exam 2

Question 1

what is a pregnancy tumor?

Answer 1

localized area of pyogenic granulation tissue

Question 2

what bacteria is found in juveline perio?

Answer 2

A. Acintomhcetemcomitans

Question 3

what is the etiologic agent that contributes to disease?

Answer 3

bacteria in the biofilm

Question 4

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

Answer 4

established stage 3 gingivitis

Question 5

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

Answer 5

Refractory perio

Question 6

what is the defining element for classifying perio disease?

Answer 6

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

Question 7

this is a pathologically deepened sulcus

Answer 7

periodontal pocket

Question 8

what does a periodontal pocket contain?

Answer 8

subgingival plaque biofilm

metabolic products from biofilm

copious amounts of gingival fluid

calculus

pus

lippopolysacharides

Question 9

Where is supragingival calculus most abundant?

Answer 9

whartons duct and stensons duct

Question 10

what two reasons can periodontal pocket depths increase?

Answer 10

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

Question 11

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

Answer 11

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

Question 12

what are other names for supragingival calculus?

Answer 12

supramarginal, extragingival, coronal calculus, or salivary calculus

Question 13

what two microbes are associated with NUG?

Answer 13

disinformation bacillus

spirochete

Question 14

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

Answer 14

early stage gingivitis stage 2

Question 15

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

Answer 15

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

Question 16

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

Answer 16

increases

Question 17

what is another name for subgingival calculus?

Answer 17

submarignal or serumal

Question 18

how does subgingival calculus attach to the tooth structure?

Answer 18

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

Question 19

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

Answer 19

calculus

Question 20

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

Answer 20

chemotaxis

Question 21

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

Answer 21

periodontal bone loss

Question 22

where does subgingival calculus form from?

Answer 22

from mineralized plaque biofilm

Question 23

what are the trace elements found in supragingival calculus?

Answer 23

fluoride,zinc, and stronium

Question 24

what does calculus provide a reservoir for?

Answer 24

bacteria and endotoxins

Question 25

what is calculus divided into?

Answer 25

supragingival and subgingival

Question 26

this is the extension of inflammation into the attachment apparatus and development of periodontal pockets

Answer 26

pathogenicity

Question 27

what is associated with dark staining and increased calculus deposition?

Answer 27

chlorhexadine

Question 28

what are some plaque retention factors?

Answer 28

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)

Question 29

what is present when perio disease is established?

Answer 29

both plasma and lymphocytes

Question 30

how are periodontal pockets classified?

Answer 30

suprabony (occur above the crest of alveolar bone) infrabony(extend apically from the crest of the alveolar bone)

Question 31

these are calcium channel blockers and cause gingival enlargement

Answer 31

nifedipine and verapamil

Question 32

what inhibits hydroxyapatite growth?

Answer 32

pyrophosphates

Question 33

what do light calculus formers have?

Answer 33

high level of partoid phosphate

Question 34

Inorganic mineral content makes up about 80% of supragingival calculus.. what are the minerals?

Answer 34

calcium phosphate 75.9% calcium carbonate 3.1% and traces of magnesium, sodium, and potassium

Question 35

what is calculus formed by?

Answer 35

the deposition of calcium and phosphate salts present in bacterial plaque

Question 36

Where is supragingival calculus found?

Answer 36

on the clinical crowns of the teeth, above the margin of the gingiva

Question 37

what are characteristics that may be related to an increased rate of calculus formation?

Answer 37

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

Question 38

what are the main crystal types and percentages found in calculus?

Answer 38

58% hydroxyapatite 21% octacalcium phosphate 21% magnesium whitlockite 9% brushite

Question 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

Answer 39

initial stage 1 gingivitis

Question 40

what does periodontitis begin with?

Answer 40

apical migration of the junctional epithelium and loss of alveolar crest bone

Question 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

Answer 41

chronic periodontitis

Question 42

this is the most common form of periodontal disease

Answer 42

chronic periodontitis

Question 43

this is porous and rough and provides a lattice on which plaque can grow

Answer 43

supragingival calculus

Question 44

what dentition does aggressive perio effect and what is it called?

Answer 44

can affect both primary and secondary dentition prepubertal perio

Question 45

what systemic diseases are related to perio?

Answer 45

IDDM AIDS down syndrome papillon lefevre syndrome

Question 46

what are the characteristics of subgingival caluclus?

Answer 46

forms on root surfaces, tenacious and black in color, deposited in rings or ledges

Question 47

what are the channels of subgingival calculus filled with?

Answer 47

bacteria

Question 48

this is similar to stage 3, destructive changes into bone and other tissues

Answer 48

advanced gingivitis stage 4

Question 49

what is the organic matrix made up of mineral crystals?

Answer 49

plaque microbes glucans glycoproteins lipids

Question 50

this is used for immunosuppressant causes gingival englargment

Answer 50

cyclosporine

Question 51

the most common gingival disease of fungal origin is from?

Answer 51

candida albicans

Question 52

why do perio pockets deepen

Answer 52

due to break down of collagen fibers due to collagenase released bacteria

Question 53

what is the most common medications for gingival disease?

Answer 53

antiseizure- phenytoin associated with gingival hyperplasia

Question 54

these do NOT reduce calculus present, but aids in inhibiting formation of new calculus

Answer 54

anticalculus agents

Question 55

what is the severity of chronic periodontitis directly related to?

Answer 55

the accumulation of plaque biofilm and calculus on surfaces of teeth

Question 56

what are some conditions that can affect the periodontal health?

Answer 56

ortho appliances malocclusion unreplaced missing teeth mouth breathing anatomic anomalies tobacco and alcohol use

Question 57

what are the characteristics of rapidly progressive perio?

Answer 57

ages 20-30 most teeth involved severe inflammation, plaque and calculus rapid bone loss over weeks and months genetic component

Question 58

what are the stages of gingivitis?

Answer 58

``` Stage 1 (initial or subclincal stage) stage 2 (early stage) stage 3 (established) stage 4 (advanced stage) ```

Question 59

what is the diagnosis of rapidly progressive perio?

Answer 59

``` less than 30 multiple areas of 5 mm attachment loss 6mm pockets P gingivalis and P intermedia E corrodens and Cr Rectus ```

Question 60

what is the difference between supra and sub gingival calculus when it comes to where it is derived from?

Answer 60

the mineral is derived from crevicular fluid not saliva

Question 61

associated with chronic nature and progression of peiodontal diseases

Answer 61

subgingival calculus

Question 62

what is another common name for calculus?

Answer 62

tartar

Question 63

this is characterized by extreme bone loss, usually seen around permanent molars and incisors...in patients younger than 20?

Answer 63

juvenile perio

Question 64

what 2 mechanisms can cause pregnancy tumor

Answer 64

increase in pathogenic bacteria and increase in Prostoglandin E

Question 65

this type of perio progresses rapidly with massive bone loss

Answer 65

aggressive perio

Question 66

inflammation of the gingival tissues and is reversible.. occurs in periodontium with no attachment loss or with loss that is not progressing

Answer 66

gingivitis

Question 67

how do you treat rapidly progressive perio?

Answer 67

plaque control subgingival scaling perio surgery antibiotics such as tetracycline,metronidazole, amoxicillin/clauvanic acid, ciprooxacin