Perio 3

Front 1

the sequence of events that occur during the development of a disease or abnormal condition

Back 1

Pathogenesis

Front 2

The periodontium exists in three basic states: ---, ----, and ----. The term periodontal disease should not be confused with the term ----.

Back 2

health, gingivitis, and periodontitis. periodontitis

Front 3

What are the two basic categories of periodontal disease?

Back 3

Gingivitis and periodontitis

Front 4

a bacterial infection that is con ned to the gingiva.

Back 4

Gingivitis

Front 5

a bacterial infection of all parts of the periodontium including the gin-• giva, periodontal ligament, bone, and cementum.

Back 5

periodontitis

Front 6

The tissue damage that occurs in gingivitis results in --- destruction to the tissues of the periodontium. The tissue damage that occurs in periodontitis results in --- destruction to the tissues of the periodontium

Back 6

reversible, irreversible

Front 7

Clinical Picture of Healthy Gingiva

A. Color: ---, may be pigmented, and is --- in consistency. B. Gingival Margin 1. --- outline 2. Located --- to (above) the cementoenamel junction (CEJ). C. Interdental Papillae: --- and occupy the embrasure spaces --- to the contact areas. D. Absence of Bleeding: --- bleeding upon probing. E. Sulcus: Probing depths range from --- to --- mm.

Back 7

Pink, resilient, Scalloped, coronal, Firm, apical, No, 1 to 3

Front 8

In health, the JE is rmly attached by --- to the enamel slightly coronal to (above) the cementoenamel junction (CEJ). the junctional epithelium has no epithelial ---. Intact --- ber bundles support the junctional epithelium. The crest of the alveolar bone is intact and located -- to -- mm apical to (below) the base of the junctional epithelium.

Back 8

hemidesmosomes, ridges, supragingival, 2 to 3

Front 9

In health

Intact periodontal ligament ber bundles stretch between the bony walls of the --- to the cementum of the ---. Cementum is ---.

Back 9

tooth socket, root, normal

Front 10

a type of periodontal disease characterized by changes in the color, contour, and consistency of the gingival tissues

Back 10

Gingivitis

Front 11

Gingivitis is observed clinically from --- to --- days after plaque biolm accumulates in the ----

Back 11

4 to 14, gingival sulcus.

Front 12

a gingivitis that lasts for a short period of time

Back 12

Acute gingivitis

Front 13

a gingivitis that lasts for months or years.

Back 13

Chronic gingivitis

Front 14

Acute gingivitis often is characterized by --- in the gingival connective tissues that results in --- gingiva.

Back 14

uid, swollen

Front 15

When gingivitis is chronic, the body may attempt to repair the tissue damage by forming new --- in the gingival connective tissue. Excess collagen bers lead to gingival tissues that are --- and --- in consistency. The excess collagen bers --- the redness caused by the increased blood ow, making the tissue appear --- red.

Back 15

collagen bers, enlarged, brotic (leathery), conceal, less

Front 16

Gingival enlargement may be caused by ---- (acute gingivitis) or --- (chronic gingivitis). Tissue enlargement causes the gingival margin to cover --- of the crown of the tooth and results in --- probing depths. This enlargement of the gingival tissue is said to produce a --- or --- pocket.

Back 16

swelling, brosis, more, deeper, false, gingival

Front 17

A gingival pocket has a sulcus depth over --- mm. This increased probing depth is caused solely by --- gingival tissue. Microscopically, the junctional epithelium --- in its normal position coronal to the CEJ on the tooth in a gingival pocket.

Back 17

3, enlarged, remains

Front 18

The tissue damage in gingivitis is ---, that is, with good patient self-care, the body can repair the damage. In many cases, gingivitis may persist for --- without ever progressing to the next stage, ---. In some cases, a combination of risk factors may result in gingivitis progressing to periodontitis.

Back 18

reversible, years, periodontitis

Front 19

a type of periodontal disease that is characterized by the (1) apical migration of the junctional epithelium, (2) loss of connective tissue attachment, and (3) loss of alveolar bone.

Back 19

Periodontitis

Front 20

Gingivitis.

