Local And Systemic Contributing Factors

Front 1

What is the definition for local contributing factors

Back 1

Oral conditions that increase an individuals susceptibility to periodontal infection in specific sites

Front 2

Do local contributing factors actually initiate gingivitis or periodontitis

Back 2

No they do not actually initiate either, only act to contribute to the disease process already initiated by bacterial plaque biofilm and host immune response

Front 3

what is a dental hygienist goal for local contributing factors

Back 3

to eliminate or minimize the impact of local contributing factors during nonsurgical periodontal treatment

Front 4

What are some examples of local contributing factors? (6)

Back 4

Dental calculus

Faulty dental restorations

Developmental defects

Dental decay

Patient habits

occlusal trauma

Front 5

What are the three primary mechanisms by which local contributing factors can increase the risk of developing periodontal disease or increase the severity of existing periodontal disease

Back 5

A local contributing factor can increase plaque biofilm retention

a local contributing factor can increase plaque biofilm pathogenicity

A local contributing factor can cause direct damage to the periodontium

Front 6

What is an example of increasing plaque retention?

Back 6

Rough edges on a restoration harbors plaque biofilm and makes it difficult to remove with a brush or floss

Front 7

what is an example of increasing plaque pathogenicity?

Back 7

Calculus which harbors plaque biofilm, allowing it to grow uninhibited for an extended amount of time

Front 8

What is an example of causing direct damage to the periodontium

Back 8

Ill-fitting partial denture that puts excessive pressure on the gingiva

Front 9

LOCAL FACTORS THAT INCREASE PLAQUE BIOFILM

Back 9

.........

Front 10

What is the most obvious example of a local contributing factor that can lead to increase plaque biofilm retention

Back 10

Dental Calculus

Front 11

What is calculus

Back 11

Mineralized bacterial plaque biofilm, covered on the external surface by nonmineralized bacterial plaque biofilm, living bacterial plaque

Front 12

when does mineralization of plaque begin

Back 12

48 hours up to 2 weeks after plaque initiation

Front 13

What are characteristics of calculus (7)

Back 13

surface is irregular

Always covered with disease-causing bacteria

Rough nature of calculus tends to harbor bacteria

As calculus builds up, it becomes irregular, forming ledges on teeth

Plaque control becomes difficult

Plaque retention on irregular calculus increases risk for disease

Controlling disease in the presence of plaque and calculus is difficult

Front 14

How much of calculus is inorganic

Back 14

70 to 90%

Front 15

How much of calculus is organic

Back 15

10 to 30%

Front 16

The inorganic part of dental calculus is primarily what

Back 16

Calcium Phosphate

Front 17

Besides calcium phosphate dental calculus also contains what

Back 17

Calcium carbonate

Magnesium phosphate

Front 18

The inorganic part of calculus is similar to the inorganic components of what

Back 18

bone

Front 19

What are the components of the 10 to 30% of organic part of calculus

Back 19

Material derived from plaque

Dead epithelial cells

Dead white blood cells

Front 20

As calculus ages on a tooth surface what happens to the inorganic components

Back 20

Changes through several different crystalline forms

Front 21

Newly formed calculus deposits appear as a crystalline form called what?

Back 21

Brushite

Front 22

What are calculus deposits called when they are less than 6 months old?

Back 22

Octocalcium Phosphate

Front 23

In calculus depostis that are more than 6 months old, the crystalline form is primarily what

Back 23

Hydroxyaptatite

Front 24

What are other names for supragingival calculus deposits?

Back 24

Supramarginal calculus

salivary calculus

Front 25

Where is supragingival calculus most often found?

Back 25

lingual surfaces of mandibular anterior

Facial surfaces of maxillary molars

crowed or in malocclusion

adjacent to large salivary ducts

Front 26

What is the shape are supragingival calculus most often found

Back 26

Irregular, large deposits

Front 27

What are other names for subgingival calculus

Back 27

Submarginal calculus

serumal calculus

Front 28

Subgingival calculus may be located where

Back 28

Localized or generalized

Front 29

What is the shape of subgingival calculus

Back 29

flattened from pressure of the pocket wall

Front 30

dental calculus attaches to tooth surfaces through several different modes and different attachment mechanisms can exist what are the different modes to attachment(3)

Back 30

Attachment by pellicle

Attachment to irregularities in the tooth surface

Attachment by direct contact to the calcified component and the tooth surface

Front 31

What is the pellicle

Back 31

thin, bacteria-free membrane that forms on the surface of the tooth during the late stages of eruption

Front 32

This mode of attachment means of pellicle most commonly occur on?

Back 32

Enamel surfaces

Front 33

Attachment by the means of pellicle are calculus deposits removed easily and why?

Back 33

Yes, are usually removed easily because attachment is on the surface of the pellicle and not locked into the tooth surface

Front 34

Attachment to irregularities in the tooth surface include what? (3)

Back 34

Cracks in the teeth

Tiny openings left where PDL detached

grooves in cementum from over

instrumentation

Front 35

is deposit removal easily done with attachment to irregularities in the tooth surface?

Back 35

No it is usually difficult because deposits lie sheltered in the tooth defects

Front 36

Attachment by direct contact to tooth is done how?

Back 36

Matrix of calculus deposit is interlocked with inorganic crystals of the tooth

Front 37

Are calculus deposits during attachment easily removed?

