Dhy 200- Perio - Test 2

Front 1

Type of periodontitis that is a bacterial infection resulting in inflammation of supporting tissue of teeth

Back 1

Aggressive Periodontitis

Front 2

Aggressive periodontitis is charaterized by rapid distruction of what two tooth structures?

Back 2

Aggressive Periodontitis Characterized by Rapid destruction of PDL and supporting bone

Front 3

A patient with aggressive periodontitis is at __ risk for tooth loss and has a ___ response to periodontal therapy

Back 3

A patient with aggressive periodontitis is at high risk for tooth loss and has a poor response to periodontal therapy

Front 4

The amount of biofilm a person have with aggressive periodontitis is?

Back 4

Aggressive periodontitis:
-Severity of destruction inconsistent with small Amount of Biofilm present

Front 5

Aggressive peridontist is __ common occuring than chronic perio

Back 5

Aggressive peridontist is less common occuring than chronic perio

Front 6

Aggressive periodontitis Affects __ of the population and occurs most often in ___
___

Back 6

Aggressive periodontitis: Affects < 1% of the population and occurs most often in black females

Front 7

Aggressive periodontitis can be classified as?

Back 7

Classified as either localized or generalized aggressive periodontitis

Front 8

The clinical features of this is seen in what type of periodontits?
-Bone destruction and rapid attachment loss
-Lack of clinical inflammation
-Relatively sparse bacterial plaque and biofilm present
-Typically patient is otherwise healthy with concerns to systemic condition

Back 8

Aggressive Periodontitis clinical features include:
-Bone destruction and rapid attachment loss
-Lack of clinical inflammation
-Relatively sparse bacterial plaque and biofilm present
-Typically patient is otherwise healthy with concerns to systemic condition

Front 9

This type of peridontitis is:
-Formerly called early onset or juvenile periodontitis
-Is circumpubertal onset meaning it occurs around puberty

Back 9

Localized aggressive periodontitis:
-Formerly called early onset or juvenile periodontitis
-Is circumpubertal onset meaning it occurs around puberty

Front 10

Localized Aggressive Periodontitis
-Rapid destruction occurs around the ___ and ___ because they are the 1st too erupt

Back 10

Localized Aggressive Periodontitis
-Rapid destruction occurs around the permanent 1st molars and incisors because they are the 1st too erupt

Front 11

Localized Aggressive Periodontitis type of bacteria that is frequently assoicated with?

Back 11

Localized Aggressive Periodontitis
-Frequently associated with A.A. bacteria and P. Gingivitis

Front 12

Localized Aggressive Periodontitis is associated with what type of neutrophil function?

Back 12

Localized Aggressive Periodontitis
-Associated with abnormal neutrophil function

Front 13

How does the bone loss of look like in an Localized Aggressive Periodontitis patient?

Back 13

Localized Aggressive Periodontitis -Bone loss can be in the shape of “ Arc” or look scooped out or U shaped

Front 14

Generalized Aggressive Periodontitis
-Affects individuals ___ years old?-Rapid destruction occurs around __ teeth?
-Associated with __ bacteria and __ __
-Has ___neutrophil function
-Previously known as ___

Back 14

Generalized Aggressive Periodontitis
-Affects individuals under 30 years old
-Rapid destruction occurs around most teeth
-Associated with A.A. bacteria and P. Gingivalis
-Has abnormal neutrophil function
-Previously known as Rapidly progressive periodontitis

Front 15

Generalized Aggressive Periodontitis are Associated with system diseases – such as?

Back 15

Generalized Aggressive Periodontitis Associated with system diseases – such as insulin dependent diabetes, down syndrome, AIDS

Front 16

Generalized Aggressive Periodontitis Someone with this has __antibody response

Back 16

Generalized Aggressive Periodontitis Someone with this has poor antibody response

Front 17

Generalized Aggressive Periodontitis treatment considerations includes?

Back 17

Generalized Aggressive Periodontitis
-Consult with physician
- individualized instructions
- reinforcement and evaluation of biofilm control
- Smoking cessation
- Debridement
- Removal of local contributing factors
- Surgical debridement of soft tissue (periodontist does this)
- Perio exam and reevaluation
- Due to potential genetic link - eval other family members

Front 18

Periodontitis As A Manifestation of Systemic Disease:
Biofilm initiated periodontal disease, but a form of disease and its progression is dependent on what?

