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PERI 5002 > Quiz 2 > Flashcards

Quiz 2 Flashcards

(67 cards)

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1
Q

What are the bacteria of concern in the mouth?

A
  • Red group: P. gingivalis, T. Forsythia, and T. denticola

- A. actino aggressive form

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2
Q

Where is the red group of bacteria located?

A

deep near the CT in the sulcus

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3
Q

How many adults in the US have periodontitis?

A

50%

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4
Q

How many adults with periodontitis have severe or aggressive perio?

A

10-11%

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5
Q

Who should get antibiotics and why?

A

People with aggressive and severe perio because they have a higher treatment complexity

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6
Q

According to a study, what has the better results: antibiotics (metronidazole with amox) or SRP (scaling and root planing)?

A

They have equal results clinically and with reducing the number of bugs

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7
Q

Why shouldn’t you treat with abx before/during non-surgical tx?

A
  • abx do not eradicate the bac completely, so you would have to continue to take it
  • most people benefit from SRP
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8
Q

What is the best time to use ABX?

A

-after reevaluation/after non-surgical tx, for people with residual pockets (when the biofilm has been disrupted)

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9
Q

How did abx affect the CAL when used with SRP?

A

-subjects gained an extra 0.5 mm

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10
Q

What are the limitations of abx?

A

-Side effects (nausea, diarrhea, hypersensitivity,etc.)

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11
Q

T/F: Local antibiotics have better clinical results than systemic antibiotics

A

False, they both averaged 0.5 mm of gain; only better because of higher concentrations and minimal side effects

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12
Q

What are the disadvantages of local abx?

A

-cost and chair time

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13
Q

What are the best abx to use?

A
  • systemic: Metronidazole with amoxicillin

- Local: minocycline

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14
Q

What is the most common reason for pain/dentin sensitivity?

A

Gingival recession (along with acid wear)

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15
Q

What type of pain is presented with dentin hypersensitiviy?

A

Short, sharp pain

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16
Q

How many patients are affected by hypersensitivity? Abrasion?

A

up to 57%; 25%

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17
Q

What are the 3 essentials of dentin hypersensitivity?

A
  • exposed dentin surfaces
  • open tubule orifices on exposed dentin
  • patent tubules leading to vital pulp
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18
Q

What is the most common contributing factor in recession?

A

Overzealous brushing

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19
Q

T/F Right handed people have more recession on right side around the molars

A

F, canines and premolars (some studies say opposite side as hand)

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20
Q

How much of dentin hypersensitivity is associated with perio therapy?

A

72.5-98%

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21
Q

What is the common therapy for early recession (1 mm)?

A

desensitizing dentifrice

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22
Q

Class I Perio

A

marginal tissue recession that doesn’t extend to the mucogingival junction

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23
Q

Class II disease

A

tissue recession that extends to or beyond mucogingival junction with no perio attachment loss in proximals

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24
Q

Class III disease

A

tissue recession to or beyond the mucogingival junction with perio attachment loss in proximals or malpositioned teeth

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25
Class IV disease
Tissue recession to or beyond mucogingival junction with severe bone/soft tissue loss or malpositioned teeth
26
Why would you use an acellular dermal allograft?
- eliminates donor site - predictable, but technique sensitive - long-term stability - useful for thickening tissue to prevent recession - useful for large areas
27
Five treatment options for sensitivity
dentifrices, restorative, root coverage surgery, varnish, lasers
28
What is a facticious injury?
Injury caused by an outside source (lip ring, fingernail, etc)
29
T/F Sub-gingival margins are the best
F, supra-gingival is the best, sub-gingival should be w/in coronal 1/2 of sulcus (.3 mm)
30
What problems are associated with sub-gingival margins?
- no access for finishing - compromises plaque control - can encroach upon biologic width
31
What is biologic width?
3 mm of tooth structure between margin and crest of bone; at LEAST 2 mm with subgingival margin
32
When is a sub-gingival margin indicated?
- esthetics - previous restorations - caries - apical extension for retention
33
T/F gingival health is better with UNDER-contoured restorations
True
34
How much space should be left between the contact area and the crest of the bone?
5 mm
35
What type of pontic design is the least desirable?
Ridge lap that straddles the entire ridge of the bone
36
What pontic design is the most hygienic?
Ovate
37
What other restorative considerations can cause recession/perio pockets?
- impressions - removable appliances - bleaching
38
T/F Bleaching procedures help control sub-gingival plaque and BOP
False, controls only supragingival plaque and reduces inflammation at gingival margin
39
In a treatment plan, when should caries and overhangs be treated?
Initial therapy--they can harbor plaque, interfere with hygiene, and cause an aggressive treatment if caries continue to progress
40
When is prosthodontic treatment performed?
AFTER active perio tx; at same time as perio maintenance
41
What perio therapy should precede restorative tx?
Initial therapy to control etiology, correction of recession, esthetic procedures, attached gingiva
42
What are clinical/radiographic signs of occlusal trauma?
widened PDL and tooth mobility
43
According to Glickman's Co-destructive Theory, where should the inflammatory infiltrate spread when no trauma present?
-Into alveolar bone (instead of PDL)
44
Does occlusal trauma cause perio/pockets?
-No! (doesn't cause attachment loss or decreased bone height)
45
Does occlusal trauma make plaque-induced perio worse?
NO
46
Does type/magnitude of occlusal trauma make a difference?
YES, when intrabony defects are also associated excessive trauma can increase attachment and bone loss
47
What should be done first in management of occlusal trauma?
resolution of perio inflammation
48
How can fremitus/pain be eliminated?
Occlusal adjustments with occlusal splint (bruxism)
49
Should teeth be splinted to manage occlusal trauma?
NO
50
How can ortho help with perio therapy?
- Corrects bony angular defects - improve crown to root ratio - preserve/increase bone volume for implants
51
When is ortho treatment performed?
After extraction of hopeless teeth and restoring caries and in conjunction with perio maintenance
52
Advantages of forced eruption for crown fabrication
- less bone removal needed - preserves adjacent teeth bones - improves crown:root - more esthetic, less loss of interdental papilla - avoid exposing furcations on adjacent teeth
53
What are risks of ortho treatment on perio?
Root resorption and gingival recession
54
Where are accessory canals mostly found?
Apical 1/3 of root, furcations (25%)
55
Perio or Endo: single, isolated deep pocket
Endo
56
Perio or Endo: Deep pocket, vital pulp
Perio
57
Perio or Endo: Deep pocket, non-vital pulp
Both: endo first, then perio then re-eval perio in 3-6 mos.
58
Perio or Endo: Better prognosis
Endo
59
What type of debridement is better for treatment of furcations?
Surgical debridement is better for calculus removal
60
Is osseous surgery better than surgical/non-surgical debridement?
Yes, less clinical breakdown
61
Tx for Class I furcation
SRP, topical antimicrobials, odontoplasty, open surgical debridement
62
Tx for Class II furcation
APF (fluoride), osseous surgery, root amputation, extraction, regeneration surgery
63
Tx for class III furcation
tunneling/root amp/hemisection, extraction
64
What are options for regenerative therapy (class II)?
osseous grafting and guided tissue regeneration
65
What are options for resective therapy (class II and III)?
Root resection and extraction/dental implant
66
What is the most common cause for failure of root resections?
Root fracture
67
Is root resection as successful as implant therapy?
yes--15 year success rate of 96.8% vs. implants: 13 year success rate of 97%

PERI 5002 (2 decks)

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