Back 37

No, it is usually difficult to remove because deposits are firmly interlocked in tooth and are difficult to remove

Front 38

Tooth morphology is another local contributing factor true or false

Back 38

TRUE

Front 39

Overhanging restorations

Back 39

Impossible for some patients to remove plaque effectively from the tooth surface adjacent to the overhang

Leads to plaque retention and can lead to increased severity of disease

Front 40

Dental caries can also increase plaque biofilm retention. Untreated tooth decay does what

Back 40

Defects in enamel harbor bacteria, where it can grow undisturbed

Plaque in contact with tissue causes disease

Front 41

developmental grooves and concavities lead to difficulty in plaque control in the site true or false

Back 41

TRUE

Front 42

Developmental grooves on palatal surface of a tooth is called?

Back 42

Palatogingival groove

Front 43

Naturally occuring concavities on roots harbor bacteria, increasing

Back 43

incidence of disease

Front 44

Palatogingival grooves are most often seen on which teeth

Back 44

maxillary lateral incisors

Front 45

Which teeth often have naturally occuring concavities

Back 45

mesial surface of maxillary first premolar teeth

Front 46

LOCAL FACTORS that INCREASE PLAQUE BIOFILM PATHOGENICITY

Back 46

............

Front 47

What is the definition for pathogencity?

Back 47

ability of a disease-causing agent to actually produce the disease

Front 48

Plaque biofilm pathogencity relates to the character of the plaque biofilm rather than simply an increase in the amount of plaque biofilm

TRUE OR FALSE

Back 48

TRUE

Front 49

Plaque allowed to grow undisturbed does what

Back 49

Matures

Front 50

As plaque biofilm matures it becomes colonized the longer plaque biofilm colonizes the?

Back 50

Greater the number of disease causing bacteria in the area

Front 51

what causes gingivitis but not periodontitis

Back 51

Gram positive Aerobic cocci and rods

Front 52

How long does it take for the pellicle to become colonized with gram positive aerobic cocci and rods

Back 52

2 days

Front 53

Immediately after cleaning what happens?

Back 53

Salivary proteins attach to the tooth and form the pellicle

Front 54

Gram-negative anerobic cocci and gram negative rods accumlate over what time period

Back 54

The week

Front 55

What can cause periodontitis

Back 55

Undisturbed mature plaque

Front 56

Which is more pathogenic mature plaque biofilm or bacteria in the initial deposition

Back 56

mature plaque biofilm

Front 57

Local contributing factors that can cause direct damage to the periodontium are what

Back 57

Food impaction

patient habits

faulty restorations or appliances

Front 58

What does food impaction mean

Back 58

Trapping food in the interdental areas

Front 59

What does food impaction cause

Back 59

Gingival tissue being stripped from the tooth surface

lead to alterations in gingival contours

Front 60

What are some patient habits that can cause direct damage to the periodontium

Back 60

tongue thrusting

mouth breathing

improper use of toothbrushes

tooth picks

Improper use of other interdental aids

Front 61

How does tongue thrusting cause direct damage

Back 61

Alters occlusion, forcing anterior teeth labially

Front 62

How does mouth breathing cause direct damage

Back 62

Dries out gingival tissues in the anterior region

Front 63

Inappropriate crown placement can cause direct damage how?

Back 63

edges are below the gingival margin and too near the alveolar bone

Front 64

a crown margin that is closer than what to the crest of the alveolar bone can reselt in resorption of the alveolar bone

Back 64

2mm

Front 65

Improperly contoured crowns (bulky crowns) or restorations can result in what

Back 65

Inadequate interproximal space for the papillae

Front 66

Bulky crowns are described as

Back 66

Encroaching upon the embrasure space

Front 67

A damaged or poorly fitting removable prosthesis do what

Back 67

Favor plaque biofilm accumulation and hasten the progress of periodontitis

Front 68

Occlusal forces is another direct damage trauma from occlusion causes what

Back 68

Resportion of the alveolar bone

more rapid destruction if periodontal disease is present

Front 69

What are the different types of occlusal trauma?

Back 69

Primary

Secondary

Front 70

What are three clinical signs of trauma from occlusion

Back 70

tooth mobility

sensitivity to pressure

migration of teeth

Front 71

What are 2 radiographic signs of occlusal trauma

Back 71

Enlarged funnel-shaped periodontal ligament space

Alveolar bone resorption

Front 72

What is the definition of primary occlusal trauma?

Back 72

Excessive occlusal forces on a healthy periodontium

Front 73

What are some examples of primary trauma from occlusion

Back 73

high restorations

Excessive force on abuntment teeth from partial dentures

Front 74

Are primary trauma reversible

Back 74

Yes is trauma is removed

Front 75

Definition of secondary occlusal trauma

Back 75

Normal occlusal forces on unhealthy periodontium weakened by periodontitis

Front 76

With secondary trauma what can occur

Back 76

Rapid bone loss and pocket formation

Front 77

What is the definition of parafunctional occlusal habits

Back 77

Results from tooth-to-tooth contact made when not chewing

Front 78

What are some examples of parafunctional occlusal habits?

Back 78

clenching

Grinding (Bruxism)

Front 79

What are several clinical therapies that can be used by a dentist to help control the damage from trauma from occlusion

Back 79

Occlusal adjustment

night guard