Back 18

Periodontitis As A Manifestation of Systemic Disease: Biofilm initiated periodontal disease, but a form of disease and its progression is dependent on the host defenses

Front 19

__ __ and __ may modify normal defenses and influence outcome of periodontal disease

Back 19

Systemic conditions and environment may modify normal defenses and influence outcome of periodontal disease

Front 20

(3) conditions Associated with Hematologic Disorders

Back 20

(3) conditions Associated with Hematologic Disorders
1.Acquired Neutopenia
2.Leukemia
3.Multiple Myeloma

Front 21

Associated with Hematologic Disorders - This descibes what type:
-Absence of circulating PMNs in blood
- Decreased number of neutrophils
- may be congenital

Back 21

Associated with Hematologic Disorders: Acquired Neutopenia
- Absence of circulating PMNs in blood
- Decreased number of neutrophils
- may be congenital

Front 22

Associated with Hematologic Disorders; this descibe what type?
-Circulating abnormal leukocytes
- Anemia
- interdental papilla can be necrotic

Back 22

Associated with Hematologic Disorders:
-Leukemia
- Circulating abnormal leukocytes
- Anemia
- interdental papilla can be necrotic

Front 23

Associated with Hematologic Disorders this descibe what type?
- Plasma cell malignancy
- Gingival bleeding is occurring
- destruction of alveolar bone
- May have Moth eaten appearance

Back 23

Associated with Hematologic Disorders:
Multiple Myeloma
- Plasma cell malignancy
- Gingival bleeding is occurring
- destruction of alveolar bone
- May have Moth eaten appearance

Front 24

Associated with Genetic Disorders:this type includes:
- Dermatologic disease
- Person has HYperkeratinazation
– this affects the structural integrity of the protective barriers
- A disruption in the immune cells occurs and they operate less efficiently
- It is a severe disruption of the periodontium – someone who has this the person loses all their teeth by adulthood

Back 24

Papillon – Lefevre Syndrome
- Dermatologic disease
- Person has HYperkeratinazation – this affects the structural integrity of the protective barriers
- A disruption in the immune cells occurs and they operate less efficiently
- It is a severe disruption of the periodontium – someone who has this the person loses all their teeth by adulthood

Front 25

Associated with Genetic Disorders:this type includes:
- Rare inherited form of albinism
- Visual difficulties occur
- WMC / neutrophil abnormalities occur

Back 25

Chediak- Higashi Syndrome
- Rare inherited form of albinism
- Visual difficulties occur
- WMC / neutrophil abnormalities occur

Front 26

Associated with Genetic Disorders:this type includes:
- Connective tissue disorder
- manifested by splitting skin, bleeding tissues
- wounds over forehead and chin are often present
- may have “ fishmouth appearance”

Back 26

Ehlers – Danlos Syndrome (types IV and VIII)
- Connective tissue disorder
- manifested by splitting skin, bleeding tissues
- wounds over forehead and chin are often present
- may have “ fishmouth appearance”

Front 27

Associated with Genetic Disorders:this type includes:
- Rare Hereditary disorder
- Decreased alkaline phosphatase – an enzyme that is necessary for proper bone formation
- If don’t have enough phosphatase will have premature loss of teeth due to inadequate PDL attachment
- resembles aggressive perio

Back 27

Hypophosphatasia
- Rare Hereditary disorder
- Decreased alkaline phosphatase – an enzyme that is necessary for proper bone formation
- If don’t have enough phosphatase will have premature loss of teeth due to inadequate PDL attachment
- resembles aggressive perio

Front 28

___ ___ ___ is:
- destructive infections of the periodontal tissues
- Involves tissue necrosis
- Gingiva tissues are combines with loss of attachment and alveolar bone loss

Back 28

Necrotizing Periodontal Disease
- destructive infections of the periodontal tissues
- Involves tissue necrosis
- Gingiva tissues are combines with loss of attachment and alveolar bone loss

Front 29

Necrotizing Ulcerative Gingivitis (NUG) is a painful infection primarily of __ and __ ___

Back 29

Necrotizing Ulcerative Gingivitis (NUG) Painful infection primarily of interdental and marginal gingival

Front 30

Necrotizing Ulcerative Gingivitis (NUG) Characterized by ?

Back 30

Necrotizing Ulcerative Gingivitis (NUG) Characterized by partial loss of interdental papilla

Front 31

Necrotizing Ulcerative Gingivitis (NUG) the interdental papilla appears ?

