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Module 9 exam 2 Flashcards

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1
Q

what are the 3 major categories of periodontitis?

A
  • chronic periodontitis
  • aggressive periodontitis
  • less common types of periodontitis
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2
Q

what are the two types of chronic periodontitis?

A

localized, generalized

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3
Q

what are the two types of aggressive periodontitis?

A

localized, generalized

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4
Q

what are the less common types of periodontitis?

A

periodontits as a mantifestation of systemic diseases, nectroizing perio diseases, perio associated with endodontic leisons

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5
Q

What is chronic periodontitis?

A

is a bacterial infection resulting in inflammation within the supporting tissues of the teeth, progressive destruction of the perio ligament, and loss of supporting alveolar bone

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6
Q

What does chronic perio start as?

A

plaque-induced gingivitis

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7
Q

What does chronic periodontitis involve

A

irreversible loss of attachment and bone and is the most frequently occuring form of periodontitis

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8
Q

what is chronic periodontitis also known as?

A

adult periodontitis, but is has changed because it can occur at any age

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9
Q

what are the alterations in color, texture and size of the marginal gingiva?

A
  • red or purplish tissue, in chronic it may appear bright red or purple, appears swollen, may have rolled margins, blunted or flattened papillae
  • the tissue may be pale pink and appear normal
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10
Q

is the clinical appearance of the tissues is a reiliable indicator of the presence or severity of chronic perio?

A

no

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11
Q

In chronic periodontitis is gingival bleeding, suppuration and increased crevicular fluid common?

A

yes

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12
Q

Chronic periodonitis is characterized by what kind of biofilm and calc?

A

mature

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13
Q

What does the amount of tissue destruction seen in chronic perio correspond with

A

the amount of biofilm accumulation, local contributing risk factors, smoking and systemic risk factors

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14
Q

what is clinical attachment loss

A

an estimate of the extent that the tooth supporting structures have been destroyed around a tooth

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15
Q

what are 4 things that loss of attachment in perio is characterized by?

A

1- relocation of junctional epithelium
2- destruction of the fibers of the gingiva
3- destruction of the perio ligament fibers
4- loss of alveolar bone support from around the tooth

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16
Q

Mild clinical attach loss is:
Moderate is
severe is:

A

1 to 2 mm
3 to 4 mm
loss greater or equal to 5 mm

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17
Q

What are clinical characteristics of attachement loss

A

loss of alveolar bone, perio pockets or recesssion, furcation involvement, tooth mobility

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18
Q

In localized or generalized inflammation can people have areas of health with areas of with chronic tissue destruction

A

yes

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19
Q

when is chronic perio classified as local?

A

when less than 30 % of sites are affected

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20
Q

What are contributing factors of chronic periodontitis?

A

local factors, systemic diseases, cigarette smoking

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21
Q

What are symptoms of chronic perio?

A

it is usually painless, pts start to see it when their gums bleed, progression of spaces between teeth, loose teeth, food impaction, sensitivity b/c of exposed root dull pain in jaw

