Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BDS4 EXAM PREP > perio > Flashcards

perio Flashcards

(77 cards)

Start Studying
1
Q

perio classifications

BSP2017

A

health
plaque induced gingivitis
non plaque induced gingivitis
gingival diseases and conditions
periodontitis
necrotising periodontal diseases
periodontitis as a manifestation of systemic diseases
systemic diseases or conditions affecting periodontal tissues
periodontal abscess
perio-endo lesions
mucogingival deformities and conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

categories of perio health
features of each

A

pt with intact periodontium (no BoP, no attachment loss)
pt with reduced and stable peirodontium (BoP <10%, PPD<4mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

clinical features of healthy periodontium

A

knife edged
scallopped gingival margin
pink/pale
stippling
firm and flat
painless
no bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

clinical features of gingivitis

A

BPE 2 or less
no bone loss
no loss of ID papilla
inflammation
loss of stippling
halitosis
BoP
red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

local and generalised

A

localised <30%
generalised >30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

local factors for perio

A

calclus
poor resotration margins/overhangs
malpositioned tooth making it hard to clean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

systemmic factors for perio

A

diabetes (hyperglyceamia)
sex hormones (puberty, pregnancy)
smoking
poor diet
drugs - nifidipine, phenytoin, cyclosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

systemmic factors for perio

A

diabetes (hyperglyceamia)
sex hormones (puberty, pregnancy)
smoking
poor diet
drugs - nifidipine, phenytoin, cyclosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

stageing

A

severity

1 - early/mild (<2mm or <15%)
2 - moderate (<1/3 bone loss on root)
3 -severe (1/3-2/3 root)
4 - very severe (>2/3 bone loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

grading

A

rate

A - mild rate (<0.5 when %bone loss/age)
B - moderate rate of progrssion (0.5-1)
C - rapid rate >1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

currently unstable

A

pockets >5mm
4mm pockets with BOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

currently stable

A

BoP<10%

PPD < or =4mm
no BOP at 4mm sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

currently in remission

A

BoP >10%
PPD <4mm
no BOP at 4mm sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

types of necrotising periodontal diseases

A

NUG - just gingiva
NUP - with bone loss
N stomatitis - bone denudation beyond mucogingival juntion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical features of NUG

6

A
  • gingivitis
  • hallitosis
  • loss of ID papilla (interproximal necrosis) puchned out appearance
  • bleeding
  • painful ulceration of ID papilla
  • pseudomembrous slough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

risks factors for NUG

A

smoking
stress
immunocompromised
poor OH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

tx for NUG

A

OHI
smoking cessation
PMPR - under LA
CHX 0.2% mouthwash

antibiotics
* metronidazole 400mg 3xdaiy for 5days
* amoxicillin 500mg 3xdaily for 5days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

periodontal abscess
definition

A

localised collectioon of dead and dying neutrophils
Acute exacerbation of periodontal pocket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

periodontal abscess
symptoms

A

swelling
pain
bleeding
pus suppuration
deep pocket
TTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

periodontal abscess tx

A

incise and drain - through pocket or incision
OHI - CHX 0.2% mouthwash advise
subgingival PMPR short of base of pocket
review in 10 days

antibiotics if systemic symptoms - PenV 500mg 4xdaily for 5days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

methods of perio-apical communication

6

A

apical forament
lateral canal
fractures
resorption
iatrogenic perforations
furcal canals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

recession

mucogingival deformities

A

lack of keratinised gingval attachment
displacement of gingval soft tissue margin to ACJ resulting in root exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

RT1

A

recession with no loss of interproximal attachemetn
(interproximal ACJ clinically undetectable both M and D, most of ID papilla remains)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