Back 31

Necrotizing Ulcerative Gingivitis (NUG) the interdental papilla appears “Punched out”

Front 32

Necrotizing Ulcerative Gingivitis (NUG)
-Considered to be a __onset
- Relatively __ incidence

Back 32

Necrotizing Ulcerative Gingivitis (NUG)
-Considered to be sudden onset
- Relatively uncommon incidence

Front 33

known as trench mouth or vincents infection

Back 33

Necrotizing Ulcerative Gingivitis (NUG) known as trench mouth or vincents infection

Front 34

Necrotizing Ulcerative Gingivitis (NUG) Mostly affects __ __ ages __-__

Back 34

Necrotizing Ulcerative Gingivitis (NUG) Mostly affects young adults ages 18-30

Front 35

Necrotizing Ulcerative Gingivitis (NUG) how does it appears on the gingiva and where?

Back 35

Necrotizing Ulcerative Gingivitis (NUG) Seen as small grey ulcerative lesions that begin at the tips of interdental papilla and spreads to the gingival margin
-consider punch out or cratered lesion
-Typically has grayish white pseudomembrane covering the area
- Usually have heavy deposits of plaque accumulation

Front 36

Predisposing factor for Necrotizing ulcerative peridontistis

Back 36

Predisposing factor for NUP
-Cigarette smoking
-Increased levels of personal stress
-Poor nutrition & Fatigue
-Immune dysfunction or suppression
-Pre existing gingivitis or some type of tissue trauma

Front 37

Treatment considerations for Necrotizing ulcerative peridontistis

Back 37

Treatment considerations for NUP
-Rinsing with hydrogen peroxide with equal parts of water
-Irrigation
-Rinse twice daily with 12% Chlorhexidine
-Debridement of tooth surfaces
-Patient self care instruction
-Pain control and antibiotic – penicillin, erythromycilin, flagellen
-Therapy as appropriate for management of systemic condition

Front 38

Dental hygiene care for Necrotizing ulcerative peridontistis

Back 38

Dental hygiene care for NUP
-Nutritional counseling
-Intake of fluids (liquid dietary replacement – Ensure)
-Biofilm control
-Smoking Cessation
-Avoid tobacco, alcohol, and condiments (due to acidity)

Front 39

This is a type of abscess that
is an Acute infection
- patient may know cause (ex. Foreign object such as popcorn kernel, fish bone, seed)
- Treatment requires removal of etiologic agent
- place patient on warm salt water rinses

Back 39

Gingival Abscess
Acute infection
- patient may know cause (ex. Foreign object such as popcorn kernel, fish bone, seed)
- Treatment requires removal of etiologic agent
- place patient on warm salt water rinses

Front 40

Type of abscess that:
Also called lateral abscess
- Acute inflammation within the periodontal tissues
- Develops as a result of bacterial infection
- Often seen in deep periodontal pockets and furcation sites
- Can also occur as a result of foreign objects that become embedded
- Presents as shiny, swollen mass on gingival or mucosa
- Finger pressure may produce purulent exudates
- Tooth is often tender to percussion, mobile
- Treatment: Establish drainage, remove causative agent, analgesic & warm saline rinse, Mucoperiosteal flap, all granulomatous tissue removed, root surface
- May occur due to Calculus that is left

Back 40

Periodontal Abscess
Also called lateral abscess
- Acute inflammation within the periodontal tissues
- Develops as a result of bacterial infection
- Often seen in deep periodontal pockets and furcation sites
- Can also occur as a result of foreign objects that become embedded
- Presents as shiny, swollen mass on gingival or mucosa
- Finger pressure may produce purulent exudates
- Tooth is often tender to percussion, mobile
- Treatment: Establish drainage, remove causative agent, analgesic & warm saline rinse, Mucoperiosteal flap, all granulomatous tissue removed, root surface
- May occur due to Calculus that is left

Front 41

Type of absces that is-Localized infection involving operculum
-Patient may have dull ache and trismus
-Food debris is often found under operculum
-Treatment: irrigation with saline solution, iodine, or water
-If infection is severe – prescribe antibiotics

Back 41

Periocoronal Abscess (periocoronitis)
-Localized infection involving operculum
-Patient may have dull ache and trismus
-Food debris is often found under operculum
-Treatment: irrigation with saline solution, iodine, or water
-If infection is severe – prescribe antibiotics

Front 42

Types of bacteria found in Nercrotizing ulcerative gingivitis

Back 42

Nercrotizing ulcerative gingivitis
bacteria: high number p, intermediate spirochetes, fusobacteria

Front 44

How does Necrotizing ulcerative peridontistis appears in the mouth?