Plaque biolm: --- numbers of bacteria Junctional epithelium: slightly coronal to the CEJ; the coronal portion of the JE --- from the tooth; probing depth ---; epithelial ridges extend down into gingival connective tissue Supragingival bers: --- ber destruction Periodontal ligament bers: --- Alveolar bone: ---

Back 20

increased, detaches, increases, some, intact, intact

Front 21

Periodontitis.

Plaque biolm:• --- numbers of bacteria Junctional epithelium: apical to the CEJ with attachment on cementum; a remnant of the JE persists at the --- of the periodontal pocket: epithelial ridges extend down into gingival connective tissue Supragingival bers:• ber --- Periodontal ligament bers:• ber --- Alveolar bone: portions of alveolar bone ---

Back 21

vast, base, destruction, destruction, destroyed

Front 22

The tissue damage of periodontitis is ---

Back 22

permanent.

Front 23

"itis"

Back 23

inflammation of

Front 24

In health and gingivitis, the crest of the alveolar bone is located approximately --- mm apical to (below) the CEJs of the teeth. In periodontitis, the bone destruction may be --- . As periodontal disease progresses (worsens), tooth loss may occur from --- of alveolar bone support.

Back 24

2, severe, lack

Front 25

What are the two types of bone loss?

Back 25

horizontal, vertical

Front 26

--- bone loss is the most common pattern of bone loss. This type of bone loss results in a fairly ---, overall reduction in the height of the alveolar bone. The alveolar bone is --- in height, but the margin of the alveolar crest remains more or less perpendicular to the --- of the tooth.

Back 26

Horizontal, even, reduced, long axis

Front 27

--- loss is a less common pattern of bone loss. Vertical bone loss is also known as angular bone loss. 2. This type of bone loss results in an uneven reduction in the height of the alveolar bone. 3. In vertical bone loss, the resorption progresses more rapidly in the bone next to the root surface. This uneven pattern of bone loss leaves a trenchlike area of missing bone alongside the root.

Back 27

Vertical bone,

Front 28

Horizontal bone loss results in bone levels that are approximately at the --- height on adjacent tooth roots. On a radiograph, if an imaginary line drawn between the CEJs of adjacent teeth is approximately ---, then the bone loss is described as horizontal bone loss.

Back 28

same, parallel

Front 29

Vertical bone loss results in an --- reduction in bone height on adjacent tooth roots, resulting in a --- area of missing bone alongside the root of one tooth. On a radiograph, if an imaginary line drawn between the CEJs of adjacent teeth is not ---, then the bone loss is described as vertical bone loss.

Back 29

uneven, trenchlike, parallel

Front 30

In horizontal bone loss, inammation spreads into the tissues in this order: (1) within the gingival --- along the connective tissue sheaths surrounding the blood vessels, (2) into the ---, and (3) nally, into the ---

Back 30

connective tissue, alveolar bone, periodontal ligament space

Front 31

Inflammation usually spreads in this manner with horizontal bone loss because it is the path of ---. The periodontal ligament ber bundles act as an effective --- to the spread of inammation. Thus, the inammation spreads into the --- and then into the ---

Back 31

least resistance, barrier, alveolar bone, periodontal ligament space.

Front 32

In vertical bone loss, inflammation spreads into the tissues in this order: (1) within the ---, (2) directly into the --- and (3) fi nally, into the ---. Infl ammation spreads in this manner whenever the crestal periodontal ligament fiber bundles are --- and no longer present an effective barrier. Prior events such as --- can be responsible for the weakened condition of the fiber bundles.

Back 32

gingival connective tissue, periodontal ligament space, alveolar bone, weakened, occlusal trauma

Front 33

Periodontitis results in different types of defects in the alveolar bone. These bony defects are called ---.

Back 33

osseous defects

Front 34

result when bone resorption occurs in an uneven, oblique direction.

Back 34

Infrabony defects

Front 35

Infrabony defects are classied on the basis of the number of --- walls. Infrabony defects may have ---, ---, or --- walls

Back 35

osseous, one, two, or three

Front 36

a bowl-shaped defect in the interdental alveolar bone, with bone loss nearly equal on the roots of two adjacent teeth

Back 36

osseous crater

Front 37

Whereas infrabony defects primarily affect --- tooth, in craters the defect affects --- adjacent root surfaces to a similar extent. The presence of an osseous crater causes --- to collect and makes it difcult to clean the --- area.

