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158 Cards in this Set
- Front
- Back
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Clinical Attachment Level
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the probing depth measured from a fixed point, such as the cementoenamel junction; CAL
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Diastema
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a space between two natural adjacent teeth
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Hyperkeratosis
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abnormal thickening of the keratin layer (stratum corneum) of the epithelium
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Hyperplasia
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abnormal increase in volume of a tissue organ caused by formation and growth of new normal cells
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Hypertrophy
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increase in size of tissue or organ caused by an increase in size of its constituent cells
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Keratinization
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development of a horny layer of flatttened epithelial cells containing keratin
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Mastication
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act of chewing
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Pus
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a fluid product of inflammation that contains leukocytes, degerated tissue elements, tissue fluids, and microorganisms
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Stippling
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the pitted, orange-peel appearance frequentlyseen on the surface of the attached gingiva
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Suppuration
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formation of puss
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Clinical crown
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the part of the crown of a tooth that can be seen by the clinician
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Clinical root
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the part of the root of a tooth that can bee seen by the clinician
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Anatomical crown
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the part of the tooth covered in enamel
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Anatomical root
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the part of the tooth coverd in cementum
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Masticatory Mucosa
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covers gingiva and hard palate and is firmly attached; keratinized
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Lining mucosa
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covers inner surfaces of the lips and cheeks, floor of mouth, under side of tongue, soft palate, and alveolar mucosa; not keratinized
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Specialized mucosa
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covers dorsum (upper surface) of tongue; composed of papillae
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Types of specialized mucosa
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filiform, fungiform, circumvallate, foliate
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Filiform papillae
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most numerous, no taste buds
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Fungiform
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mushroom shaped, more red and contains taste buds
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Circumvallate papillae
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10-14 large round papillae in a V shape
contains taste buds |
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Foliate papillae
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on lateral posterior sides of tongue; no taste buds
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What kind of tissue are periodontal ligaments made up of?
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fibrous connective tissue
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What do periodontal ligaments do?
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surround and connecta the alveolar bone to the roots of the teeth
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Where are periodontal ligaments located?
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in the periodontal space between the cementum and alveolar bone
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Sharpey's fibers
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fibers that are inserted into the cemetum on one side and alveolar bone on the other
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What are the five GINGIVAL fiber groups of the periodontium?
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Dentogingival, alveologingival, cercumferential, dentoperiosteal, transseptal
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What are the four PRINCIPAL fiber groups?
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apical, oblique, horizontal, alveolar crest
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Dentogingival fibers
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cementum to free gingiva
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Alveologingival fibers
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alveolar crest to free and attached gingiva
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A: Circumferential fibers
B: Dentogingival fibers C: Alveologingival fibers D: Dentoperiosteal fibers |
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Circumferential fibers
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around the neck of the tooth
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Dentoperiosteal fibers
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cervical cementum over the alveolar crest
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Transseptal fibers
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cervical area of one tooth across to an adjacent tooth
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Apical fibers
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root apex to surrounding bone
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Oblique fibers
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root above apical fibers obliquely toward the occlusal
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Horizontal fibers
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cementum in the middle of each root to adjacent alveolar bone
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Alveolar crest fibers
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alveolar crest to cementum just below CEJ
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A: Transseptal fibers
B: Alveolar crest fibers C: Horizontal fibers D: Oblique fibers E: Apical fibers F:Interradicular fibers |
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Cementum
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layer of calcified connective tissue that covers the root of the tooth
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Function of cementum (2)
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to seal tubules of dentin and to provide attachment for fibers; not sensitive
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How thick is cementum?
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about 50 to 200 micrometers about the apex and 30-60 about the cervical are
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Alveolar bone
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consists of lamina dura which surrounds the tooth socket and supporting bone
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Gingiva
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surrounds the necks of teeth and is attached to the teeth and alveolar bone
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What three parts is the gingiva made up of?
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free gingiva, attached gingiva, and interdental gingiva
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Free gingival groove
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a shallow linear groove that demarcates the free from the attached gingiva
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Gingival sulcus
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the crevice or groove between the free gingiva and the tooth
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Inner boundary of gingival sulcus
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tooth surface; could be enamel, cementum, or both
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Outer boundary of gingival sulcus
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Sulcular epithelium
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Base of gingival sulcus
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coronal margin of tha ttached tissues; also called the probing depth or bottom of the pocket
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Healthy sulcus depth minimum
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0.5 mm
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Average depth of healthy sulcus
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1.8 mm
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Healthy readings for depth of healthy sulcus
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1-3 mm
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Junctional epithelium
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cufflike band of stratified squamous epithelium that is continuous witht he sulcular epithelium and completely encircles the tooth; not keratinized
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Size of Junctional epithelium
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up to 15-20 cells at sulcular epithelium down to 1-2 cells at apical end
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Interdental papillae
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gingival occupying the interproximal area between two adjacent teeth; also called embrasure
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Type 1 embrasure
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gingival tissue fills area; pyramidal
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Type 2 embrasure
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slight to moderate recession; blunted
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Type 3 embrasure
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extensive recession or complete loss; absent
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Col
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depression between the lignal or palatal and facial papillae that conforms to the proximal contact area
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Where do most periodontal infections start?