Back 44

Necrotizing ulcerative peridontistis
-ulcerated and necrotic papillary and marginal gingival
-covered by yellowish-white or grayish slogh or pseudomembrane
-blunting and cratering of papilla
-bleeding on provocation or spontaneous bleeding
-pain and fetid odor

Front 45

Necrotizing ulcerative peridontistis may be accompanied by _,_,_

Back 45

Necrotizing ulcerative peridontistis may be accompanied by fever, malaise, lymphadenopahthy

Front 46

Necrotizing ulcerative peridontistis is an extensive necrosis of gingival with rapid destruction of the underlying bone extending past the __ ___

Back 46

Necrotizing ulcerative peridontistis extensive necrosis of gingival with rapid destruction of the underlying bone extending past the mucoginigival junction

Front 47

Necrotizing ulcerative peridontistis may coexist with other forms of perio such as __ or __

Back 47

Necrotizing ulcerative peridontistis may coexist with other forms of perio such as aggressive or chronic (HIV)

Front 48

The most current classification of perio disease is based on all the following factors except one. which is the exception? a) age of patient b) clinical presentation c) radiographic survey d) historical data

Back 48

a) age of patient

Front 49

What term replaced the older term of Adult periodontitis?

Back 49

Chronic Periodontitis

Front 50

What term replaces the older term Localized Juvenile Periodontitis?

Back 50

Localized Aggressive Periodontitis

Front 51

Which of the following conditions is listed as a Mucogingival deformity? a) secondary occlusal trauma b) perio abcess c) lack of keratinized gingiva d) allergy to toothpaste e) recurrent oral herpes

Back 51

c) lack of keratinized gingiva

Front 52

Which one of following features differentiates periodontitis from gingivitis?
a)engorged lamina propria
b) redness of gingiva
c) loss of connective tissue attachment d) # of bacteria present in the gingival crevice

Back 52

c) loss of connective tissue attachment
- is the feature that differentiates periodontitis from gingivitis

Front 53

What periodontal lesion is characterized by chronic gingival inflammation and the presence of plasma cells?

Back 53

Established lesion
- is characterized by chronic gingival inglammation and presence of plasma cells

Front 54

What periodontal lesion is characterized by attachment loss and bone resorption?

Back 54

Advanced Lesion
- is characterized by attachment loss and bone resorption

Front 55

During the disease process, the Junctional Epithelium transforms into _____

Back 55

during disease process the junctional epithelium transforms into POCKET EPITHELIUM

Front 56

What lesion features a predominance of plasma cells?

Back 56

Advanced lesions
- features a predominance of plasma cells

Front 57

Which feature describes gingivitis? a) occurs primarily in children b) extensive attachment loss c) bone loss does not occur d) primary risk factors include pathogenic bacteria & calculus

Back 57

Bone loss does not occur
- is a feature that describes gingivitis

Front 58

All of following medications are contributing risk factors in causing gingival enlargement except one? which is the exception? a) phenytoin b) cyclosporin c) ibuprofen
d) nifedipine e) valporic acid

Back 58

c) ibuprofen
- phenytoin, cyclosporin, nifedipine, & valporic acid are all contributing risk factors in causing gingival enlargement

Front 59

What periodontal disease is described by having inflammation of the gingiva without loss of clinical connective tissue attachment?

Back 59

Dental Plaque- Induced Gingivitis
- a type of perio disease that is described by having inflammation of gingiva w/o loss of clinical connective tissue attachment

Front 60

What bacteria is found in high numbers in pregnancy gingivitis?

Back 60

Prevotella Intermedia
- bacteria found in high numbers in pregnancy gingivitis

Front 61

What systemic disease features gingival involvement due to elevated glucose levels?

Back 61

Diabetes
- a condition that features gingival involvement due to elevated glucose levels

Front 62

Which one of the following features describes chronic periodontitis? a) it occurs primarily in kids b) no connective tissue attachment loss occurs c) bone loss doesn't occur d) risk factors include pathogenic bacteria & smoking

Back 62

Risk factors include pathogenic bacteria and smoking
- a feature that describes chronic periodontitis

Front 63

Which form of periodontitis is associated with a chemotactic defective in the polumorphonuclear leukocytes?

Back 63

Localized Aggressive Periodontitis
- form of perio that is associated with a chemotactic defective in the polymorphonuclear leukocytes

Front 64

What bacteria is found in high numbers in localized aggressive periodontitis?

