Perio Revision Flashcards by David Jack

Name the important pathogenic bacteria in periodontitis

P. Gingivalis
P. Intermedia
T. Forsythia
T. Denticola

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Describe an overactive immune response for periodontitis

Lots of inflammatory mediators which cause long standing inflammation and destruction of tissues

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Describe an under active immune response for periodontitis

Host immune reaction is lessened, and therefore the biofilm is allowed to grow and diversify, resulting in destruction of tissues

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Give examples of systemic risk factors for periodontitis

(Modifiable and non-modifiable)
Age
Genetic factors/hereditary
Hormonal changes (pregnancy/puberty)
Smoking
Poorly controlled diabetes
Osteoporosis
Medications

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Give examples of local risk factors of periodontitis

Calculus

Overhanging restorations

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What is another common risk factor in periodontitis

Poor dental attendance

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Name the different probes used in perio patients

CPITN/BPE Probe
PCP 12 Probe
UNC Probe
William’s Probe
Naber’s Probe

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Describe a BPE Probe

0.5mm ball point end

Black band from 3.5mm - 5.5mm

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Describe a PCP 12 Probe and when it is used

Black bands from 3-6mm and 9-12mm

Used for 6 point pocket charts

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Describe a UNC probe

Bands every mm from 1-15

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Describe a William’s probe

Black bands from 1-3, 5 and 7-10mm

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What is the Naber’s probe used for

Used for measuring furcation areas

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Describe a BPE score of 0

Black band of CPITN probe is completely visible
No probing depths of >3.5mm
No bleeding on probing
No plaque retentive factors
No need for periodontal treatment

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Describe a BPE score of 1

Black band of CPITN probe is still completely visible
No probing depths >3.5mm
No plaque retentive factors
Bleeding on probing
Treatment - OHI

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Describe a BPE score of 2

Black band of CPITN probe still completely visible
No probing depths of >3.5mm
Plaque retentive factors present
Bleeding on probing
Treatment - OHI, removal of plaque retentive factors including all supra- and sub-gingival calculus

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Describe a BPE score of 3

Black band of CPITN probe partially visible
Probing depths of between 3.5mm and 5.5mm
Bleeding can occur
Plaque retentive factors often present
Treatment - OHI, RSD

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Describe a BPE score of 4

Black band of CPITN probe no longer visible
Probing depths greater than 6mm
Bleeding can occur
Plaque retentive factors often present
Treatment - OHI, RSD, assess the need for more complex treatment, referral to a specialist may be needed

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Describe furcation involvement and how it is treated

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Measure of intra-radicular bone loss
Use a Naber’s probe to assess it grade 1-3
Treatment - OHI, RSD, assess the need for more complex treatment, referral to a specialist may be required

What is a 6 point pocket chart

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A specialist investigation used to gather more information about the level of periodontal disease the patient has

When should a six point pocket chart be taken

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A full mouth 6PPC is any sextant scores a BPE 4/* or if more than one sextant scores a BPE 3

Which surfaces of teeth are examined in a 6PPC

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Palatal/lingual:
Mesial
Mid
Distal

Buccal:
Mesial
Mid
Distal

What does a 6PPC measure

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Position of gingival margin
Probing depths
Clinical attachment loss
Bleeding on probing
Mobility
Furcation involvement

What is the position of the gingival margin and how is it measured

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Where the gingiva sits in relation to the ACJ

Measured using the PCP12 probe

What are probing depths and how are they measured

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The depth of the periodontal pocket being measured

Measure from the base of the pocket to the gingival margin using a PCP12 probe

What is clinical attachment loss

A measure of how much supporting tissue attachment has been lost in relation to periodontal health where there would be little/no attachment loss

How is clinical attachment loss calculated

By adding the position of the gingival margin to the probing depths

What is important to note during the calculation of clinical attachment loss

Sometimes the gingival margin can sit coronal to the ACJ (swelling, hyperplasia etc.) In this case, the position of the gingival margin is given a negative value

How is tooth mobility measured

With the ends of two rigid instruments eg - mirror and probe, or with one instrument and a finger

Describe a tooth mobility score of 0

‘Physiological’ mobility measured at the crown level | The tooth is mobile within the alveolus to approximately 0.1 - 0.2mm in a horizontal direction

Describe a tooth mobility score of 1

Increased mobility of the crown of the tooth to, at the most, 1mm in a horizontal direction

Describe a tooth mobility score of 2

Visually increased mobility of the crown of the tooth exceeding 1mm in a horizontal direction

Describe a tooth mobility score of 3

Severe mobility of the crown of the tooth in both horizontal and vertical directions, impinging on the function of the tooth

How is furcation involvement measured

In thirds: Grade 1 = 1/3 of the tooth width Grade 2 = 2/3 of the tooth width Grade 3 = 3/3 or 100% of the tooth width

Name the different scalers used in perio patients

``` Colombia Curette Mini-Sickle Hoe 134-135 Hoe 156-157 Gracey 1-2 Gracey 7-8 Gracey 11-12 Gracey 13-14 ```

Describe a Colombia Curette scaler

``` Red 2 cutting edges Used for all tooth surfaces Used sub gingivally Semi-circular cross-section ```

Describe a Mini-Sickle scaler

``` Red 2 cutting edges Used on buccal and lingual surfaces Used supra-gingivally Triangular cross-section ```

Describe a Hoe 134-135 scaler

Yellow Removes gross caries Used on buccal and lingual surfaces Used supra- and sub-gingivally

Describe a Hoe 156-157 scaler

Red Removes gross caries Used on mesial and distal surfaces Used supra- and sub-gingivally

Describe a Gracey 1-2 scaler

``` Grey 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on anterior teeth Used on all surfaces ```

Describe a Gracey 7-8 scaler

``` Green 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on posterior teeth Used on buccal and lingual surfaces ```

Describe a Gracey 1-12 scaler

``` Orange 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used on posterior teeth Used on the mesial surface ```

Describe a Gracey 13-14 scaler

``` 1 cutting edge Used for fine/deep scaling Used sub-gingivally Used in posterior teeth Used on the distal surface ```

What is TIPPS

An intervention used to help patient change their behaviour/attitude towards their oral hygiene routine, there are 5 steps

Name and describe the steps of TIPPS

Talk - to the patient about the causes of periodontitis Instruct - on the best ways to ensure plaque removal Plan - put into place a plan which specifies how the patient will incorporate the given instructions into their routine Practice - ask the patient to practice cleaning their teeth in the dental surgery Support - the patient at subsequent visits

Perio Revision Flashcards

(44 cards)