RT2

A

gingival recession associated with loss of some interproximal attachement

some ID papilla remains; amount of attachemnt loss less than or = to buccal attachemnt loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
RT3
gingival recession associated with more loss of IP attachment * no ID papilla remains * amount of IP attachment loss is greater than buccal attachement loss
26
reasons for recession | 5
* successful HPT * vigorous brushing * traumatic incisal realtionship * iatrogenic restorative damage * foreign body trauma
27
causes of tooth mobility | 4
alveolar bone loss clinical attachement loss PDL widening periodontal tissue disruption (due to inflammation)
28
effect of abnormal occlusal forces on healthy periodontium
areas of intermittent pressure and tension * areas of widened PDL until forces adequately dissipated, inc in tooth mobility * if demand reduced - dec in tooth mobility and PDL returns to normal normal physiological response
29
effect of abnormal occlusal force too great on healthy periodontium
if demand too great - PDL conts to widen until forces adequately dissipated or tooth is lost
30
effect of abnormal occlusal forces on healthy but reduced periodontium
tooth effefctively on alveolar bone fulcrum hypermobile tooth no plaque gingival margin remains intact and perio disease will not restart
31
effect of abnormal occlusal forces on diseased periodontium
zone of co destruction supra-physiological occlusal forces widen PDL width at base of pocket, hypermobile teeth * pathological disease (inflammation) causing CAL or excessive bone loss when combined
32
why to intervene in occlusal trauma | 3
symptomatic mobility progressively inc mobility assoc with deep pockets
33
BPE 1
pockets <3.5 BoP no Plaque retentive factors OHI
34
BPE2
pockets <3.5mm BOP plaque retentive factors PMPR and OHI
35
BPE3
pockets 3.5-5.5mm PMPR OHI 6PPC after tx
36
BPE 4
pockets >5.5 radiographs, 6PPC that sextant PMPR and review
37
BPE *
furcation involvement
38
furcation grades
1 - <1/3 2 - >1/3 but not through 3 - through and through
39
factors that affect toothmobility
height of PDL width of PDL presence of inflammation nuber/shape/length of roots
40
tx option for tooth mobility | pros and cons
splinting when mobilty is due to LoA, there is discomfort/chewing diffiiculties stabilises teeth for debridement doesnt influence rate of disease OH difficulties for pt
41
causes of tooth migration | 3
unfavourable occlusal forces unfavourable soft tissue profiles loss of attachemtn
42
tx options for tooth migration
tx underlying perio disease accept and stabilise ortho and stabilise extract correct occlusal relations
43
problems with antibiotic use for perio disease | 5
* unable to penetrate biofilm - need mechanical therapy * can be inactivated by non target organisms * superinfection possible * allergies * resistance
44
causes of antibiotics resistance | 5
* can be inactivated against non target orgaisms * trapped and destroyed by enzymes * **expression of biofilm specific resistance genes** * may fail to penetrate beyond surface layer of biofilm * stress reponse to hostile environment denatures AB
45
substantivity
persistence of action and ability to stick to target how long agent works for
46
substantivity depends on
maintenance of antimicrobial aactivey and slow neutralisation of antimicrobial activity
47
chlorohexidine
antiseptic bisbiguianide dicationic action - one cation adsorbs to tooth/pellicle and other cation sticks on bacteria in low conc causes inc cell permeability and at high conc causes cytoplasm precipitation (causing cell death)
48
indications for CHX
pre surgical mouthwash/aseptic technique immunocompromised pt limited manual dexterity/unable to perform OH oral candidiasis RAS NUG post- PMPR post extraction/surgery
49
side effects of CHX
bitter taste staining taste disturbance mucosal erosion parotid swelling
50
successful perio features
BOP <10% - reduced reduced probing detph - gain in clinical attachement via junctional epithelium improve OH - reduced plaque and bleeding scores no worsening in furcation scores reduced or stabilised mobility
51
aims of perio tx
arrest disease regenerate lost tissue maintain longterm perio health prevent tooth loss improve soft tissue consistency so easier management