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Col area
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Attached gingiva
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continuous with the oral epthelium of the free gingiva and is covered with keratinized stratified squamous epithelium cells
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How is attached gingiva attached?
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firmly bound to the underlying cementum and alveolar bone
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Mucogingival junction
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a line that marks the connection between the attached gingiva and the alveolar mucosa
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Alveolar mucosa
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movable tissue with smooth, shiny surface; nonkeratinized
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Clinically normal gingival tissue
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pale or coral pink pigment, knife edged, stippling, firm, no bleeding
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Gingival examination
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examine color, shape, consistency, surface texture, position, bleeding, exudates
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Healthy gingiva in children
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pink, thick, rounded or rolled, not tightly adapted to teeth, may not have stippling,
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Explorer
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a slender stainless steel instrument with a fine flexible sharp point used for examination of the surfaces of the teeth to detect irregularities
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Fremitus
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a vibration perceptible by palpation
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Probe
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smooth, slender instrument usually round in diameter with a rounded tip designed for examination of the teeth and soft tissues; except for a few probes made only for blunt examination, probes are calibrated in millimeter increments to facilitate recordings for comparisn with periodic assessment
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Probing depth
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the distance from the gingival margin to the location of the periodontal probe tip at the coronal border of attached periodontal tissues
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Mirror surfaces (3)
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Plane, concave, front surface
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Plane mirror surface
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may produce double image
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Concave mirror surface
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magnifying
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Front surface mirror surface
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reflecting surface is on the front of the lense rather than on the back
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Purposes of the mouth mirror (4)
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indirect vision, indrect illumination, transillumination, retraction
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Uses of air water syringe
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Improve and facilitate procedures, improve visibility of treatment area, prepare teeth for certain procedures
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Probe characteristics
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straight working end
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Pocket
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diseased gingival sulcus
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How is a pocket measured?
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from base of pocket to gingival margin
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How are proximal surfaces approached?
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by entering from both the facial and lingual aspects of a tooth
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Where is the probe stopped in normal healthy tissue?
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base of sulcus at the coronal end of junctional epithelium
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Where is the probe stopped in gingivitis and early periodontitis?
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within junctional epithelium
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Where is the probe stopped in advanced periodontitis?
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probe tip passes through junctional epithelium and reaches attached connective tissue fibers
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How do you line the probe up to get an accurate reading?
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with the long axis of the tooth
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Purposes and uses of an explorer (5)
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detect texture of tooth surfaces, subgingival tooth surfaces, define extent of instrumentation needed, evaluate treatment
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Tooth surface irregularities
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deposites, anomalies (enamel pearls), restorations, demineralization, restoration
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Angular or vertical bone loss
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reduction in height of crestal bone that is irregular; commonly localized
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Furcation involvement
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when a pocket extends into a furcation area
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Periodontal ligament space
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connective tissue that appears radiolucent on a radiograph
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Edema
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accumulation of excessive fluid in cells, tissues, or a serous cavity
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Gingivitis
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inflammation of the gingival tissues
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Iatrogenic
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resulting from treatment by a professioal person
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Lesion
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any pathologic or traumatic discontinuity of tissue or loss of function of a part; broad term including wounds, sores, ulcers, tumors, and any other tissue damage
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Periodontitis
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inflammation in the periodontium affecting gingival tissue, periodontal ligament, cementum, and supporting bone
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Permeable
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permitting passage of fluid
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Refractory
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not readily responsive to treatment
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Toxin
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a poison; protein produced by certain animals, higher plants, and pathogenic bacteria
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Xerostomia
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dryness of the mouth from a lack of normal secretions
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Initial lesion
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occurs within 2 to 4 days of irritation, fluid fills the spaced in the connective tissue
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Early lesion
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Biofilm becomes older and thicker within 7 to 14 days, breakdown to the support at gingival margin
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Established lesion
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Fluid migration into tissues and sulcus increase; plasma cells = area of chronic inflammation; pocket epithelium is more permeable, early pocket formation
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Advanced lesion
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bacteria enter sulcus and provide subgingical boifilm; inflammation spreads resulting in bone loss
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Gingival pocket
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pocket formed by gingival enlargement without apocal migration of the junctional epithelium
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Periodontal pocket
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result of disease or degeneration that caused the junctional epithelium to migrate apically along the cementum
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Suprabony
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base of pocket is coronal to the crestof the alveolar bone
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Intrabony
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base of pocket is below or apical to the crest of alveolar bone
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What substances are found in a pocket?
