Periodontology Flashcards
(264 cards)
1
Q
free gingiva location
A
located at the crest of the alveolus, not attached, outer boundary of the sulcus (called free because it is unattached)
2
Q
free gingival groove location
A
located at the inferior border of free gingiva, point opposite of alveolar crest, depression
3
Q
attached gingiva location
A
located below free gingival groove, lies over underlying bone
4
Q
mucogingival junction
A
located where gingiva ends.
junction between gingival and oral mucosa
5
Q
alveolar mucosa
A
located under mucogingival junction
6
Q
gingival sulcus
A
denotes space between gingiva and tooth
7
Q
col* consists of? location?
A
consists of NONKERATINIZED TISSUE located between lingual and facial papilla
8
Q
interdental papilla
A
denotes tissue that occupies space between two adjacent teeth
9
Q
epithelial attachment
A
located at the base of the sulcus, where epithelium attaches to the tooth
10
Q
where does keratinization of the attached gingiva end
A
ends at the free gingival margin
11
Q
masticatory mucosa
A
KERATINIZED tissues
protect the gingiva and hard palate
keratinization of the attached gingiva ends at the free gingival margin
12
Q
lining mucosa? contains what areas
A
NONKERATINIZED TISSUES:
alveolar mucosa, soft palate, vestibular mucosa, buccal mucosa, and sublingual area as well as the sulcular and junctional epithelium
13
Q
lining mucosa typically supports what
A
removable partial denture
14
Q
specialized mucosa
A
dorsum of tongue
15
Q
oral mucosa is composed of what layers and separated by what
A
composed of a stratified squamous epithelial layer and a connective tissue/lamina propria and are
separated by basement membrane
16
Q
what is the prominent cell in the PDL**
A
fibroblasts
17
Q
what are fibroblasts in the PDL responsible for
A
collagen synthesis and degradation
18
Q
what is the healthy collar of tissue around the around the neck of the tooth*
A
gingival sulcus
19
Q
in a healthy situation, gingival sulcus is called
A
gingival sulcus
20
Q
in a periodontal situation, gingival sulcus is called
A
21
Q
oral mucosa is what layer*
A
stratified squamous epithelial layer
22
Q
3 types of mucosa
A
- masticatory mucosa
- lining mucosa
- specialized mucosa
23
Q
lamina propria aka
A
connective tissue
24
Q
connective tissue (lamina propria) underlies the _____ in the _____
A
connective tissue (lamina propria) underlies the _stratified squamous epithelium____ in the _oral mucosa____
25
connective tissue (lamina propria) encircles
the tooth
26
connective tissue (lamina propria) contains
blood vessels, nerve endings
is vascular and has nerve tissue
27
connective tissue (lamina propria) contains what cells . what do these cells do
contain fibroblasts,
they produce collagen and elastic fibers
28
what gives connective tissue (lamina propria) its strength
collagen
29
rete pegs*
epithelial extensions that project into underlying connective tissue. (think stakes in the ground to prevent tent from flying away)
30
rete pegs purpose*
aid in increased strength between the epithelium and connective tissue and enable the epithelium to obtain its blood supply from the connective tissue papilla
31
rete pegs hold what together
hold epithelium and connective tissue together
32
marginal tissue is stippled or not stippled *****
marginal tissue is NOT stippled
33
attached gingiva is stippled or not stippled
attached gingiva is STIPPLED****
34
attached gingiva is stippled or not stippled
attached gingiva is STIPPLED****
35
rete pegs give the observation of
stippling
36
PDL consists of what tissue and connect what
connective tissue (collagen)
connect tooth to bone
37
is PDL visble on radiographs
NO
38
PDL is not visible on a radiograph, but the PDL space can be seen as what
radiographic lucency surrounds the root of the tooth
39
widening of PDL space on radiograph can indicate what
occlusal trauma
40
PDL has _____ endings but no _____
PDL has __nerve___ endings but no __blood vessels___
41
PDL functions (4)
- resists the impact of occlusal forces (shock absorber)***
-attach cementum to the bone by sharpeys fibers****
-transmit occlusal forces, touch, pressure, and pain through sensory nerve fibers
-protect nerve and vessels from injury by surrounding root with soft tissue
42
sharpeys fibers anchor into
anchor into cementum
43
Principal fiber groups ***
transseptal
alveolar crest
horizontal
oblique
apical
interradicular
44
transseptal--- trans=across. septal= bony septum
45
transseptal connect
tooth to tooth.
