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DMD6350 - perio > periodontal diagnosis, prognosis and tx planning > Flashcards

periodontal diagnosis, prognosis and tx planning Flashcards

1
Q

chief complaints with periodontal disease

A

bleeding gums, bleeding on brushing, dull generalized pain, mobility of teeth

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2
Q

t/f PSR is recorded in sextants

A

yes. the probe has a 0.5mm ball at the end so the first line up is 3.5mm. the highest score is recorded for each sextant

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3
Q

psr code 0

A

colored area of probe is visible in deepest cervice. no calculus or defective margins, tissues are healthy with no bop

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4
Q

psr code 1

A

same thing as 0 but there is bop (gingivitis).

DO A PROPHY

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5
Q

psr code 2

A

colored area of probe is visible in deepest probeing depth. supra/subgingival calculus and defective margins (overhangs)
CALCULUS AND PLAQUE REMOVAL, CORRECT OVERHANGS

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6
Q

psr code 3

A

colored area partly visible (between 3.5-5.5mm)

COMP EXAM and CHARTING (probe, mobility, recession, furcation, radiographs)

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7
Q

psr code 4

A

colored area of probe completely disappears
1 section of code 4 or 2 of code 3 = full mouth exam
COMP EXAM AND CHARTING

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8
Q

psr code *

A

whenever there is a problem with codes 0, 1, 2

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9
Q

psr code X

A

edentulous sextant

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10
Q

t/f you should drag the probe and point the probe away from the tooth when perio charting

A

false. walk the probe and keep the tip on the tooth

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11
Q

what does BOP tell you

A

objective indication of inflammation

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12
Q

recession

A

distance from the cej to the gingival margin when the margin is apical to the cej (+)

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13
Q

pseudopocket/overgrowth

A

distance from the cej to the gingival margin when the gingival margin is coronal to the cej with no attachment loss (-)

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14
Q

t/f al can be present without recession

A

true

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15
Q

how do you measure the fgm if you cant see the cej

A

feel for the cejj with your rpobe and measure how much further the probe goes beyond the cej

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16
Q

pocket depth is relative to what

A

the gingival margin. you can have attachment loss without a pocket (recession)

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17
Q

mobility index I

A

1st distinguishable sign of movement greater than normal

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18
Q

mobility index II

A

movement of the crown by up to 1 mm in any direction

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19
Q

mobility index III

A

movement of crown more than 1 mm in any direction and/or vertical depression or rotation

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20
Q

what do you use to detect furcation involvement

A

nabers probe

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21
Q

how many furcations are there on mandibular molars compared to maxillary molars

A

2 mand (B/L), 3 max (B/ML/DL)

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22
Q

glickmans furcation I

A

pocket formation into the flute but intact interradicular bone

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23
Q

glickmans furcation II

A

loss of interradicular bone and pocket formation of varying depths into the furcation.
probe sticks

24
Q

glickmans furcation III

A

through and through lesion to the other side

25
Q

glickmans furcation IV

A

same as III with recession and the furca is clearly visible clinically

26
Q

max 1st: furcal aspect of the root is concave in what percent of MB roots

A

94

27
Q

max 1st: furcal aspect of root is concave in what percent of DB roots

A

31

28
Q

max 1st: furcal aspect of root is concave in what percent of P roots

A

17

29
Q

max 1st: where is the deepest furcal concavity found

A

MB root (about 0.3 mm)

30
Q

t/f the concavity in the mand 1st molar is bigger than the max 1st molar

A

true. about 0.7 mm

31
Q

mand 1st: furcal aspect of root is found in what percent of M roots

A

100

32
Q

mand 1st: furcal aspect of root is found in what percent of D roots

A

99

33
Q

why is it so hard to clean furcations

A

furcation is narrower than the instrument we use (curret) in 58% of 1st molars

34
Q

what do furcation triangle show us

A

there could be bone loss

35
Q

width of attached gingiva is the distance from

A

the bottom of the pocket to the mgj

36
Q

t/f lack of attached ging means there is loss of attachment

A

no

37
Q

how do you tell if the tissue is attached gingiva or mucosa

A

using the rolling technique, if you roll the probe and the tissue moves, it is mucosa, if not it is attached gingiva

38
Q

fremitus

A

movement of tooth when in function

39
Q

where does healthy bone lie in a radiograph

A

2mm below cej

40
Q

slight bone loss

A

loss up to 25% of root length

41
Q

moderate bone loss

A

bone loss from 25-50% of root

42
Q

severe bone loss

A

loss more than 50%

43
Q

t/f. angular/vertical bone loss can be fixed

A

true. you can place a bone graft, whereas horizontal you cannot

44
Q

what can radiographs tell you about a perio patient?

A 
bone loss (amount and type), furcation involvement, overhangs, crown root ratio (should be less than 1)
must also check clinically to further evaluate radiographic findings
45
Q

how do you classify localized aggressive perio

A

M1 and incisors

46
Q

how do you classify generalized aggressive perio

A

3+ teeth in addition to M1 and molars

47
Q

how do you classify localized perio

A

less than 30% of sites

can be slight (1-2mm), moderate (3-4) or severe (5+)

48
Q

prognosis

A

prediction of the probable course, duration, and outcome of a disease based on a general knowledge of the pathogenesis of the disease and the presence of risk factors for the disease

49
Q

when do you establish the prognosis

A

after diagnosis, before tx plan

50
Q

determination of prognosis is what kind of process?

A

dynamic

51
Q

should the prognosis be reevaluated?

A

yes. after the completion of all phases of therapy and perio maintenance

52
Q

good prognosis

A

control of etiologic factors and adequate periodontal support ensure the tooth will be easy to maintain by the patient and clinician

53
Q

fair prognosis

A

25% of AL, Class I furcation involvement

54
Q

poor prognosis

A

50% AL, Class II furcation

55
Q

questionable prognnosis

A

more than 50% AL, poor crown:root ratio, poor root form, Class II/III furcation, more than 2+ mobility, root proximity

56
Q

hopeless prognosis

A

inadequate attachment to maintain health, comfort, and function, class 3 mobility

57
Q

Tx protocol for periodontitis

A
  1. ohi and Tx plan discussion
  2. intial therapy: SRP
  3. reeval (4-6 wks) with ohi
  4. probe deph resolved (pocket 3mm or less) = perio maintenence
  5. probe deph not resolved = surgery/referral with perio maintenance

DMD6350 - perio (6 decks)

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