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Flashcards in Perio Revision Deck (44)
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1

Name the important pathogenic bacteria in periodontitis

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

2

Describe an overactive immune response for periodontitis

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

3

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

4

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

5

Give examples of local risk factors of periodontitis

Calculus
Overhanging restorations

6

What is another common risk factor in periodontitis

Poor dental attendance

7

Name the different probes used in perio patients

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

8

Describe a BPE Probe

0.5mm ball point end
Black band from 3.5mm - 5.5mm

9

Describe a PCP 12 Probe and when it is used

Black bands from 3-6mm and 9-12mm
Used for 6 point pocket charts

10

Describe a UNC probe

Bands every mm from 1-15

11

Describe a William’s probe

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

12

What is the Naber’s probe used for

Used for measuring furcation areas

13

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

14

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

15

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

16

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

17

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

18

Describe furcation involvement and how it is treated

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

19

What is a 6 point pocket chart

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

20

When should a six point pocket chart be taken

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

21

Which surfaces of teeth are examined in a 6PPC

Palatal/lingual:
Mesial
Mid
Distal

Buccal:
Mesial
Mid
Distal

22

What does a 6PPC measure

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

23

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

Where the gingiva sits in relation to the ACJ
Measured using the PCP12 probe

24

What are probing depths and how are they measured

The depth of the periodontal pocket being measured
Measure from the base of the pocket to the gingival margin using a PCP12 probe

25

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

26

How is clinical attachment loss calculated

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

27

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

28

How is tooth mobility measured

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

29

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

30

Describe a tooth mobility score of 1

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

31

Describe a tooth mobility score of 2

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

32

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

33

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

34

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

35

Describe a Colombia Curette scaler

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

36

Describe a Mini-Sickle scaler

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

37

Describe a Hoe 134-135 scaler

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

38

Describe a Hoe 156-157 scaler

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

39

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

40

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

41

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

42

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

43

What is TIPPS

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

44

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