they extend interproximally over the alveolar crest, embedded in the cementum of two adjacent teeth
46
transseptal fibers are adjusted during*****
orthodontic treatment (get moved/stretched during ortho)
47
alveolar crest fibers
located apically to the junctional epithelium and extend obliquely to the cementum to the alveolar crest
48
horizontal group
extend at right angles to long axis of tooth
(horizontally
49
oblique
extend from cementum in a coronal direction to the bone
50
which fiber withstands the masticatory stress in a vertical direction***
oblique
51
***what is the largest and most significant fiber group
oblique
52
apical
extend from cementum at root apex to the base of socket
53
interradicular: inter=between. radicular= root
in between the root
54
interradicular
found between root
found only in multirooted teeth.
extend from cementum at furcation to bone in furcation area
55
****interradicular tooth is only present in which teeth
multirooted teeth
56
sulcular fluid aka
crevicular fluid ,gingival crevicular fluid
57
definition: sulcular fluid (crevicular fluid ,gingival crevicular fluid)
a serum-like fluid that passes from the connective tissue (lamina propria) and flows into the gingival crevice
58
sulcular fluid (crevicular fluid ,gingival crevicular fluid) contains what elements
calcium, sodium, phosphorus, along with cells and bacteria
59
how much sulcular fluid (crevicular fluid ,gingival crevicular fluid) do you have in health vs inflammation
flow is minimal to absent in health
increases due to inflammation from plaque accumulation
60
sulcular fluid (crevicular fluid ,gingival crevicular fluid) presence of fluid depends on
the rate of passage is dependent on the absence or presence of inflammation in the connective tissue
61
purpose of sulcular fluid (crevicular fluid ,gingival crevicular fluid)
cleanses the sulcus
62
how can sulcular fluid (crevicular fluid ,gingival crevicular fluid) be destructive
can provide a source of nutrients for subgingival bacteria & supports subgingival calculus formation
63
what can be released in sulcular fluid (crevicular fluid ,gingival crevicular fluid) and example
some antibiotics are concentrated in this fluid.
ex: tetracycline
64
how is cementum arranged***
arranged in layers or lamellae
like a rings in tree
65
patterns of formation for cementum
the continuous process with periods of greater and lesser activity.
forms more readily at the apex
66
acellular cementum does not contain
does not contain cells
67
cellular cementum does contain
does contain cells
68
acellular cementum is located more
coronoal
69
cellular cementum is located more
apical
70
acellular cementum contains calcified _____
what is their significant role
calcified Sharpey's fibers
play a significant role in supporting the tooth in the socket
71
cellular cementum contains less _____ and fewer______
cellular cementum contains less __calcification___ and fewer___sharpeys fibers___
72
cellular cementum compensated for
lost tooth crown length that occurs with attrition
73
cementum consists of ____ tissue covering ________
cementum consists of _calcified__ tissue covering ___tooth root _____
74
CEJ defines the
tooth's anatomic crown
75
CEJ is useful in assessing
useful in assessing attachment loss
76
what is the most common CEJ orientation****
overlap
cementum overlapping the enamel 60% of cases
77
what forms first, enamel or cementum
enamel
78
bone is referred to
alveolar process
79
alveoli are
tooth sockets
alveoli- multiple
alveolus- one
80
cancellous bone is
spongy, trabeculae pattern
81
cortical bone
is smooth bone
82
interdental septum
bone in the interdental space.
area of bone between teeth
83
bone coverings are composed of
composed of vascular connective tissue containing osteogenic cells
84
periosteum
covers outer bone surface
85
endosteum
covers inner bone surface
86
alveolar bone shape is determined by
size and shapes of crowns of approximating teeth
87
are there periodontal pockets in gingivitis?
