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Finals > Perio > Flashcards

Perio Flashcards

1
Q

What is a local risk factor?

A

Within the mouth

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2
Q

What is a systemic risk factor?

A

Within the body

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3
Q

What is an example of a local risk factor?

A

Something plaque retentive

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4
Q

What is an example of a systemic risk factor?

A

Smoking

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5
Q

Signs of gingivitis?

A

Swollen/puffy gums
Red/inflamed gums
Bleeding gums
Gum tenderness
Halitosis
Gum recession

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6
Q

Signs of periodontal disease?

A

Periodontal pockets
Halitosis
Bad taste
Mobile teeth

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7
Q

What is the name of index used to measure mobility?

A

Millers of mobility

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8
Q

What does score 0 mean for mobility?

A

less than 0.2mm

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9
Q

What does score 1 mean for mobility?

A

0.2mm - 1mm

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10
Q

What does score 2 mean for mobility?

A

1mm horizontal

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11
Q

What does score 3 mean for mobility?

A

Horizontal + vertical

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12
Q

What is the name of index used for furcation?

A

Hampathe

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13
Q

What does a score of 1 mean for furcation?

A

Probe less than a third

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14
Q

What does a score of 2 mean for furcation?

A

Probe more than a third

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15
Q

What does a score of 3 mean for furcation?

A

Probe all the way through

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16
Q

What radiographs are used for bone loss?

A

Vertical bitewings

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17
Q

Why is furcation a problem?

A

Food trap for bacteria stagnation
Prone to abscess for accessory canals
Bacteria floats in and out resulting in endodontic abscess

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18
Q

Types of toothbrush techniques?

A

Modified bass
Mini scrub
Stillmen modified
Roll technique

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19
Q

What does a spiral bacteria allow for?

A

They produce undulating movement through fluid allowing for tissue invasion and dissemination

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20
Q

What are the 4 bacteria complex involved in perio disease?

A

Orange
Red
Purple
Green

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21
Q

What bacteria are involved in the orange complex?

A

Prevotella intermedia
Fusobacterium nucleatum
Campylactobacter rectus
Eubacterium

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22
Q

What bacteria are involved in the red complex?

A

Porphyromonas gingivalis
Tannerella forsythia
Treponeme denticola

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23
Q

What bacteria is involved in the purple complex?

A

Aggregatibacter actinomycetemcomitans

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24
Q

What bacteria is found in the green complex?

A

Eiknella corrodens

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25
Q

What is NG?

A

Necrotising gingivitis

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26
Q

What causes NG?

A

Malnutrition
Poor OH
Smoking
Stress

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27
Q

What is the treatment of NG

A

Metronidazole 400mg 3x for 3 days or 250mg for 10-17 years
Local debridement
Chlorhexidine mouthwash
Review 1 week

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28
Q

What bacteria causes NG?

A

Treponeme vincetil
Treponeme denticola
Fusobacterium nucleatum
Prevotella intermdia

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29
Q

Symptoms of NG?

A

Pain
Halitosis
Bleeding
Loss of papillae
Ulceration
Lymphadenitis
Malaise

30
Q

How does an USS work?

A

Gives a cavitated affect, oxygen in air bubbles kills bacteria

31
Q

What does smoking do to the periodontium?

A
  • Weakens immune system
  • Vasoconstriction reducing blood, oxygen and cells getting to area
  • Delayed wound healing
  • Masks symptoms
  • Decreased response to treatment
32
Q

What 3 ways can neutrophils reach the site if inflammation?

A

Margination (only in venules)
Adhesion
Transendotheilial migration

33
Q

What does pale gums indicate?

A

Red blood cells are not carrying enough oxygen

34
Q

What is keratosis?

A

Benign abnormality of mucous membrane lining inside the mouth

35
Q

How does keratosis present?

A

White patch in the mouth normally in gum or cheek along with thickening of skin in the affected area

36
Q

What causes keratosis?

A

Tobacco

37
Q

What does a loss of fibroblasts cause?

A

Loss of collogen

38
Q

What does a loss of collogen lead to?

A

Loss of teeth
Stiff mucosa
Xerostomia
Increase in decay

39
Q

What does collagen do?

A

Strengthens teeth and gums

40
Q

What the lesions of periodontal disease?

A

Initial lesion
Early lesion
Established lesion
Advanced lesion

41
Q

What happens at initial lesion?

A
  1. 24 - 48 hours after plaque formation
  2. Vasodilation of blood vessels
  3. Increased number of neutrophils
  4. GCF production
  5. No symptoms
42
Q

What happens in early lesion?

