by?
the deposition of calcium and phosphate salts present in bacterial plaque
36
Where is supragingival calculus found?
on the clinical crowns of the teeth, above the margin of the gingiva
37
what are characteristics that may be related to an increased rate of calculus formation?
elevated salivary PH concentration of calcium in saliva concentration of salivary bacterial protein and lipid lower individual inhibitory factors higher salivary urea and protein from the submandibular glands higher total salivary lipid levels
38
what are the main crystal types and percentages found in calculus?
58% hydroxyapatite 21% octacalcium phosphate 21% magnesium whitlockite 9% brushite
39
there are no clinical signs of this, however.. blood vessels dilate, PMN's migrate into connective tissue, plasma leaks into connective tissue, gingival fluid flows from pockets, T lymphocytes predominate
initial stage 1 gingivitis
40
what does periodontitis begin with?
apical migration of the junctional epithelium and loss of alveolar crest bone
41
this type of periodontitis is characterized by bone resorption that progresses slowly and predominantly in a horizontal direction... not clinically significant until about age 35 and more common in men
chronic periodontitis
42
this is the most common form of periodontal disease
chronic periodontitis
43
this is porous and rough and provides a lattice on which plaque can grow
supragingival calculus
44
what dentition does aggressive perio effect and what is it called?
can affect both primary and secondary dentition prepubertal perio
45
what systemic diseases are related to perio?
IDDM AIDS down syndrome papillon lefevre syndrome
46
what are the characteristics of subgingival caluclus?
forms on root surfaces, tenacious and black in color, deposited in rings or ledges
47
what are the channels of subgingival calculus filled with?
bacteria
48
this is similar to stage 3, destructive changes into bone and other tissues
advanced gingivitis stage 4
49
what is the organic matrix made up of mineral crystals?
plaque microbes glucans glycoproteins lipids
50
this is used for immunosuppressant causes gingival englargment
cyclosporine
51
the most common gingival disease of fungal origin is from?
candida albicans
52
why do perio pockets deepen
due to break down of collagen fibers due to collagenase released bacteria
53
what is the most common medications for gingival disease?
antiseizure- phenytoin associated with gingival hyperplasia
54
these do NOT reduce calculus present, but aids in inhibiting formation of new calculus
anticalculus agents
55
what is the severity of chronic periodontitis directly related to?
the accumulation of plaque biofilm and calculus on surfaces of teeth
56
what are some conditions that can affect the periodontal health?
ortho appliances malocclusion unreplaced missing teeth mouth breathing anatomic anomalies tobacco and alcohol use
57
what are the characteristics of rapidly progressive perio?
ages 20-30 most teeth involved severe inflammation, plaque and calculus rapid bone loss over weeks and months genetic component
58
what are the stages of gingivitis?
``` Stage 1 (initial or subclincal stage) stage 2 (early stage) stage 3 (established) stage 4 (advanced stage) ```
59
what is the diagnosis of rapidly progressive perio?
``` less than 30 multiple areas of 5 mm attachment loss 6mm pockets P gingivalis and P intermedia E corrodens and Cr Rectus ```
60
what is the difference between supra and sub gingival calculus when it comes to where it is derived from?
the mineral is derived from crevicular fluid not saliva
61
associated with chronic nature and progression of peiodontal diseases
subgingival calculus
62
what is another common name for calculus?
tartar
63
this is characterized by extreme bone loss, usually seen around permanent molars and incisors...in patients younger than 20?
juvenile perio
64
what 2 mechanisms can cause pregnancy tumor
increase in pathogenic bacteria and increase in Prostoglandin E
65
this type of perio progresses rapidly with massive bone loss
aggressive perio
66
inflammation of the gingival tissues and is reversible.. occurs in periodontium with no attachment loss or with loss that is not progressing
gingivitis
67
how do you treat rapidly progressive perio?
plaque control subgingival scaling perio surgery antibiotics such as tetracycline,metronidazole, amoxicillin/clauvanic acid, ciprooxacin