Back 37

one, two, dental plaque biolm, interdental

Front 38

occurs on a multirooted tooth when periodontal infection invades the area between and around the roots, resulting in a loss of alveolar bone between the roots of the teeth.

Back 38

Furcation involvement

Front 39

Bone loss in the furcation area may be hidden by the --- or may be clinically ---- in the mouth

Back 39

gingival tissue, visible

Front 40

the destruction of the bers and bone that support the teeth.

Back 40

Attachment loss

Front 41

Tissue destruction spreads not only in an --- direction but also in a --- direction. A pocket on different root surfaces of the same tooth can have different ---. The loss of attachment may vary from surface to surface of the tooth, with the base of the pocket exhibiting very --- patterns of tissue destruction

Back 41

apical (vertical), lateral (side-to-side), depths, irregular

Front 42

an area of tissue destruction.

Back 42

disease site

Front 43

A disease site may involve only a --- surface of a tooth, for example, the distal surface of a tooth. The disease site may involve --- surfaces of the tooth or all four surfaces (mesial, distal, facial, and lingual)

Back 43

single, several

Front 44

a disease site that is stable, with the attachment level of the JE remaining the same over time.

Back 44

Inactive disease site

Front 45

a disease site that shows continued apical migration of the JE over time.

Back 45

Active disease site

Front 46

The disease activity of each site in the mouth should be assessed using a --- and recorded in the patient chart at regular --- (scheduled checkup appointments).

Back 46

periodontal probe, intervals

Front 47

an area of tissue destruction left by the disease process.

Back 47

periodontal pocket

Front 48

The presence of a periodontal pocket does not indicate necessarily that there is --- disease at that site. The majority of pockets in most adult patients with periodontitis are --- disease sites.

Back 48

active, inactive

Front 49

In health, the sulcus is --- to --- mm in depth. The junctional epithelium is --- to the CEJ and attaches along its --- length to the enamel of the tooth.

Back 49

0.5 to 3 , coronal ,entire

Front 50

a deepening of the gingival sulcus as a result of swelling or enlargement of the gingival tissue

Back 50

gingival pocket

Front 51

Also known as a “----,” meaning “false pocket,” because there is no destruction of the --- or --- in a gingival pocket. There is no --- migration of the junctional epithelium in a gingival pocket. The junctional epithelium remains --- to the CEJ. In gingivitis, however, the coronal portion of the junctional epithelium detaches from the tooth resulting in a slight --- in probing depths.

Back 51

pseudopocket, periodontal ligament bers, alveolar bone, apical, coronal, increase

Front 52

The increased probing depth seen in a gingival pocket is due to (1) --- of the coronal portion of the JE from the tooth and (2) ---- tissue size due to (a) --- of the tissue or (b) tissue enlargement due to increased ---- in the connective tissue.

Back 52

detachment, increased, swelling, collagen bers

Front 53

a pathologic deepening of the gingival sulcus.

Back 53

periodontal pocket

Front 54

Pocket formation occurs as the result of the (1) apical migration of the ---, (2) destruction of the ---, and (3) destruction of ----

Back 54

junctional epithelium, periodontal ligament bers, alveolar bone

Front 55

the movement of the cells of the JE from their normal position—coronal to the CEJ—to a position apical to the CEJ.

Back 55

Apical migration

Front 56

In health, the junctional epithelium cells attach to the --- of the tooth ---. In periodontitis, the JE cells attach to the --- of the tooth ---.

Back 56

enamel, crown, cementum, root

Front 57

The type of periodontal pocket is determined based on the relationship of the JE to the crest of the ---.

Back 57

alveolar bone

Front 58

Suprabony pockets occur when there is --- bone loss. The JE, forming the base of the pocket, is located --- to (above) the crest of the alveolar bone.

Back 58

horizontal, coronal

Front 59

Infrabony pockets occur when there is --- bone loss. The junctional epithelium, forming the base of the pocket, is located ---- to (below) the crest of the alveolar bone. The base of the pocket is located within the --- area of the bone alongside of the root surface.

Back 59

vertical, apical, cratered-out