NO PERIODONTAL POCKETS *
88
dental plaque-induced gingivitis Is associated with only
PLAQUE ONLY
89
dental plaque-induced gingivitis is modified by
systemic factors, nutrition, endocrine disorders, blood dyscrasias, drug-induced enlargements
90
for non-dental plaque-induced gingivitis will debridement help
debridement will not help because the gingivitis is not related to the plaque
91
non-dental plaque-induced gingivitis can be caused by
viral, fungal, bacterial, or genetic in origin
it is a gingival manifestation of systemic conditions
foreign body reactions
92
gingivitis results from the******* important questions
ulceration of the sulcular lining/base of the sulcus
93
if you have a patient with non-dental plaque-induced gingivitis you would***
refer the patient to a primary case physician to evaluate the etiology of disease
94
gingival inflammation can also be caused by
open contacts and subgingival margins of restorations
example- patient complaint of fraying of floss
95
necrotizing periodontal disease are in what patients ****
patients with no known systemic disease or immune dysfunction
96
*****microbe associated with necrotizing periodontal disease
spirochetes & vibrios
97
what is encouraged for necrotizing periodontal disease
antiobiotic therapy is encouraged
98
what is the drug of choice for necrotizing periodontal disease? and why******
the drug of choice is tetracycline because it is released in GCF
- it has anti-collagenase properties (antibiotic stops the enzyme)
99
tetracycline is intrinsic or extrinsic
intrinsic
100
NUG and NUP primary sign**
punched out papilla
101
NUG affects the what component of the periodontium***
the interdental gingival component of the periodontium
102
NUG and NUP signs and symptoms
primary- punched out papilla*
pseudomembrane
fetid odor
pain
severe inflammation
103
is a patient has punched out papilla, what disease do they have*
NUG or NUP
104
you only stage and grade if the patient has *
active periodontal disease
105
staging
severity
106
grading predicts
rate of progression of disease + risk factors
107
________ is not a diagnosis.
Diagnosis is _________
___staging and grading_____ is not a diagnosis.
Diagnosis is _periodontitis_____*
108
staging and grading help clarify
clarify extent, severity & complexity to potential rate of disease progression (how complex it is to treat the patient)
109
a patient who has a history of periodontitis is considered what and why?
an at-risk patient because they require a more intensive level of maintenance and evalulation
110
a stable perio patient should not return to*
to a level of evaluation and maintenance identical to a patient who has never had periodontitis
111
stage 1- disease severity
mild disease
112
stage 1 probing depths and cal
<4 mm
CAL- <1-2mm
113
stage 1 bone loss
horizontal bone loss
114
stage 1 treatment
non-surgical treatment
115
we should not be able to see patients CEJ
116
stage 1 post-treatment
no post-treatment tooth loss is expected
this indicated the case has a good prognosis going into maintenance
117
stage 2 disease
moderate disease
118
stage 2 probing depths + CAL
<5 mm- max probing depth
CAL: <3-4 mm
119
stage 2 bone loss
horizontal bone loss
120
stage 2 treatment requirement
will require non-surgical and surgical treatment
121
stage 2 post-treatment expectations
no post-treatment loss is expected , indicating the has a good prognosis going into maintenance (same as stage 1)
122
stage 3 disease
severe disease
123
stage 3 probing depths + cal
>6mm or greater
CAL->5mm
124
stage 3 bone loss
vertical or angular bone loss/ furcation involvement of class 2 or class 3
125
stage 3 treatment
requires surgical and possibly regenerative treatment
126
stage 3 risk
risk of losing teeth (0-4 teeth )
could have already lost 4 or less teeth
127
stage 3 prognosis
fair prognosis going into maintenance
128
stage 4 disease
very severe disease
129
how long will stage 4 remain
stage 4 will remain stage 4 for life
130
can stage 3 become stable?
stage 3 can become stable on a reduced periodontium
131
stage 4 bone loss
(same as s3)
may have vertical bone loss and/or furcation involvement of class 2 or 3
132
stage 4 probing depths and CAL
(same as S3)
probing depths >6mm
CAL : >5MM
133
stage 4 tooth loss*******
possibly fewer than 20 teeth remain
the patient has lost or will lose 5 or more teeth******
134
stage 4 treatment
will often require multi-specialty treatment
advanced surgical treatment/regenerative therapy may be required
very complex implant/restorative treatment may be needed
135
stage 4 prognosis
questionable prognosis going into maintenance
136
what is more common. staging or grading
garding is more common
137
what does grading aim to do
aims to indicate the rate of periodontitis progression, responsiveness to standard therapy and potential impact on systemic health
138
grade A speed
slow rate
139
grade B rate
moderate rate
140
grade C rate
rapid rate
141
direct evidence for grading
probing depths and radiographs over 5 years
142
indirect evidence for grading
amount of bone loss a patient has based on age
amount of debris in the mouth and how the body responds to debris (how much destruction there is )
143
grading modifiers
smoking status
diabetes status
144
where is CDC located
atlanta georgia
145
1999 used what descriptions of stage
used slight, moderate, and sever periodontitis and could be divided into severity levels in different parts of the mouth
146
the new classification on introduced what view
a multidimensional view based on full-mouth diagnosis
147
***a diagnosis of periodontitis is determined first with
staging and grading providing supplemental data
148
which area determines the stage
the area with the most severe destruction
149
a perio patient who has been treated and is now stable should receive what maintenance
they should not return to a level of evaluation and maintenance identical to a patient who has never has periodontitis
