Initial Examination and Clinical Diagnosis

Question 1

A comprehensive periodontal exam for daily practice provides what?

Answer 1

Adequate/accurate baseline data
Initial diagnosis/therapy
Re-evaluations (via baseline data)

Question 2

What are the components of a Comprehensive Exam?

Answer 2

Health History
Data on Risk Factors
Radiographic Exam/Treatment
Clinical Charting

Question 3

What are the components of health history?

Answer 3

Basic Info
Chief Complaint
Medical History
Dental History
Family History

Question 4

What are the components of Data on Risk Factors?

Answer 4

Primary Local Factors

Primary Systemic Factors

Question 5

What are components of primary local factors?

Answer 5

Bacteria (species and plaque retentive areas)

Patient compliance to OHI and maintenance programs (an informed patient decreases the gap between wants and needs)

Question 6

What are primary systemic factors

Answer 6

Smoking
Diabetes
Genetics

Question 7

What do we want to have for Radiographic Exam/Treatment

Answer 7

Full set of PA radiographs

Patients old radiographs/charts (helps show progression)

Question 8

What are the components of clinical charting?

Answer 8

Probe depths
Gingival recession (+) or hyperplasia (-)
BOP
Plaque (tells us if it's plaque induced)
Suppuration (pus)
Mobility and fremitus
Furcations
Amount of attached and keratinized gingiva

Question 9

What is the Diagnosis of Periiodontal Problems based on?

Answer 9

• Probe depths + Gingival recession = CAL
• Ammount of keratinized tissue, BOP, furcations, mobility
• Fremitus (mobility on occlusion)
• Bony defects (horizontal, vertical, walled)

Question 10

What are the types of perio probes (that we use)

Answer 10

CPITN (used for PSR)

Williams

Question 11

CPITN probe measurements

Answer 11

0. 5
1. 5
2. 5
3. 5
4. 5

Question 12

WIlliams probe measurements

Answer 12

1
2
3
5
7
8
9
10
(skips 4 and 6)

Question 13

3 catergories of perio diagnosis

Answer 13

Health
Gingivitis
Periodontitis

Question 14

Signs of healthy gingiva

Answer 14

Probe depths ≤ 3mm
No history of CAL
No inflammation

Question 15

If a patient has no current disease, but has a history of periodontal disease (CAL), what are they labeled as?

Answer 15

Health on a reduced periodontium

Question 16

What are the types of gingivitis? Which is more common

Answer 16

Plaque-induced**

Non-plaque induced

Question 17

Non-plaque induced gingivitis

Answer 17

Difficult to diagnose/treat

Due to systemic disease and/or medication etiology

Question 18

Signs of gingivitis

Answer 18

Probe depths ≤ 3mm
No history of CAL
Inflammation via plaque or other causes

Question 19

Signs of periodontitis

Answer 19

Probe depths ≥ 4mm
CAL
Inflammation (unless it’s GAP)

Question 20

What are the types of periodontitis?

Answer 20

Chronic Periodontitis

Aggressive Periodontitis

Question 21

How do you measure the severity of chronic periodontitis?

Answer 21

Slight = 1-2mm
Moderate = 3-4mm
Severe = 5+ mm

Question 22

How do you measure the extent of chronic periodontitis?

Answer 22

Localized = 30% of sites

Question 23

What are some characteristics of Aggressive Periodontitis?

Answer 23

Specific sites
Non-plaque induced
Familial history - genetically predisposed and have the right bacteria
Must have at least 1 1st molar to be considered AP

Question 24

Localized Aggressive Periodontitis

Answer 24

≤2 permanent teeth besides 1st molars and incisors

Question 25

Generalized Aggressive Periodontitis

Answer 25

≥ 3 permanent teeth besides first molars and incisors

Question 26

How do we know aggressive periodontitis is non-plaque induced?

Answer 26

The amount of CAL does not correlate to the amount of plaque present

Question 27

Signs of Localized Aggressive Periodontitis

Answer 27

Puberty-20 years old High/robuts serum-antibody response Little gingival inflammation

Question 28

Signs of Generalized Aggressive Periodontitis

Answer 28

Under 30 years old (usually) Episodic destruction of CAL/Bone Poor/little serum-antibody response Lots of gingival inflammation

Question 29

Glickman's Classification

Answer 29

``` Classification of furcation involvement Class I Class II Class III Class IV ```

Question 30

Class I furcation

Answer 30

Not seen on radiograph | Just a catch in the probe

Question 31

Class II furcation

Answer 31

Seen radiographically aka a Cul-de-sac furcation Does not go all the way through

Question 32

Class III furcation

Answer 32

Through and through furcation

Question 33

Class IV furcation

Answer 33

When the furcation can be seen clinically