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113 Cards in this Set

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What is the basic lesion of periodontitis?
periodontal pocket
What is ADA/AAP Case type 1 described as?
gingivitis
What is ADA/AAP Case type 2 described as?
mild periodontitis
bone loss of 20% or less
What is ADA/AAP Case type 3 described as?
moderate periodontitis
bone loss up to 40-50%
furcation involvement
mobility
What is ADA/AAP Case type 4 described as?
severe periodontitis
bone loss greater than 50%
class II or III furcation involvement
mobility and tooth migration
How much attachment loss is there in mild periodontitis?
1-2 mm
How much attachment loss is there in moderate periodontitis?
3-4 mm
How much attachment loss is there in severe periodontitis?
at least 5 mm
What percentage of sites are involved in localized periodontitis?
up to 30%
What percentage of sites are involved in generalized periodontitis?
at least 30%
Which type of periodontitis progresses slowly?
chronic
Which type of periodontitis progresses rapidly?
aggressive
Which type of periodontitis has a strong familial background?
aggressive
Which type of periodontitis is more common in patients over the age of 35?
chronic
Which type of periodontitis is more common in patients under the age of 35?
aggressive
What is one systemic diseases that causes periodontitis?
lupus erythematosis
How common is gingivitis in all ages?
greater than 50%
How common is mild chronic periodontitis?
35%
How common is severe chronic periodontitis?
10-15%
How common is localized aggressive periodontitis in African-Americans?
1%
How common is localized aggressive periodontitis in white Americans?
0.1%
Which type of teeth are most susceptible to periodontitis?
molars
Which type of teeth are least susceptible to periodontitis?
incisors
What is the main cause of tooth loss in people up to age 40-45?
caries
What is the main cause of tooth loss in people over age 45?
both caries and periodontal disease equally
What are three specific populations that have very high progression rates for periodontitis?
Nigerians
Polynesians
Sri Lankan tea workers
What percentage of chronic periodontitis is linked to heredity?
50%
Is periodontitis more severe in females or males?
males
True or False: The prevelance of gingivitis increases with age.
False
True or False: The prevelance of periodontitis increases with age.
True
Besides age and gender, what are three risk factors for periodontitis?
smoking
poorly controlled diabetes
low socio-economic status
Why is it believed that epidemiologic studies have underestimated the prevelance of periodontitis?
studies used to only examine two sites of the teeth in two randomly selected quadrants
How deep are probing depths in gingivitis?
greater than 3 mm
How is the junctional epithelium affected by periodontitis?
it migrates apically
True or False: Pain is a typical symptom of periodontitis.
False
What are some common complaints of a patient suffering from periodontitis?
swollen gums
bleeding while brushing
bad taste
persistent bad breath
tooth sensitivity
loose teeth
What causes redness of the gingiva in periodontitis?
increased vascularity and decreased epithelial keratinization
What causes blueness of the gingiva in periodontitis?
venous stasis
Periodontitis with pale pink tissue is often seen in what type of people?
smokers
What causes gingiva and papillae to swell in periodontitis?
increased tissue fluid
What kind of gingiva is stippling seen on?
attached gingiva
What causes a smooth and shiny appearance of the gingiva in periodontitis?
interstitial edema and thinning of surface epithelium
Where are probing depths measured from?
free gingival margin to probe tip
True or False: It is possible for the probe tip to reach the CEJ even when there is no attachment loss present.
False
Where is junctional epithelium located in health?
slightly coronal to the CEJ
True or False: It is possible for bone loss to be present with the overlying tissue appearing healthy.
True
What is the best indicator of periodontal support around a tooth?
clincal attachment level
What values must you know in order to calculate clinical attachment level?
probing depth and gingival margin level
If the gingival margin is at or slightly coronal to the CEJ, what is the clinical attachment level equal to?
probing depth
If the gingival margin is coronal to the CEJ, what is the clinical attachment level equal to?
probing depth - gingival margin level
If the gingival margin is apical to the CEJ, what is the clinical attachment level equal to?
probing depth + gingival margin level
What is the first clinical sign of periodontitis?
bleeding on probing
Why does bleeding on probing occur in periodontitis?
blood vessels become engorged and the sulcus lining become ulcerated
What causes bone destruction in periodontitis?
extension of inflammation from marginal gingiva to the supporting periodontal tissues
What is the normal level of the alveolar crest?
2 mm apical to CEJ
What does the biologic width consist of?
