periodontology 1 Flashcards
(24 cards)
SYMBIOSIS
• DYNAMIC BALANCE EXISTS BETWEEN
RESIDENT COMMUNITIES OF
MICROORGANISMS AND THE HOST
DYSBIOSIS
• DISEASE RESULTS FROM A BREAKDOWN OF
THIS DELICATE RELATIONSHIP
GINGIVITIS
NON-SPECIFIC, REVERSIBLE INFLAMMATORY
RESPONSE TO AN INCREASED ACCUMULATION
OF BIOFILM AROUND THE GINGIVAL MARGIN
PERIODONTITIS
AN INFLAMMATORY DISEASE AFFECTING ALL OF THE PERIODONTAL STRUCTURES CAUSED BY PLAQUE
• THERE IS A LOSS OF ATTACHMENT
• THERE IS A LOSS OF BONE HEIGHT
HOW DO WE RECORD AND MONITOR GINGIVAL
HEALTH AND DISEASE?
- BPE-TELLS US WHAT’S HAPPENING
- PLAQUE AND BLEEDING SCORES-TELL US HOW MUCH PLAQUE IS PRESENT, AND THE PATIENT’S
ADHERENCE TO ORAL HYGIENE - PHOTOS (USEFUL FOR MEMORY, AND MOTIVATION!)
- CPE
O’LEARY PLAQUE SCORE
- DISCLOSE THE TEETH
- THE PRESENCE OF PLAQUE AT THE GINGIVAL MARGIN IS RECORDED FOR ALL TEETH AT 4 SITES:
MESIO-BUCCAL, BUCCAL, DISTO-BUCCAL, LINGUAL/PALATAL. - THE NUMBER OF SITES WITH PLAQUE IS EXPRESSED AS A PERCENTAGE OF THE TOTAL NUMBER OF SITES IN THE MOUTH
CPE
- PROBING POCKET DEPTH
- BLEEDING ON PROBING (FROM THE BASE OF THE POCKET)
- PUS ON PROBING
- TOOTH MOBILITY
- FURCATION INVOLVEMENT
- RECESSION
HOW ARE POCKETS MEASURED?
WE USE A GRADUATED PERIODONTAL PROBE (METAL OR PLASTIC) WHICH IS 0.5MM AT THE TIP
• THE THIN TIP ALLOWS THE PROBE TO ENTER A NARROW POCKET
• IT IS BLUNT SO THAT IT DOES NOT PERFORATE THE TISSUES
WHAT DETERMINES HOW MUCH A PROBE WILL PENETRATE BEYOND THE GINGIVAL
MARGIN?
- CALCULUS/RESTORATIONS/CAVITIES SUBGINGIVALLY
- THE INTEGRITY OF THE EPITHELIAL BARRIER
- SIZE/SHAPE/TIP OF PROBE
- OPERATOR PRESSURE
- PATIENT’S REACTION!
- WHETHER LOCAL ANAESTHETIC IS USED
WHAT DO WE USE TO MEASURE TOOTH MOBILITY
WE USE MILLER’S CLASSIFICATION (1950)
MILLER’S CLASSIFICATION GRADE 1
SLIGHT MOBILITY, LESS THAN 1MM IN A HORIZONTAL DIRECTION
MILLER’S CLASSIFICATION GRADE 2
MOBILITY 1-2 MM IN A HORIZONTAL DIRECTION
MILLER’S CLASSIFICATION GRADE 3
MOBILITY OVER 2MM IN ANY DIRECTION
WHAT IS A FURCATION INVOLVEMENT?
THIS IS WHEN THE PROGRESSION OF PERIODONTAL DISEASE AFFECTS THE
FURCATION AREA OF A MULTI ROOTED TOOTH
WHAT IS USED TO MEASURE FURCATION?
NABERS PROBE
CLASSIFICATION BY HAMP ET AL. (1975)
CLASS 1
CLASS 1 LOSS OF HORIZONTAL PERIODONTAL SUPPORT NOT EXCEEDING
ONE THIRD OF THE WIDTH OF THE TOOTH
CLASSIFICATION BY HAMP ET AL. (1975)
CLASS 2
LOSS OF HORIZONTAL PERIODONTAL SUPPORT EXCEEDING ONE THIRD OF THE WIDTH OF THE TOOTH, BUT NOT ENCOMPASSING THE TOTAL WIDTH OF THE FURCATION AREA
CLASSIFICATION BY HAMP ET AL. (1975)
CLASS 3
HORIZONTAL ‘THROUGH AND THROUGH’ DESTRUCTION OF THE
SUPPORTING TISSUES IN THE FURCATION
RECESSION
• RECESSION IS THE EXPOSURE OF THE ROOTS OF THE TEETH CAUSED BY A LOSS
OF GUM TISSUE AND/OR RETRACTION OF THE GINGIVAL MARGIN AND IS THE
DISTANCE MEASURED FROM THE CEJ TO THE GINGIVAL MARGIN
ATTACHMENT LOSS
THIS IS DEFINED AS THE APICAL MIGRATION OF THE JE FROM ITS ACCEPTED NORMAL POSITION AT THE CEJ, IN CONJUNCTION WITH THE LOSS OF CONNECTIVE TISSUE ATTACHMENT
WHY DOES LOSS OF ATTCHMENT OCCUR?
LOSS OF ATTACHMENT OCCURS AS A RESULT OF PERIODONTAL PATHOGENETIC DESTRUCTION
WHAT MUST OCCUR IF THE JE IS TO MIGRATE SIGNIFICANTLY
BONE LOSS MUST OCCUR IF THE JE IS TO MIGRATE SIGNIFICANTLY
LOA
LOA
• IT IS THE DISTANCE FROM THE CEMENTO-ENAMEL JUNCTION TO THE LOCATION OF
THE INSERTED PROBE TIP
• BUT! WE MEASURE THE DISTANCE FROM THE PROBE TIP TO THE OBSERVABLE GINGIVAL
MARGIN
• IF THERE IS RECESSION THEN LOSS OF ATTACHMENT/CLINICAL ATTACHMENT LOSS=
RECESSION PLUS THE PROBING DEPTH
