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19 Cards in this Set
- Front
- Back
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1. What are the four main structures of the periodontum?
What is the periodontum in important for? |
1. Gingival tissues
2. Periodontal Ligament (PDL) 3. Cementum 4. Alveolar bone Providing support for teeth **w/o these structures you cannot hold the tooth in the mouth |
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2. What are the two main plaque-related diseases that cause severe damage and loss of periodontal tissue?
What happens in gingivitis? What happens in periodontitis? |
1. Gingivitis
2. Periodontitis Gingivitis -inflammation of the gingival tissues w/o loss of attachment Periodontitis -in addition to gingival inflammation there is also loss of clinical attachment and destruction of bone tissues |
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3. What hare both conditions characterized by?
Where does the gingival inflammatory lesion extend towards? What happens when periodontal pockets form? |
Characterized by an inflammatory response to bacterial plaque
Lesion extends towards the bone structures supporting the tooth Bone is destroyed |
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4. What are the mechanisms of destruction?
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1. Soft tissue destruction (gingival)
2. Hard tissue destruction (alveolar bone) |
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5. In soft tissue destruction what does plaque bacteria trigger?
What do the polymorphonuclear leukocytes (PMN's) do? |
Host inflammatory response in the gingival tissues
Migrate from within gingival tissues towards gingival sulcus/pocket **build a wall against the bacteria |
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6. What do the gingival macrophages and fibroblasts produce?
What does these cytokines do? |
IL-1 and TNF-alpha
Activate collagneases and other destructive enzymes **these enzymes destroy the gingival tissues |
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7. How is bacteria involved in soft tissue destruction?
What is destruction mainly due to? Why is the response important? |
Bacteria are indirectly involved in destructive process
Destruction is mainly due to inflammatory response of host in response to presence of bacteria **bacteria mainly trigger response Response is important b/c it prevents bacteria from invading our system |
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8. How does hard tissue destruction take place?
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IL-1 and prostaglandins are produced
Balance between bone formation and resorption is disturbed Get more bone destruction than formation |
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9. What are some factors that can affect and influence the host response?
What are the three main objectives of managing plaque-related inflammatory disease? |
1. Acquired factors (smoking)
2. Innate factors (systemic disease) 1. Control the inflammatory response 2. Correct damage caused by inflammatory response 3. Preserve the status of health we have achieved |
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10. What does prolonged and repeated gingival inflammation is susceptible individuals cause?
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Anatomcially altered periodontium characterized by gingival pocketing and bone defects
**makes it easier for bacteria to build up and cause more damage |
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11. How do we achieve control of the inflammatory response usually?
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Non-surgical modalities
-mechanical plaque control -medications -anti microbial therapies -self performed cleanings -host response modifications -behavioral changes in patient |
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12. Is adequate homecare going to resolve the inflammatory process?
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No, self performed plaque control has very limited use in treating periodontitis
Tooth brush has limited access inside periodontal pockets Extremely ineffective in removing bacteria below the gingival margin |
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13. What does scaling and root planning allow for?
What happens when you scale and root plane? |
Reach into these pockets
1. Gingival inflammation is resolved 2. Tissue gets tighter **Pocket is till there but gingiva gets tighter and the gingival tissue is kind or reattached along the root surface through long-junctional epithelium **have not eradicated the pocket |
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14. What conditions might require use of antibiotics?
What is the most effective type of antibiotic delivery? What are three examples of antibiotics that are used? |
Aggressive periodontitis & ANUG
Control-released antibiotic coupled w/ a vehicle that releases the drug gradually over a period of time 1. Atridox (doxycyline 10%) 2. Arestin (minocycline 1 mg) 3. Periochip (chlorohexidine) |
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15. What other drugs can be sued to control the inflammatory response?
What do these medications do? What drugs are given? |
Systemic inflammatory enzymes suppressing drugs
Interfere w/ the release of the cytokines and prostaglandins of the inflammatory response Modified tetracycline or doxycycline at a very low dose or 20 mg Periostat |
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16. How are the anatomical aberrations (gingival pockets and osseous deformities) usually corrected?
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Surgical modalities
1. Ressective surgery 2. Attachment surgery 3. Regenerative surgery 4. Implant surgery |
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17. What is ressective surgery?
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Cut away and remove all of the aberrant tissue and recreate a normal periodontium at a reduced height
**most commonly used surgical procedure |
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18. What is a common attachment procedure?
What is done in regenerative surgeries? What are some examples of regenerative surgeries? |
Widman flap
Build back the lost periodontium 1. Bone grafting -fill an intra-bony defect 2. Membrane barrier between the gingival tissues and root surfaces *healing and regeneration of true CT attachment |
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19. How do we maintain the status of health we have achieved following active treatment?
In the end when you are done w/ treatment and evalualate the patient what two things do you want to see? |
Supportive periodontal care (periodontal maintenance)
1. Resolution of inflammation 2. A maintainable periodontal environment |