150
a maintenance patient with active sites becomes an
unstable case of recurrent periodontitis
151
***does the patient typically drop down to a lower stage?
NO
152
what does periodontitis as a manifestation of systemic disease mean
it means if the patients have any of those diseases it will manifest into periodontitis
153
familial and cyclic neutropenia oral manifestations
recurrent aphthous ulcers
episodic periodontitis
154
neutropenia means
disease or problem associated with neutrophils
155
down syndrome aka
trisomy 21
156
in down syndrome patients congenital heart defects are seen in what % of cases
30-55% of cases
(patients can be premedicated because heart defects)
157
down syndrome patients have a higher incidence of
cleft lip or palate
158
in down syndrome what occlusion can occur
prognathism/protrusion of mandible,
posterior cross bite
severe crowding
159
in down syndrome what occlusion can occur
prognathism/protrusion of the mandible,
posterior crossbite
severe crowding
160
in down syndrome patients we can see macroglossia which is
the enlargement of tongue
161
in down syndrome what we can see what sizes of tonsils / nasopharynx and can see what condition
- open mouth
- small/narrow nasopharynx
-enlarged tonsils
- can see xerostomia
162
leukocyte adhesion deficiency syndrome can be classified as
periodontitis as a manifestation of systemic disease
163
what systemic disorders can be classified as periodontitis as a manifestation of systemic disease (12)
familial and cyclic neutropenia
down syndrome
leukocyte adhesion deficiency syndrome
Papillion-le feuvre syndrome
Chediak-Higashi syndrome
Histiocytosis syndromes
glycogen storage syndrome
infantile genetic agranulocytosis
cohen syndrome
Ehlers-danlos syndrome
hypophosphatasia
associated with hematological disorders: acquired neutropenia
164
how does Papillion-le feuvre syndrome show up
shows as hyperkeratosis (palmar-plantar)- meaning there is an overgrowth of keratinization on the palms and base of the foot
165
Papillion-le feuvre syndrome can cause what of the periodontal attachment apparatus
generalized rapid destruction
neutrophil defects
166
chediak-higashi syndrome is an inherited disorder of
impaired neutrophil chemotaxis
167
chediak-higashi syndrome can demonstrate
osteogenesis imperfect and premature loss of teeth
168
gingival abscess is
an abscess of the periodontium limited to the gingival margin or interdental papilla without the involvement of deeper structures of the periodontium
limited to gingiva
likely wont see attachment loss or bone loss associated with this
169
gingival abscess results from****
the injury to or an infection of surface gingival tissue
170
gingival abscess: pulp, location, pain?
vital pulp, localized, constant pain
171
periodontal abscess
usually occurs in a site with pre-existing periodontal disease, and affects the deeper structures of the periodontium
172
periodontal abscess: pulp, location, pain?
vital pulp, localized, constant pain
173
a periodontal abscess can result from***
infection spreading deep into periodontal pockets and drainage is blocked
****may develop from incomplete scaling(clinician cause*****
174
pericoronal abscess develops where? ****
develops in inflamed dental follicular tissue overlying the crown of a partially erupted tooth*
streptococci milleri are likely involved
175
flap of tissue is called
operculum
176
what bacteria can be involved with pericoronal abscess***
streptococci milleri are likely involved **
177
periapical abscess= endodontic-periodontal lesion
178
systemic diseases of conditions affecting periodontal supporting tissues (5)
diabetes (two way street with perio)
obesity
osteopopsis
rheumatoid arthritis
tobacco dependence
179
the level of glycemic control in diabetes influences the
grading of periodontitis
180
diabetes should be included in
a clinical diagnosis of periodontitis as a descriptor
181
compared to women with normal bone and mineral density, postmenopausal women with osteoporosis or osteopenia exhibit what?