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subgingival biofilm, microorganisms, gingival sulcus fluid, desquamated epithelial cells, leukocytes, purulent exudate
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Small amount of dentin exposed in __% of teeth
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10%
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Cementum and enamel meet in __% of teeth
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30%
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Cementum overlaps enamel in __% of teeth
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60%
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Complications of pocket formation
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furcation involvement and mucogingival involvement
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Class I furcation involvement
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early beginning involvement; probe can enter furcation area and feel anatomy of roots
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Class II furcation involvement
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Moderate involvement; probe can enter but cannot pass through
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Class III furcation involvement
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Severe involvement; probe can be passes between roots through the entire furcation
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Class IV furcation involvement
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exposure of furcation; probe can pass through entire furcation
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Mucogingival involvement
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a pocket that extends to or beyond the mucogingival junction and into the alveolar mucosa
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Functions of attached gingiva
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supports, withstands stress, provides attachment
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Factors involved in disease development (4)
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Etiologic, predisposing, contributing, risk
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Etiologic factor
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factor that is the actual cause of a disease or condition
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Predisposing factor
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factor that redners a person susceptible to a disease or condition
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Contribution factor
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factor that lends assistance to, supplements, or adds to a condition or disease
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Risk factor
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an exposure that increases the probability that disease will occur
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Dental factors (4)
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tooth surface irregularities, tooth contour, tooth position, dental prostheses
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Gingival factors (3)
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position, size and contour, and effect of mouth breathing
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Other factors that contribute to disease development (2)
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personal oral care and diet and eating habits
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Self cleansing mechanisms (3)
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saliva, tongue, morphology of teeth
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Risk factors for periodontal disease (5)
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Drugs, tobacco, diabetes, osteoporosis, and psychosocial factors
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Amelogenesis
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production and development of enamel
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Dental caries
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disease of the mineralized structures of the teeth characterized bu demineralization of the hard components and dissolution of the organic matrix
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Arrested caries
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carious lesion that has become stationary and does not show a tendency to progress further; frequently has a hard surface and takes on a dark brown or reddish-brown color
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Primary caries
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occurs on a surfae not previously affected; also called initial caries; early lesion may be referred to as incipient caries
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Rampant caries
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widespread formation of chalky white areas and incipient lesions that may increase in size over a comparatively short time
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Recurrent caries
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occurs on a surface adjacent to a restoration; may be a continuation of the original lesion; also called secondary caries
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endentulous
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without teeth
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Exfoliation
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lossof primary teeth following physiologic resorption of root structures
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Idiopathic
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denoting a condition of unknown cause
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Incipient
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beginning; coming into existence
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Resorption
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removal of bone or tooth structure; gradual dissolution of the mineralized tissue; may be internal or external; occurs during exfoliation of a primary tooth and from the pressure of orthodontic treatment
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Requirements for Dental caries (3)
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microorganisms, carbohydrate, and susceptible tooth surface
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Acid forming bacteria in dental biofilm
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mutans streptococci and lactobacilli
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Simple cavity
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one tooth surface
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compound cavity
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two tooth surfaces
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complex
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more than two tooth surfaces
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Phase I: incipient lesion; Enamel caries (4)
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subsurface demineralization, visualization, first clinical evidence, reminerilization
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Phase II: untreated incipient lesion; Enamel caries (3)
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Breakdown of enamel, progression of carious lesion, spread of carious lesion
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Pit and fissure dental caries
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begins in a minute fault in the enamel where 3 or more lobes of tooth meet irregularly
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Smooth surface dental caries
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begin in smooth surfaces where there is no pit, groove, or other fault; occurs where biofilm is protected from removal
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Early childhood caries
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caused by baby bottle syndrome
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Root caries
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increases with age but not because of age, lesion of cementum and dentin
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Types of noncarious dental lesions (6)
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enamel hypoplasia, attrition, erosion, abrasion, fractures, abfraction
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Enamel hypoplasia
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defect that occurs as a result of a disturbance in the formation of the organic enamel matrix
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Attrition
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wearing away of a tooth as a result of tooth to tooth contact
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Erosion
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loss of tooth substance by a chemical process that does not involve known bacterial action
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Abrasion
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mechanical wearing away of tooth substance by forces other than mastication
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Fractures
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caused by trauma to the face
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Abfraction
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a wedge shaped lesion with sharp line angles at the cervical region of the dentition. caused bu stresses resulting from biomechanical loading forces on the teeth.
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