1 mm of junctional epithelium
1 mm of connective tissue fibers
Which area shows bone loss more clearly on radiographs: facial-lingual or interproximal?
interproximal
Which type of bone loss is more common: horizontal or vertical?
horizontal
What does a 0 on the mobility scale mean?
no mobility
What does a 1 on the mobility scale mean?
less than 1 mm of movement in the buccal-lingual direction
What does a 2 on the mobility scale mean?
at least 1 mm of movememnt in the buccal-lingual direction
What does a 3 on the mobility scale mean?
at least 1 mm of movement in the buccal-lingual direction with vertical depression or rotation of the tooth in the socket
What does furcation involvement frequently signal the need for?
periodontal surgery
What is Class I furcation defined as?
curvature of the concavity can be felt, but probe does not enter the furcation
What is Class II furcation defined as?
probe penetrates the fircation but does not pass through it
What is Class III furcation defined as?
probe passes completely through the furcation
What is Class IV furcation defined as?
you can see completely through the furcation
The crest of the bone follows a line between what?
adjacent CEJs
Is the crest of the bone flat or pointed in anterior teeth?
pointed
Is the crest of the bone flat or pointed in posterior teeth?
flat
What is lamina dura?
thin layer of dense bone the lines the normal tooth socket
What is the lamina dura continuous with on radiographs?
cortical bone layer of the crest of interdental septa
How much mineral resorption needs to occur in order for it to appear on radiographs?
30-50%
How much of calculus present on teeth is visible on radiographs?
40%
Radiographic evaluation of bone is mainly based on what features?
interdental septa and crest of the bone
What is an ideal crown-to-root ratio?
2:1
What is the minimum acceptable crown-to-root ratio?
1:1
What is a radiographic sign of occlusal trauma?
widened PDL space
True or False: Bacteria in biofilms are resistant to antibiotics.
True
Scaling and root planing reduces bacterial count by how much?
99%
How many bacterial isolates are found in healthy gingiva sites?
100-1,000
How many bacterial isolates are found in periodontally diseased sites?
100,000-100,000,000
What percentage of bacteria in healthy gingiva is gram-negative?
15%
What precentage of bacteria in periodontally diseased sites is gram-negative?
15-50%
How many bacteria might be on a single tooth?
300,000,000
Periodontitis shows an increase in what kind of bacteria compared to gingivitis?
anaerobic
Which bacteria are associated with periodontal health?
S. sanguinis
S. gordonii
Which bacteria are associated with gingivitis?
A. isrealii
A. naeslundii
Which bacteria are associated with periodontitis?
P. gingivalis
T. forsythia
T. denticola
Which bacteria is possibly associated with the initiation of periodontitis?
T. forsythia
Which bacteria is strongly associated with Localized Aggressive Periodontitis?
A. actinomycetemcomitans
What are some virulence factors of periodontal pathogens?
endotoxin
adhesins
proteases
leukotoxin
capsules
biofilm
What are some future strategies to combat biofilms?
anti-adhesins
replacement therapy
degrade matrix molecules
block quorum-sensing molecules
What are some non-oral biofilm diseases?
prostate infection
kidney stones
tuberculosis
Legionnaire's disease
middle ear infection
How are PMNs and macrophages recruited?
complement activation
FMLP
Toll-like Receptors
Which cells are characteristic of acute inflammation?
PMNs
Which cells are characteristic of chronic inflammation?
macrophages
plasma cells
B-cells
Which cells are characteristic of repair and healing?
fibroblasts
endothelial cells
epithelial cells
Which complement pathway does the innate immune system use?
alternate pathway
Which complement pathway does the adaptive immune system use?
classical pathway
Which mediators are pro-inflammatory?
TNFα
IL-1β
INFγ
PGE2
MMPs
Which mediators are anti-inflammatory?
IL-1ra
IL-10
TGFβ
TIMPs
Which drugs decrease attachment loss in periodontitis?
NSAIDs, such as ibuprofen
What is the primary etiology for periodontal disease?
microbial plaque
True or False: Local contributing factors may increase the severity of already established periodontal disease, but they do not increase the risk of developing periodontal disease.
False
How do local contributing factors increase the risk of periodontal disease?
increase plaque retention
increase plaque pathogenicity
cause direct damage to the periodontium
True or False: Calculus is always covered by plaque.
True
What is a common cause of failure of periodontal therapy?
failure to remove calculus
Which teeth are palatogingival groove most commonly found on?
maxillary lateral incisors (6%)
maxillary central incisors (3%)
Which tooth surfaces are cervical enamel projections most commonly found on?
buccal surface of molars
What percentage of isolated furcation involvements are associated with cervical enamel projections?
90%
Which tooth surfaces are enamel pearls most commonly found on?
furcation areas of third molars
True or False: Mouth breathing can increase susceptibility to inflammation.
True