exhibit a modest but significantly greater loss of periodontal attachment loss
181
recent meta-analyses show a significant positive association between ___ and ___
recent meta-analyses show a significant positive association between obesity and periodontitis
182
mucogingival deformities and conditions around teeth (6)
(changes in display)
gingival/soft tissue recession
lack of keratinized gingiva
decreased vestibular depth
aberrant frenum/muscle position
gingival excess
abnormal color
183
fenstration*
bone loss occurring apically
hole in the fence
184
dehiscence
bone loss moving from the margin
185
primary occlusal trauma
excessive force on a tooth with normal bone support
- is reversible******
no bone loss occurred
186
secondary occlusal trauma
normal or excessive force on a tooth with loss of support
187
signs and symptoms of occlusal trauma
- increased mobility**
-tooth migration
-sensitivity
-radiographic widening of the PDL space (no BOP)
188
a tooth in traumatic occlusion will demonstrate
wear facets
189
for a patient who is peri-implant health*
you do not need to do tx
190
for a patient who is peri-implant mucositis*
is reversible (gingivitis)
191
peri-implant diseases and conditions (4)
peri-implant health
peri-implant mucositistis
peri-implantitis (irriversible)
peri-implant soft and hard tissue deficiencies
192
hypertrophy
gingival enlargement due to an increase in cell size
193
hyperplasia
gingival enlargement due to an increase in cell numbers
194
****what is the primary factor in the reduction or elimination of gingival and periodontal disease
plaque control*****
195
local etiology of plaque
the ability for plaque to adhere dramatically impacts the risk that plaque will impact oral disease
things that allow more plaque to accumulate
196
plaque retentive factors- 3
irritating restorations (overhang)
food impactions (open contacts)
poor fitting crown margins
197
mineralized plaque is calculus
198
mineralized plaque sources of minerals
become mineralized through precipitated salts in saliva and crevicular fluid
199
inorganic content of calculus
mainly calcium phosphate with lesser amounts of calcium carbonate
200
supragingival calculus mineralization results from
saliva deposits occur on buccal surfaces of maxillary molars opposite to Stenson's duct and mandibular anterior teeth opposite to Wharton's duct
201
subgingival calculus mineralization results from
gingival crevicular fluid depoisits occur on all root surfaces in sulcus or pockets
and is more difficult to remove than supra calc
202
*tobacco use significantly influences the progression of
periodontal disease
203
tobacco users exhibit
greater bone loss, increased pocket depths, and calculus formation
204
tobacco use alters _________. this reduces what?
periodontal tissue microvasculature (shrinks microcapillaries) which means less bleeding
this reduces immunoglobin levels and antibody responses to bacterial plaque and biofilm
205
tobacco users are less likely to develop
aphthous ulcers
206
tobacco cessation may cause
recurrent aphthous stomatitis
207
is hairy leukoplakia associated with smoking?
NO
208
what is hairy leukoplakia associated with
Epstein Barr Virus
209
Normal Radiographic Bone Patterns (4)
- crest of alveolar bone is typically 1-2mm apical to the CEJ
-contour of the bone follows the contour of the CEJ
(bone in the interdental space follows bone of the contacts) will be a pointer in the anterior contacts and wider in the posterior because wider contacts )
- uniform PDL space
-intact lamina dura
210
Horizontal bone loss radiographic findings
-typically indicated by >2mm loss of bone height from the CEJ
211
vertical bone loss radiogarphically
loss of bone in the furcal space
212
gingiva color in health
pink or coral pink or melanin pigmentation
213
gingiva contour in health
not enlarged, fits tightly around the tooth
214
gingiva consistency in health
firm, attached gingiva firmly bound
215
gingiva texture in health
free gingiva is smooth
attached gingiva is stippled
216
no bleeding is a criterion for healthy tissue
217
gingiva color in disease (acute & chronic)*
blue: venous blood, highly vascular
acute: erythema, red associated with inflammation
218
gingiva contour in disease (acute & chronic)*
enlarged, swollen, blunted, hyperplastic, festooned (rolled margins)
219
gingiva consistency in disease (acute & chronic)*
acute: soft, spongy, with loss os stippling
chronic: disease is firm, hard, stippled and FIBROTIC *
220
gingiva texture in disease (acute & chronic)*
acute: edematous. vasodilation of the peripheral circulation is noted in edema
chronic: fibrotic. highly stippled due to an increase in cellular components
221
hallmark sign of acute inflammation
edematous
222
