Lecture 7

Question 1

What are local contributory factors?

Do Local Contributory Risk Factors contribute to periodontal diseases? Are they etiology?

Do Local Contributory Risk Factors include systemic conditions?

Answer 1

Question 2

Why do Local Contributory Risk Factors lead to more disease?

Answer 2

Question 3

What is a major etiologic factor to the development of dental caries, and initiation and progression of periodontal diseases? Why?

Answer 3

Question 4

Name two categories under the 2017 classification for periodontal disease

Answer 4

Question 5

What classification, category and subcategory does dental calculus fall under?

Answer 5

Naturally Occurring Contributing Factors

Classification:Periodontal Health, Gingival Diseases, and Conditions

Category: Gingivitis - dental biofilm-induced

Subcategory:Local risk factors (naturally occuring)

Question 6

What is the secondary risk factor for periodontal disease?

What is the most important local contributing factor?

What risk factor plays a significant role in pathogenesis of periodontal disease?

Answer 6

Question 7

How does dental calculus alter gingival/ sulcular tissue? Why?

What is the surface of calculus like?

Dental calculus is a reservoir for___

How does dental calculus alter oral hygiene?

Answer 7

Question 8

Dental biofilm is a _____substance covered on exterior surface by

Answer 8

Question 9

Locations of calculus deposits

Answer 9

Question 10

Where does supragingival calculus form?

Is supragingival calculus site specific or non site specific? With what is it associated?

Supragingival can be worse on ____(hint: occlusion)

Localized or generalized?

Answer 10

Question 11

Calculus is a mineralized substance. Where does supragingival calculus get its minerals?

Formation time for supragingival calculus varies upon what?

Mineralization process begins within ____ to _____

Answer 11

Question 12

What color is supragingival calculus?

How does formation occur?

Answer 12

Question 13

What percentage of supragingival calculus is mineralized?

Mineralization can begin within 48 after biofilm formation. ____% of the biofilm will mineralized in 2 days. ___% in twelve days

Answer 13

Question 14

How much of supragingival calculus is inorganic?

What inorganic material is SGC primarily made of? Name two other additional minerals

This composition is similar to___

Answer 14

Question 15

Inorganic component of Supragingival calculus changes through _____with time

Newly formed:

<6 months old:

> 6 months old:

Answer 15

Question 16

What percentage of supragingival calculus is organic?

What material makes up the organic composition?

Answer 16

Question 17

Supragingival calculus mode of attachment. Where does the MOA occur? Interlocking to tooth? Easy or hard to remove?

Answer 17

Question 18

Is subgingival calculus site specific or non site specific?

How to detect extent and location?

What is the distribution usually like?

Where are the mineral components derived?

Answer 18

Question 19

What color is subgingival calculus?

Why is it that color?

What is the shape guided by?

What shapes will you usually find?

Answer 19

Question 20

What percentage of subgingival calculus is mineralized?

Occurs with or separate from supragingival calculus?

Forms faster or slower than supragingival calculus?

Answer 20

Question 21

Does the inorganic composition of subgingival calculus have more or less minerals that supra?

What minerals will you usually find in sub?

What crystals usually form?

What mineral increases with the pocket depth?

Answer 21

Question 22

Does sub gingival calculus have salivary proteins?

What makes up the organic composition of subgingival calculus?

Answer 22

Question 23

What is the mode of attachment for subgingival calculus?

Is it easy to remove like supra?

Answer 23

Question 24

Subgingival calculus covered by bacterial biofilm is associated with

Answer 24

greater disease progression than biofilm alone

Question 25

If you do not see calculus on a radiograph is it not there? Only ~___% of surfaces with clinically visible calculus are detected radiographically

Answer 25

Question 26

Name an anticalculus agent. What does it do? What type of calculus does it target? What doesnt it eliminate? Useful for what type of patients?

Answer 26

Question 27

Anatomic Contributing Factors are under what classification and category? What qualifies as a anatomic contributing factors?

Answer 27

Classification: Other Conditions Affecting the Periodontium: Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions Category: Tooth and prosthesis-related factors Fenestration, dehiscence, root proximity, enamel pearl, cervical enamel projections, palatogingival groove, mesial concavity, cemental tears, accessory canals, exodontics

Question 28

What is meant by tooth anatomic factors? Pathologic? When relevant? Why? Examples:

Answer 28

Question 29

What is a dehiscence and a fenstration?

Answer 29

Question 30

Root proximity is poor alignment of teeth in arch due to___

Answer 30

Question 31

What are cervical enamel projections? Allows for? Can predispose to?

Answer 31

Question 32

Cervical enamel projections cause ___% of isolated furcation involvements Highest incidence in which teeth? In which surface? Treatment directed by___

Answer 32

Question 33

What are enamel pearls? Where and in what teeth are they often found? Often mistaken for? May be removed as ___

Answer 33

Question 34

What is a Palatogingival Groove? Affects what percentage of what type of teeth? Begins where and extends where? What does it look like/ how to describe it?

Answer 34

Question 35

Palatogingival Groove Extends onto root__% of time What does it accumulate? What can occur because of this? How to treat?