A
  1. After 1 week
  2. Immunoglobulin production
  3. Cytokines released
  4. Loss of fibroblasts and collagen
  5. Inflammation present
43
Q

What happens at established lesion?

A
  1. Clinical diagnoses of gingivitis
  2. Junctional epithelium replaced by leaky pockets
  3. Loss of attachment to tooth
  4. Continued loss of collagen
44
Q

What happens in advanced lesion?

A
  1. Transition from gingivitis to periodontal disease
  2. Breakdown of PDl fibers
  3. Bone loss
  4. Advancing inflammation front where host attempts to stop spread of disease
45
Q

Examples of surgicals

A

Gingivectomy
Gingival graft
Furcation plasty
Hemisection
Flap surgery
Guided tissue regeneration

46
Q

Explain a gingivectomy

A
  • Portion of gum from in and around tooth removed
  • Remaining gum reattached by sutures and cleaned with saline
47
Q

Explain gingival graft

A
  • Removal of a piece of tissue from roof of mouth or nearby healthy gum tissue
  • Attachment of new tissue to area with glue or sutures
48
Q

Explain furcation plasty

A
  • Tunnel is created in furcation area to open furcation
  • Allows easy access for oral hygiene
49
Q

What is necrotizing periodontists?

A

Atypical painful form of periodontal disease
Bone and ligament destruction
Associated with patients with aids and HIV

50
Q

Why does periodontal disease become more common during pregnancy?

A

Vasodilation caused by oestrogen results in plaqye exaggerated response

51
Q

What is an epulus?

A

Common in pregnancy and is a pyogenic lymphoma
In between teeth
Seen in areas of crowding and overhangs

52
Q

What is RSD?

A

Render root surface compatible with healing

53
Q

Why carry out RSD?

A

Removal of deposit subgingival to remove bacteria
Allows gum to heal

54
Q

What types of USS is there?

A

Magnetostrictive
Peso electric

55
Q

What is a magnetostrictive USS?

A

Tip attached to the nickel based stack which inserts into a coil in the handle (cavitron)

56
Q

What is a peso electric USS?

A

Crystals of peso electric material which oscillates in the electromagnetic field

57
Q

What happens during periodontal disease?

A
  1. Bacteria in pocket not tissues
  2. Bacteria release enzymes toxins and acid
  3. Substances cause host cells to react
  4. Host cells also release enzymes toxins and acid
  5. Battle causes destruction to tissues
58
Q

What are the four stages to healing?

A
  1. Haemostasis
  2. Inflammation
  3. Proliferation
  4. Remodelling
59
Q

What happens during haemostasis?

A
  1. Vasoconstriction to limit bleeding
  2. Platelet activation
  3. Release of growth factors (PDGF + TGF - B)
  4. Clot acts as a signal for inflammatory cells
60
Q

What happens during inflammation?

A
  1. Signalling molecules (cytokines + chemokines) attract immune cells (neutrophils + macrophages)
  2. Neutrophils and macrophages engulf bacteria and debris
  3. Fibroblasts become activated and allow for synthesis of collogen
  4. Epithelial cells act as a barrier
61
Q

What happens during proliferation?

A
  1. Fibroblasts synthesize collagen forming granulated tissue
  2. New blood vessels invade wound area providing oxygen, nutriants and growth factors for tissue repair
  3. Stem cells differentiate into specialized cells such as osteoblasts
62
Q

What happens during remodelling?

A
  1. Hemidesmosomes cells anchor the epithelium cells of the long junctional epithelium to the tooth surface and zips
  2. New attachment occurs
63
Q

What do osteoblasts do?

A
  1. Repair bone function
  2. Contribute to regeneration of lost bone
  3. Function regulated by TGF -B
64
Q

Explain a hemisection

A
  • Surgical separation of a multirooted tooth usually a lower molar
  • Accessed through the furcation in a way that a tooth and associated portion of crown is removed
65
Q

Explain flap surgery

A
  • A flap like incision in the gum is created to access the pocket
  • Makes it possible to clean the root surfaces properly and removes dead tissue
66
Q

What two ways is treatment carried out after referral?

A
  • Chemical
  • Surgical
67
Q

What kind of chemical adjuncts can be used for perio disease?

A
  • Systemic
  • Local
68
Q

Explain local chemical adjuncts

A
  • Antiseptic placed directly into the periodontal pocket
69
Q

Explain systemic chemical adjuncts

A
  • Antibiotic given to patient to swollow
70
Q

Examples of antibiotic for periodontal disease

A
  • Metronidazole
  • Amoxicillin
  • Doxycycline
  • Tetracycline
71
Q

Examples of antiseptics for periodontal disease

A
  • Chlorhexidine

Finals (7 decks)

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