hallmark sign of chronic inflammation
fibrotic
223
bleeding on probing is a significant indicator of
inflammation
224
bleeding on probing indicated
diseased gingiva
225
ulcerated pocket wall bleeds ******
226
probe is what type of instrument***
calibrated instrument***
227
what do probing depths depict
the distance in mm from the gingival margin to the base of the sulcus or the pocket as measured with a calibrated probe
allows us to measure the sulcus or pocket
228
Assessment of normal tissue with a probe
the junctional epithelium offers more resistance (tissue will push back and we know to stop probing)
- probing is stopped by the coronal portion of the junctional epithelium
229
Assessment of gingivitis & early perio with a probe
the JE offers less resistance
the probe passes farther into the JE
230
Assessment of advanced perio with a probe
the JE offers little to no resistance
probe may penetrate JE to reach the attached connective tissue fibers
(can probe all the way to connective tissue)
231
suprabony pocket*
base of the pocket is coronal to the alveolar bone
(supra means above)
above the bone
horizontal bone loss lead to suprabony pocket
232
infrabony pocket********
the base of the pocket is apical to the crest of the alveolar bone
233
what is furcation grade measuring
invasion of periodontal infection into the area between and around the roots
234
class 1 furcation*
curvature of concavity can be felt with probe tip; the probe penetrates no more than 1 mm
235
class2 furcation*
the probe tip penetrates into furcation greater than 1mm but does not pass through
236
class 3 fucation*
probe passes completely through furcation, but is not clinically visible
237
class 4 furcation*
probe passes through and through
entrance to furcation is clinically visible because of the recession of the gingival margin
238
CAL demonstrates what
enlargement, normal, and recession sites
239
mucogingival examination determines the
width of the attached gingiva; used to determine width of attached gingiva, used to determine the amount of attached gingiva present
240
to calculate the width of the attached gingival
subtract the probing depth from the distance between the gingival crest to the mucogingival junction
241
width of the attached gingival is not calculated for
lingual (palatal) surfaces
242
mobility grade is checked with *
two hard-handled instruments *
243
pathologic tooth migration is indicative of
severe periodontis
244
mobility grade 1
perceptible mobility <1mm in buccolingual direction
245
mobility grade 2
>1mm but <2mm in horizontal direction
246
mobility grade 3
>2mm or depressibility in the socket (horizontal and/or vertical mobility
247
fremitus definition and what it is checked with
the palpable vibration of root surfaces when the patient taps their teeth together
checked with the pad of the index finger against the tissue overlying the root
248
what is periodontal surgery
advanced procedures to address periodontal challenges
249
gingivectomy *
used to treat pseudopocketing and hyperplasia
250
most common surgical procedure for pocket reduction is
gingivectomy
251
2 osseous surgeries *
osteoplasty- remodeling the bone
osteoectomy- removing the bone
252
in osseous surgery, sutures are used to
close incisal edges and decrease the distance cells must travel for wound healing
253
pneumatization
a condition in which there is a connection from the sinus to an extraction site
tooth has been extracted and sinus drops in the extraction site (maxilla)
in this area you cannot do an implant you will have to do sinus lift
254
healing of the periodontium involves :
fibrous repair via proliferation of fibroblasts
255
healing of periodontium steps
1. blood clotting
2. wound cleansing
3, rebuilding tissue
4. wound remodeling
256
healing of periodontium step 1 : blood clotting
clot forms scaffolding with fibrin and platelets for PMN's and macrophages to migrate
257
healing of periodontium step 2 : wound cleansing
macrophages ingest debris/debride clot. PMN's attack bacteria
258
healing of periodontium step 3 : rebuilding tissue
fibroblasts deposit collagen
resulting tissue is edematous and highly vascular - "granulation tissue"
259
healing of periodontium step 4 : wound remodeling
granulation tissue is remodeled into scar tissue via the long junctional epithelium
260
what primarily treats infrabony defects
periodontal regenerative procedures
261
reversible pulpitis
mild pulpal inflammation resulting from placement of a deep restoration; associated with episodic temperature-related pain
262
occlusal trauma does not effect
the attached gingiva
263
occlusal trauma does not cause gingivitis or periodontits because...
the junctional epithelium is not affected by occlusal trauma