52
side effects of perio tx
recession sensitvity initial bleeding
53
components of perio tx
risk factor managenent - smoking, diet, diabetes etc OHI PMPR - supra and sub removal of PRFs re-eval
54
when to re-eval
8-12 weeks after PMPR most healing occurs at 6 weeks longer allows better healing and replacement of junction epithelium
55
reasons why PMPR may fail
* inadequate operator technique * blunt instrument * pt not engaging with OHI regime * no correction of risk factors - smoking, poorly controlled diabetes * not debriding enitre pocket anatomy - unable to access * poor visiualisation of pocket meaning unable to assess when successful cleared pocket - not enough suction
56
aims of periodontal surgery | 2
arrest disease by gaining access to complete PMPR regenerate loss perio tissues
57
contraindications for perio surgery
non engaing pt e.g. poor OH, smoking
58
types of perio surgery | 3
access - OFC regenerative - GTR, GBR mucogingival
59
features of healing post OF PMPR
organisation of blood clot replacement by collagenous connective tissue attachement via long junctional epithelium reduciton in probing depths (gain in clinical attachement and recession)
60
aims of gingivectomy
facilitate pt OH improve aesthetics facilitate restorative dentistry
61
indications for gingivectomy | 4
gingival overgrowth/hyperplasia areas with difficult acces pseudopockets idiopathic gingival fibromatosis shallow suprabony pocket
62
drugs that can cause gingival hyperplasia
anticonvuslants - phenytoin immunosuppressants - cyclosporin m Ca channel blockers - nifedipine
63
inidications for GBR
2 or 3 walled proximal defetc
64
indications for elimination perio surgery types of
grade II furcation defects in mandible grade II buccal furcation defects maxilla tunnel prep and furcation plasty (make through and through) hemisection or separation
65
indications for XLA
non functional tooth gross mobility little remaining attachement and recurrent symtpms
66
key perio pathogens
p gingivalis t denticola t forsythia
67
pathophysiology of gingivitis
inc PRR stimulation inc production of pro inflammatory mediators inflammation inc vasodilation and immune cell migration amlification of healthy immune resopnse
68
pathophysiologi of perio
biofilm extends into pocket and adaptive immune response predominates further amplification of pro inflammatory processes Connective tissue destruction - MMPs Alveolar bone resorption - RANKL - due to exacerbated uncontrolled immune response
69
perio biofilm formation
conditioning film - organisms ATTACHES to enamel and growth from supra to deep gingival crevice * more harmful bacteria furhter in = anaerobic, Red Sockranskys coaggregation of bacteria = dense biofilm formation chronic inflammation but P.ging subverts immune response * dysbiosis of biofilm complement activated * bone destruction and PDL loss
70
bacteria in gingivitis and NUG
p.intermedia anaerobic -ve rod black | w
71
red sokranskys organisms
t.denticola t.forsythia p.gingivalis
72
p.gingivalis | virulence
* gingipains - nutrients to self, degrade host immune response * tissue toxic byproducts * endotoxic LPS * capcular polysaccharides * proteases * frimbriae - adherence and invasion
73
smoking and perio
Acidic favours p.ging Delayed wond healing Vasocontriction Impacted chemotaxis Cytokine production dec Enzyme catalase dec
74
diabetes and perio
Healing delayed (dec collagen) Inc chemotaxis by macrophages IL6 and TNF alpha advanced Glycerin end products due to abnormal glucose Heightened inflammatory reponse and dec neutrophils HbA1c - ideal 48mmol/mol (below 6.5%) | birelational
75
endo perio lesions with root damage | 3
root fracture or cracking root canal or pulp chamber perforation external root resoprtion
76
endo perio lesiosn without root damage in periodontitis pts | 3
grade 1 - narrow deep perio pocket in 1 tooth surface grade 2 - wide deep pocket in one tooth surface grade 3 - deep pocket in more than 1 tooth surface
77
endo perio lesion in non perio pt | 3
grade 1 - narrow deep pocket in 1 tooth surface grade 2 - wide deep perio pocket in 1 tooth surface grade 3 - deep pocket in more than 1 tooth surface

BDS4 EXAM PREP (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions