Perio Final Review Flashcards
(175 cards)
1
Q
the tissues of the periodontium
A
gingiva cementum PDL alveolar bone
2
Q
protects underlying tooth structures from oral environment
A
gingiva
3
Q
suspends and maintains the tooth in the socket
A
PDL
4
Q
hard, mineralized tissue that attaches to the dentin
A
cementum
5
Q
protects the dentin and compensates for tooth wear
A
cementum
6
Q
valley like depression apical to the contact area of 2 adjacent teeth that connects facial and lingual papillae
A
gingival col
7
Q
there will be no col if
A
there is a large space in between 2 teeth
8
Q
5 functions of the PDL
A
tooth support sensory nutrition cementoblasts/osteoblasts bone remodeling
9
Q
primary function of cementum
A
PDL attachment
10
Q
terminal endings of periodontal ligaments attached to the cementum
A
sharpeys fibers
11
Q
seals the ends of open dentinal tubules
A
cementum
12
Q
compensates for occlusal attrition to maintain tooth length
A
cementum
13
Q
excess cementum in apical 1/3 of root
A
hypercementosis (radiopaque)
14
Q
sensitive to mechanical forces and inflammation
A
alveolar bone
15
Q
compact bone
A
cortical bone
16
Q
bone closest to the PDL
A
ABP
17
Q
cementum that is closer to the oral cavity; doesn’t rebuild
A
acelluar cementum
18
Q
covers cervical 1/3 of root; closer to the oral cavity; doesn’t rebuild
A
acelluar cementum
19
Q
covers the apical half of root; continuously deposited; thickness increases w/age
A
cellular cementum
20
Q
the process which epithelial cells on the surface of the skin become stronger and waterproof
A
keratinization
21
Q
type of epithelium that comprises flat cells arranged in several layers
A
stratified squamous epithelium
22
Q
cell to basal lamina connection
A
hemidesmosomes
23
Q
connect neighboring epithelial cells together
A
desmosomes
24
Q
located at base of sulcus
A
JE
25
connect neighboring epithelial cells together; "cell-to-cell"
desmosomes
26
covers the free and attached gingiva
oral epithelium (OE)
27
network of roselike collagen fiber bundles located coronal to the crest of the alveolar bone
supragingival fiber bundles
28
brace the free gingiva firmly against the tooth and reinforce the attachment of the JE to the tooth
supragingival fiber bundles
29
connect adjacent teeth to one another to control tooth positions within the dental arch
supragingival fiber bundles
30
5 principal fiber groups of PDL
horizontal oblique interradicular apical alveolar crest
31
3 possible arrangements of the enamel & cementum
overlap meet gap (OMG)
32
sequence of events that occur during the development of a disease or abnormal condition
pathogenesis
33
sequence of events that occur during the development of a disease or abnormal condition
pathogenesis
34
fibers that are regenerated continuously and separated the site of inflammation from remaining alveolar bone
transseptal fibers
35
in health, the crest of the alveolar bone is located approx. ___ mm apical to the CEJs
2mm
36
suprabony defects are
horizontal
37
infrabony defects are
vertical
38
infrabony defects are more _______ than suprabony defects
aggressive & complex
39
describing health of the gingiva
color size consistency texture position of margin shape bleeding/exudate
40
describing health of the gingiva
color size consistency texture position of margin shape bleeding/exudate
41
a type of periodontal disease characterized by apical migration of JE, connective tissue loss, and alveolar bone loss
periodontitis
42
gingivitis that may exist without ever progressing to periodontitis; resolves upon professional care/self care; tissues can appear bluish/red to purplish (usually no pain)
chronic
43
papillary inflammation includes
interdental
44
marginal inflammation includes
margins papillary
45
diffuse inflammation include
gingival margin papilla attached gingiva
46
modifying factors for dental biofilm-induced gingivitis
systemic conditions oral factors drug influenced
47
NAME THE STAGE 1-2 mm CAL RBL coronal 1/3 \<15% No tooth los Max PD
Stage I
48
NAME THE GRADE -no loss over 5 yrs -heavy biofilm deposits w/low levels of destruction -
A
49
NAME THE STAGE CAL: 1 - 2 mm RBL: coronal 1/3 (\<15%) No tooth loss Max PD = 4mm Mostly horizontal bone loss
Stage I
50
NAME THE STAGE CAL: 3 - 4mm RBL: coronal 1/3 15-33% No tooth loss Max PD \>/= 5mm Mostly horizontal bone loss
stage II
51
NAME THE STAGE: CAL: \>/= 5mm RBL: middle 1/3 & beyond Tooth loss: = 4 teeth PD: \>/= 6mm Vertical bone loss: \>/= 3mm Class 1 or 2 furcation Moderate ridge defects
Stage III
52
NAME THE STAGE CAL: \>/= 5mm RBL: middle 1/3 & beyond Tooth loss: \>/= 5 teeth PD: \>/= 6mm Vertical bone loss: \>/= 3mm Class 1 or 2 furcation Masticatory dysfunction Secondary occlusal trauma Bite collapse, drifting, flaring Severe ridge defects 20 remaining teeth
Stage IV
53
assessment data for periodontal diagnosis
radiographs med/dental hx gingival observations perio charting
54
assessment data for periodontal diagnosis
radiographs med/dental hx gingival observations perio charting
55
features of a disease that can be observed or are measurable by a clinician
signs
56
features of a disease that are noticed by the patient
symptoms
57
initial periodontitis stage
stage I
58
moderate periodontitis stage
stage II
59
severe periodontitis w/potential f/tooth loss stage
stage III
60
advanced periodontitis w/extensive tooth loss & potential for loss of dentition
stage IV
61
localized extent of disease is \_\_\_\_% or less of the teeth in the mouth
30%
62
initial periodontitis stage
Stage I
63
moderate periodontitis stage
Stage II
64
severe periodontitis w/potential f/tooth loss stage
Stage III
65
advanced periodontitis w/extensive tooth loss & potential for loss of dentition
Stage IV
66
SHARE approach 5 steps
share info discuss & agree on goals jointly review plan record & share plan agree on follow-up schedule jointly develop care plan
67
needs to have: understandable language opportunity for pt questions assesses pt understanding
informed consent
68
risk factors for periodontal disease
smoking systemic disease medications social atmosphere habits periodontal pathogens
69
periodontal pathogens
a. actinomycetemcomitans tannerella forsythia p. gingivalis
70
occurs when there is a balance between disease-promoting factors and health-promoting factors
biologic equilibrium
71
occurs when there is a balance between disease-promoting factors and health-promoting factors
biologic equilibrium
72
a living film of well-organized bacteria that grows on a surface
biofilm
73
dense protective barrier; protects bacteria from antibiotics, antimicrobials and the body's immune system
slime layer
74
most effective way to control dental plaque biofilms
mechanical cleaning
75
best achieved by brushing, interproximal plaque removal and periodontal instrumentation
mechanical cleaning
76
plaque biofilms are the cause of initial inflammation, but the ______ determines the periodontal destruction progresses
host response
77
body's protective response to pathogens, foreign bodies or an injury
inflammation
78
capture and destroy bacterial invaders
polymorphonuclear leukocytes (PMNs)
79
attracted to bacteria by chemotaxis
PMNs
80
contains many strong bactericidal and digestive enzymes called lysosomes
PMNs
81
periodontal pathogens are most effectively destroyed by
PMNs
82
essential for the control of bacterial infections
PMNs
83
large leukocytes with one kidney-shaped nucleus and some granules
macrophages
84
highly phagocytic cells that actively engulf and destroy microorganisms
macrophages
85
slower to arrive at the infection site than PMNs
macrophages
86
macrophages are most numerous in ______ infection
chronic
87
TRUE or FALSE PMNs are short lived; macrophages are long-lived
TRUE
88
macrophages are in the tissue and when in the bloodstream they are called
monocytes
89
secrete antibodies and can further differentiate into plasma B-cells and memory B-cells
B-lymphocytes (plasma cells)
90
inflammation
\*\*\*\*\*\*\*\*\*\*
91
no symptoms exaggerated host response
chronic inflammation
92
heat redness pain loss of function inflammation
acute inflammation
93
body's response to bacteria
host response
94
unresolved acute inflammation will progress to
sustained chronic inflammation
95
biologically active compounds secreted by immune cells that activate the body's inflammatory response
biochemical mediators (middle men) cytokines, MMPs, prostaglandins
96
regulatory proteins released by host immune cells that influence behavior of other cells
cytokines
97
initial tissue destruction and bone loss; play major role in perio
cytokines IL1, IL6, IL8, TNF-a
98
inflammatory mediators that increase permeability and dilation of blood vessels
prostaglandins
99
can trigger osteoclasts to destroy alveolar bone
prostaglandins
100
can promote overproductions of MMPs
prostaglandins
101
enzymes that act together to break down the connective tissue matrix
MMPs
102
PMNs and gingival fibroblasts are the major source of ____ in periodontitis
MMPs
103
increased MMPs cause the destruction of _____ in the periodontal tissues
collagen
104
elevated levels lead to greater activation of osteoclasts and bone resorption
RANKL
105
binds to RANKL and jams the signal between RANKL and RANK offering bone protection
OPG
106
binds to RANKL and jams the signal between RANKL and RANK offering bone protection
OPG
107
conditions or diseases that increase an individual's susceptibility to periodontal infection by modifying or amplifying host response to microbial infection
systemic risk factors
108
the relationship between periodontal disease and systemic disease is a
two-way street
109
diabetes leads to a hyperinflammatory response to the bacteria in periodontitis and
impaired repair
110
the hyperinflammatory response and impaired repair in diabetes are partly mediated by the signaling mechanisms of the
AGE-RAGE reaction
111
when glucose in the bloodstream attaches to proteins and lipids, it forms harmful new molecules called
advanced glycation end products (AGES)
112
AGE formation is increased in pt's that have
hyperglycemia
113
degrade collagen and elastin causing fibers to lose elasticity
AGEs
114
pathologic tissue destructions happens when AGEs interact with
RAGEs
115
3 meds that cause gingival enlargement
phenytoin (anticonvulsant) cyclosporine (immunosuppressive) nifedipine (calcium channel blocker)
116
what type of contributing factors are listed? restoration overhangs rough surfaces calculus ill-fitting appliances frenum attachments trauma from occlusion
local factors
117
calculus is always covered with
pathogenic bacteria
118
trauma from occlusion
%\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*
119
zone of tissue occupied by the JE and connective attachment tissue fibers, approx. 2mm
biologic width
120
when violates, the body attempts to re-establish this zone through the inflammatory process
biologic width
121
elevated production of both inflammatory cytokines and ROS (reactive O2 species) are linked to
obesity
122
how do antioxidants help the body?
neutralize free radicals
123
smokers are ___ times more likely to develop periodontal disease
7x
124
smoking has a negative effect on fibroblast function and \_\_\_\_\_\_\_\_\_\_\_
wound healing
125
efficient info-gathering process used to determine the periodontal health of the pt
periodontal screening
126
intensive info-gathering process used to gather detailed data needed to make a periodontal dx and to document periodontal health of a pt for long-term monitoring
comprehensive periodontal assessment
127
components of a CPC
-eval of gingiva -pocket/sulcus -teeth -presence of local contributing factors -radiographs
128
BOP can be either
immediate or delayed
129
exudate can occur through either
probing or finger press
130
palpable or visible movement of a tooth when in function
fremitus
131
name the SPC calc classification: No calculus present
A-0
132
name the SPC calc classification: light supragingival and/or localized light subgingival
A (light)
133
facial to lingual movement of tooth less than 1mm (slight)
class 1 mobility (horizontal)
134
facial to lingual movement of tooth greater than 1mm but less than 2mm
class 2 mobility (horizontal)
135
facial to lingual OR vertical displacement; tooth depressible in socket
class 3 mobility (vertical)
136
PASS scores are performed on all pts over the age of
12
137
incipient furcation; detects but cannot enter furcation
class I furcation
138
probe penetrates furcation greater than 1mm; does not pass through
class II furcation
139
the probe passes completely through the furcation
class III furcation
140
the entrance to the furcation is VISIBLE looking into the mouth
class IV furcation
141
calculate the CAL: PD: 4mm GM: +2mm
CAL = 6mm _______________________ 4mm + 2mm = 6mm
142
the surfaces of the interdental bone are smooth and covered in a thin layer of ______ bone
cortical bone
143
the thin, dense layer of cortical bone that lines the tooth socket appears as a thin, white line on a radiograph called the
lamina dura
144
TRUE or FALSE radiographs reveal presence or absence of periodontal pockets
FALSE
145
TRUE or FALSE radiographs do not reveal presence of early stages of bone loss
TRUE
146
TRUE or FALSE radiographs do not reveal precise morphology of any existing alveolar bone destruction
TRUE
147
TRUE or FALSE radiographs do not reveal any information about periodontal disease activity
TRUE
148
bone loss that is measured from a plane parallel to a tooth-to-tooth line drawn from the CEJs of adjacent teeth
horizontal bone loss
149
bone loss seen on the interproximal aspect of one tooth more than the adjacent tooth; bone level is at an angle from the CEJs
vertical bone loss
150
bone loss seen on the interproximal aspect of one tooth more than the adjacent tooth; bone level is at an angle from the CEJs
vertical bone loss
151
which furcations are harder to detect on radiographs?
maxillary molars
152
what will a furcation area of a maxillary molar look like on a radiograph?
triangle radiolucency
153
ideal crown to root ratio
1:2
154
bone loss around an implant is a major sign of
periimplantitis
155
the bone levels around an implant should ideally be at or above the
first screw
156
the conscientious, explicit and judicious used of current best evidence in making decisions about the care of individual pts
evidence-based practice
157
requires integration of pt preference, individual clinical expertise and external clinical evidence
evidence-based decision making
158
what level(s) of evidence represent the best levels of evidence?
systematic reviews; randomized clinical trials
159
what levels of evidence have the lowest levels of evidence?
case reports; expert opinion
160
term used to describe the many nonsurgical steps used to eliminate inflammation in the periodontinum of a pt with periodontal disease
nonsurgical periodontal therapy
161
goals of nonsurgical periodontal therapy
1. minimize bacterial challenge 2. eliminate local contributing factors 3. minimize impact of systemic risks factors 4. stabilize attachment level
162
instrumentation to remove plaque biofilm and calculus from the root surface
scaline
163
removing diseased cementum that is contaminated with toxins or microorganisms
root planing
164
removal or disruption of plaque biofilm, its byproducts and biofilm retentive calculus deposits from coronal and tooth root surfaces
periodontal instrumentation
165
pts with periodontitis that have returned to a state of health and free from inflammation, have a _______ JE
long JE
166
when inflammation resolves, epithelial cells can readapt to the root surface with is referred to as a
long JE
167
what do pts need to be warned of the possibility of during and after NSPT?
hypersensitivity
168
formal step in NSPT that is designed to gather into to be used in several critical clinical decisions regarding future care
re-evaluation
169
formal step in NSPT that is designed to gather into to be used in several critical clinical decisions regarding future care
re-evaluation
170
periodontitis usually damages the _______ tissue first
interdental
171
cribriform plate which is a thin layer lining the socket
alveolar bone proper (ABP)
172
layer of compact bone that forms the outer wall on the facial and lingual
cortical bone
173
spongy bone that fills the interior portion of the alveolar process and is found MOSTLY in interproximal
cancellous bone
174
layer of connective tissue that covers the outer surface of the bone
periosteum
175
TRUE or FALSE epithelial cells do not co stain blood vessels
TRUE