Answer 35

Question 36

What is this?

Answer 36

Mesial concavity?

Question 37

What are cemental tears? What does it remain attached to? Induced by? Can lead to? Treatment involves?

Answer 37

Question 38

Accessory canals provide a communication between? Pulpal necrosis and how it involves accessory canal? Occurs on what percentage and type of teeth?

Answer 38

Question 39

Isolated periodontal lesions on endodontically treated teeth should be evaluated for

Answer 39

accessory canals

Question 40

How is exodontics a local contributing factor? How?

Answer 40

Question 41

Restorative Contributing Factors are under what classification and category? What qualifies as restorative contributing factors?

Answer 41

Classification: Other Conditions Affecting the Periodontium: Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions Category: Tooth and prosthesis-related factors Overhang restorations, Crown contours (Pontic forms), margins (rough margins, margin location), RPD, restorative materials, open contacts and food impaction, untreated tooth decay

Question 42

Why do overhanging restoration contribute to periodontal disease? What it causes in the periodontium and teeth?

Answer 42

Question 43

How does overhanging restorations influence subgingival flora? What type of flora increases?

Answer 43

Question 44

For overhang restorations, which type cause the most attachment loss? How can we prevent attachment loss caused by overhang restorations? What tools?

Answer 44

Question 45

How do Crown Contours and Margins influence biofilm formation? What mechanisms or component of contours and margins may influence biofilm formation?

Answer 45

Question 46

How do rough margins influence biofilm and biofilm removal?

Answer 46

Question 47

What type of margins can cause bone resorption? How does an inadequate fit of a margin manifest in the gingival tissues? What other side effects will be present? These type of margins can lead to

Answer 47

Question 48

What type of crown contours are more compatible with periodontal health? Excessive cervical bulge accumulates ___ and promotes ____.

Answer 48

Question 49

Bulky crowns result in ___ They encroach on___ What does excess cement do to the tissues?

Answer 49

Question 50

How should the contours and embrasures of Pontics be formed? What type of pontics shouldn’t be used?

Answer 50

Question 51

RPDs encourages the formation of what mineralized substance in the mouth ? What do they require for care? Abutment teeth susceptible to ___and ___

Answer 51

Question 52

Are most restorative materials are compatible with gingival tissue? Gingival inflammation from dental material is associated with

Answer 52

Question 53

Open contacts can lead to ___.

Answer 53

Food impaction

Question 54

What is food impaction? What can it lead to?

Answer 54

Question 55

Predisposing factors for food impaction

Answer 55

Question 56

Untreated tooth decay results in ___ How does untreated tooth decay influence biofilm? What is possible because of this?

Answer 56

Question 57

Orthodontic Contributing Factors is what classification and category? Give examples

Answer 57

Ortho appliances

Question 58

Name some ortho appliances and how they affect biofilm and in turn the tissues and teeth. How do elastics cause periodontal problems? How important is oral hyg with ortho appliances?

Answer 58

Question 59

Name some examples of malocclusion and their affect or relation with biofilm. How does it complicate oral hygiene?

Answer 59

Question 60

Do unreplaced missing teeth initiate periodontal disease? What patients are usually affected by unreplaced missing teeth? How does it affect the occlusion of teeth? What may that lead to?

Answer 60

Question 61

Habits as Contributing Factors classification and category Example

Answer 61

Classification: Periodontal Health, Gingival Diseases and Conditions category: non-dental biofilm Subcategory: traumatic lesions Toothbrushing Floss trauma Oral piercings Self inflicted injuries Tongue thrusting Chemical injury: aspirin burn, alcohol burn, anbesol burn Mouthbreathing (biofilm induced)

Question 62

The effects of mouth breathing are confined to ___ mouth breathing increases susceptibility to ____ which occurs because of____ What will labial gingiva of maxillary teeth in mouth breathing look like? How does mouth breathing affect biofilm? What condition in the gingiva may occur? How should Mouth breathing affect a persons oral hygiene? Will gingival inflammation always be resolved after removal of biofilm?

Answer 62

Question 63

Toothbrush trauma can do what to attached gingiva? What does it do to epithelium? What does it do to the root? What does it create or lead to?

Answer 63

Question 64

What is created when floss is forcefully snapped through contact point? Sawing of the floss over a period of time can create a___ into tooth

Answer 64

Question 65

Oral Piercings can cause what Dental and periodontal injuries? Lip piercings usually affects what surfaces? Tongue piercings usually affect what surfaces?

Answer 65

Question 66

Name some self inflicted injuries and how do they often result?

Answer 66

Question 67

What is tongue thrusting? What teeth does it affect and how? Can be traumatic to___

Answer 67

Question 68

How is chemical injury sustained to periodontium? How do they result? Temporarily interfere with___and contribute to ____ Give two examples

Answer 68

Question 69

What is this?

Answer 69

Aspirin burn

Question 70

Rubbing alcohol burn can happen with what dental material? Symptom? How long does it take to heal?

Answer 70

Question 71

What is this?

Answer 71

Anbesol burn

Question 72

Other local contributing factors

Answer 72

Malocclusion Unreplaced missing teeth