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22
Q

What is peri-implantitis

A

term for chronic periodontitis in the tissues surrounding a dental implant

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23
Q

Gingivitis is a risk factor for chronic perio T/F

A

True

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24
Q

What is the age of onset for chronic perio

A

it can be at any age but is most common in adults over 35

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25
at what rate does chronic periodontitis progress?
at a slow to moderate pace
26
Does tissue destruction in chronic perio occur in all teeth
no it is a site specific disease
27
does chronic perio progress at an even rate throughout the mouth?
no some sites may not change forever, and some may progress rapidly
28
What does initial care for chronic perio include?
- consult with physicial for systemic risk factors - instruction, reinforcement of self care skill - smoking cessation - peiro instrumentation - anti microbial agents - removal or control of local factors
29
what goals should be included in treatment of chronic perio?
- control bacterial biofilm - alter or eliminate local or systemic risk factors - arrest disease progression - prevent recurrence of perio
30
what are the desired outcomes in tx of chronic perio?
- reduction in gingival inflammation - reduction of dental biofilm - reduction of probing depths
31
what is going to determine long term outcome of perio therapy?
patient compliance with self care
32
what is a refractory disease?
destructive perio in a patient who when monitored over time exhibits additional attachment loss at one or more sites despite repeated prof. perio therapy and a patient who practices good self care
33
What are primary features of aggressive periodontitis?
- rapid destruction of attachment and rapid loss of supporting bone - no obvious signs of systemic disease - other family members with aggressive perio
34
What are secondary features of aggressive perio?
- small amounts of biofilm - elevated a. actinomycetemcomitans - phagocyte abnormalities - lack of clinical signs of a disease - poor response of perio therapy - episodic disease progression
35
what is episodic disease progression?
occuring in succession of acute destructive phases with intermittent inactive phases
36
When is the onset of localized aggrestive periodontitis?
around the time of puberty
37
Where is localized aggressive perio seen?
first molars and or incisor and involving no more than 2 teeth other than first molars and incisors
38
What should you look for in LAP?
vertical bone loss around the first molars and incisors beginning around puberty
39
What is the onset of generalized aggressive periodontitis
occurs in persons younger than 30, but they can be older
40
What is Generalized Aggressive Periodontitis? (gap)
generalized interproximal attachment loss affecting at least 3 permanent teeth other than the first molars and incisors, Destruction of the attachment and alveolar bone is very episodic occuring in a succession of acute phases
41
what are clinical manifestations of GAP?
tissues may be acutely inflammed, ulcerated and fiery red, the y may also appear pink and free of inflammation although they have deep pockets
42
What are some examples of periodontitis as a manifestation of systemic disease?
- associated with hematological disorders | - associated with genetic disorders
43
what are some examples of perio associated with hematological factors?
- aquired neutropenia - leukemias - other
44
what are some examples of perio associated with genetic disorders?
- familial and cyclic neutropenia - down syndrome - leukocyte adhesion deficency syndrome - papillon-lefevre syndrome - chediak-higashi sydrome - histiocytosis syndromes - glycogen storage disease - infantile genetic agranulocytosis - cohen syndrome - hypophosphatasia
45
What is a hematologic disorder?
abnormalities in the structure or function of the blood and blood forming tissues
46
what is aquired neutropenia?
blood disorder characterized by abnormally low level of neutrophils which can be seeen with chemo, radiotherapy, viral infections
47
what is important for us to know about neutropenia
lowers the immunologic barrier to bacterial and fungal infections, affects PMNS which may result in severe perio destruction
48
What are periodontal manifestations of leukemia?
gingival enlargement, bleeding and infections
49
what are the most common HIV assicated perio diseases?
LGE and necrotizing perio diseases
50
What should we remember about perio disease in HIV infected individuals
perio attach loss and alveolar bone destruction may be extremely rapid
51
What is important to know about familial and cyclic neutropenia?
they may experiencce severe periodontal destruction, appear at a young age
52
What is important to know about down syndrome?
they develop severe, agressive perio, substantial plaque formation, deep pockets, gingival inflamation
53
what is important to know about Leukocyte adhesion deficency syndrome?
- perio attributed to this is rare | - begins upon eruption of the primary teeth with rapid attachment and tooth loss
54
what is important to know about papillon lefevre syndrome?
- characerized by hyperkeratosis of palms of hands and soles of feet and severe destruction of periodontium - primary teeth are lost by 5 or 6, permanent teeth are lost due to bone destructon by 15
55
What is important to know about chediak-higashi syndrome?
- pale colored hair, eyes and skin, - imparment of neutrophil chemotaxis - aggressive perio
56
What is glycogen storage disease?
- characterized by neutropenia | - perio manifestations appear at a young age with potential for early tooth loss
57
What is infantile genetic agranulocytosis?
- severe chronic neutropenia usually detected soon after birth - experience severe perio
58
What is Cohen syndrome?
- neutropenia, developmental delay, mental retardation, small head, weak muscle tone - increase susceptibility to early perio breakdown, assicated with neutropenia
59
what is ehlers danlos syndrome types IV and VIII
- connective tissue disorder associated with bruising, joint hypermobility skin laxity, weakness of tissues - early onset of generalized periodontitis, premature loss of deciduous and permanent teeth
60
what is hypophosphatasia?
- deficency in alkaline phosphate, skeletal defects resembling rickets - severe loss of alveolar bone and premature loss of primary and permanent teeth in absence of inflammatory response - early exfoliation of anterior teeth
61
What is necrotizing periodontal disease?
-inflammatory destructive infection of periodontal tissues that involve tissue necrosis
62
What is NUG?
tissue necrosis limited to the gingival tissues
63
What is NUP?
tissues necrosis of the gingival tissues combined with loss of attachment and alveolar bone loss
64
NUP is a painful infection characterized by
necrosis of gingival tissues, perio ligament, and alveolar bone
65
How quickly can loss of attachment happen in NUP
within days
66
Necrotizing perio disease primarily involves what area of the mouth
interdental and marginal gingiva
67
what is necrotizing perio disease characterized by
ulcerated and necrotic papillae and gingivall margings, appear punched out or cratered
68
the necrotic arease in necrotizing perio disease are covered by what
a yellowish white or grayish tissue slough called a pseudomembrane
69
Where are the first leisons seen in npd?
interproximally in the mandibular anterior sexant
70
Is an odor present in NPD
yes there can be
71
what may NPD be associated with
excessive salivation
72
what is an interdental crater in NPD?
central tissue destruction between facial and lingual portions of papilla
73
what happens to the bone in NPD?
deep craters in the interdental alveolar bone
74
what are the systemic signs and symptoms of NPD?
-swelling of lymph nodes especially the submandibular and cervical nodes
75
What are some predisposing factors for NPD?
-systemic diseases which impair immunity -poor self care emotional stress inadequate sleep, fatiuge alcohol use caucasian cigarette smokers poor nutrition prexisting gingivitis or tissue trauma
76
what is the goal of the acute phase of tx of NPD
eliminate disease activity and relieve pain and discomfort
77
what is done in treatment of NPD
- perio instrumentation - self care instruction - oxygen therapy with hydrogen peroxide - pain control - antibiotic therapy - seen daily, appropriate tx should releive symptoms in a few days
78
what should education of the patient of NPD involve?
-nutrition, intake of fluids, smoking cessation
79
What are the 4 subgroups of developmental or aquired deformities and conditions?
- localized tooth related factors that modify or predispose to plaque induced gingival diseases or perio - mucogingival deformities and conditions around teeth - mucogingival deformities and conditions on edentulous ridges - occlusal trauma
80
WHat are some tooth related factors that predispose to perio disease?
-enamel pearls, cervical enamel projections, palatolingual grooves, malalignment
81
what is the most common mucogingival deformity related to perio disease
recession of the gingival margin

Perio (11 decks)

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