Perio Disease Flashcards
(23 cards)
Initial Lesion
Inflammatory response to biofilm
Occurs 2-4 days within bacterial irritation
Clinical appearance:
Early breakdown of collagen
Looks normal from outside, ulcerations in pocket
4 stages of development of gingival and PD
Initial Lesion
Early Lesion
Established Lesion
Advanced Lesion
Early Lesion
Increased inflammatory response
Biofilm becomes older/thicker
7-14 days
Infiltration of fluids - lymphocytes, plasma cells
Breakdown of collagen cells supporting ging.
Epithelium of sulcus migrates
Established Lesion
Progression from early lesion
Formation of pocket epithelium
Collagen destruction
Clinical appearance:
JE proliferates
Loss of connective tissue
Advanced Lesion
Extension of inflammation thru to underlying bone
Connective tissue destruction
Long appearance of teeth
Root exposure
Intrabony pocket
Gingival pocket
PD pocket
Suprabony pocket
IP - Pocket depth below bone
GP - Affects gingiva
PDP - affects bone
SP - pocket depth above bone
Contents found in a pocket
Microbes and their products
Ging sulcus fluid
Desquamated epithelial cells
Leukocytes
Purulent exudate (living/dead microbes)
Pocket development factors
Deepens due to continuos action of irritants and biofilm
PDL fibers detach
JE migrates apically
Exposes cementum to fluids - can alter cementum
Normal Tooth surface irregularities
Enamel surface - sometimes will have cracks and grooves
CEJ - determine bt this and calculus. Can feel similar
Root surface - can be rough.
Types of furcation NEED ANSWER
Class I
Class II
Class III
Class IV
Function of attached gingiva
NEED ANSWER
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Contributing factors to Disease Development
Etiologic - actual cause of a dz / condition
Predisposing - susceptible to a dz / condition
Contributing - lends assistance to / supplements a dz / condition
Risk - exposure that increases probability that dz will occur.
Dental factors to Disease Development
Tooth surface irregularities
Pits, grooves, cracks
Calculus
Exposed altered cementum
Demineralization and cavitated caries
Rough and groove surfaces left after scaling
In adequately contoured and polished restorations
Dental factors to Disease Development
Tooth contour
Congenital abnormalities
Extra / missing cusps
Flattened proximal surfaces
Occlusal surfaces affected by attrition
Areas of erosion / abrasion
Dental factors to Disease Development
Tooth position
Crowded Rotated Anterior overbite Open contact Open bite Food impaction Overhang of restoration Embrasures Tipped tooth
Dental factors to Disease Development
Dental prosthesis
Ortho appliances
Denture with deficient margin
Dental with bad clasp
Ging position
Receded - gums below CEJ Enlarged - height extended coronally Reduced height of interdental papilla - food trapped Tissue flap over occlusal PD pocket - deep, hard to clean
Ging contour
Sharp - healthy Rolled Bulbous Cratered McCalls Festoon Clefted
Effect of mouth breathing
Red gums
Dehydration -> bacterial proliferation -> inflammation -> red
Other factors affecting PD
Personal OH:
Neglect
Biofilm control
Awareness
Diet:
Soft food - adhere to teeth
Cariogenic
Masticatory deficiencies
Self cleaning mechanisms of mouth
Food enters mouth
Teeth together for chewing
Food forced out by pressure of bite
Food particles brought to occlusals
Food particles remaining on teeth can be removed by tongue, lips, teeth
Risk factors for PD
Drugs - cause ging enlargement (phenotocin, cyclosporine)
Tobacco
Diabetes
Systemic conditions - osteoporosis, psychosocial pressures (stress)
Factors to teach pt about PD
What is a pocket
How does a pocket form
Sig of pocket measurement
Personal and prof care