Back 64

Actinobacillus Actinomycetemcomitans A.A.
- bacteria that is found in high # in localized aggressive periodontitis

Front 65

Which one of following types of poclet has its base located apical to the alveolar crest as evidenced on radiograph?
a) gingival b) psuedo
c) suprabony d) Infrabony

Back 65

d) Infrabony
- type of pocket that has its base located apical to alveolar crest as evidenced on a radiograph

Front 66

Which statement describes an HIV (+) patient with necrotizing perio disease? a) higher prevalence in females than males b) higher incidence of skin lesions
c) microbial profile is similar in noninfected periodontally involved patients d) geographic distribution shows a higher prevalence in the eastern US

Back 66

c) Microbial profile is similar in noninfected periodontally involved patients
- describes an HIV pt with necrotizing perio disease

Front 67

which bacterium present in NUG patients may penetrate periodontal tissues?

Back 67

SPIROCHETES
- the bacterium present in NUG pt may penetrate periodontal tissues

Front 68

Both Necrotizing Ulcerative gingivitis (NUG)& Necrotizing ulcerative periodontitis (NUP) are categorized under the title _____

Back 68

Necrotizing ulcerative diseases
- what NUG & NUP are caregorized under

Front 69

NUG may be the first clinical sign of an underlying systemic disease such as ____

Back 69

Human Immunodeficiency virus infection (HIV)
- NUG may be 1st clinical sign of HIV

Front 70

Which of following diseases must be differentiated from NUG? a) Herpes simplex type 2 b) primary herpetic gingivostomatitis c) actuve necrotizing ulcerative gingivitis d) Acquired immunodeficiency syndrome

Back 70

b) Primary herpetic gingivostomatitis
- disease that must be differentiated from NUG

Front 71

What is most common bacterium found in the purulent exudate of a tooth with a periodontal abscess?

Back 71

Porphyromas Gingivalis
- most common bacterium found in the purulent exudate of tooth with perio abscess

Front 72

A gingival abscess is localized to the ____

Back 72

interdental papilla
- where the gingival abscess is localized

Front 73

Which of following is a clinical feature of a perio abscess?
a) fibrotic gingiva b) edematous gingiva c) gingival recess d) firm gingiva

Back 73

b) edematous gingiva
- a clincial feature of a perio abscess

Front 74

Which of following is a compication from a pericoronal abscess? a)gingival recession b) trismus c) attrition d) furcation defect e) fibrotic gingiva

Back 74

b) trismus
- a complication from a pericoronal abscess

Front 75

What is occurring when a pocket is probed on a tooth with an acute periodontal abscess?

Back 75

Incision and drainage is occurring when a pocket is probed on a tooth with an acute perio abscess

Front 76

___ appears 2-4 days after the inflammation appears.
- Has an increase in GCF
- has more migration of PMNs to the area
- Has an acute stage

Back 76

INITIAL LESION
- stage 1
- has an increase in GCF
- appears 2-4 days after inflammation appears
- has more migration of PMNs to the area
- Has an acute stage

Front 77

___ is not clinically visible at this stage it is subclinical
- bacteria that is present is mainly gram + cocci
- It is reversible

Back 77

INITIAL LESION
- subclinical- not clinically visible at this stage
- bacteria that is present is mainly gram + cocci
- it is reversible

Front 78

___ is the inflammatory response of gingiva to biofilm &is aggravated by poorly controlled glucose levels
Clinical signs= well demarcated gingival swelling and is soft, red, irregular, and hemorragnic surface of hyperplastic tissue is bulbous or papulunodular

Back 78

Diabetes Mellitus Associated Gingivitis = well demarcated gingiva is red , soft , increased gingival levvel in gingival fluid that could change microflora
Bacteria present: Actinomyces Sp. ; Polphymonas Gingivalis ; Prevotella intermedia ; A. A. ; Caphocytophaga ; Anaerobic Vibrios

Front 79

___ is found in pregnancy associated gingivitis
- Form of inflammatory hyperplasia
- The growth is exaggerated response to irritation
- Appears bright red, fleshy, & soft
- base is polypoid or pedunculated
-most frequently arises in the interdental papilla

Back 79

Pyogenic Granuloma
- form of inflammatory hyperplasia - exaggerated response to irritation -Appears red, fleshy, soft --base is pedunculated-- most frequent arises in inderdental papilla

Front 80

___ has elevated levels of progesterone, estrogen, prevotella intermedia , GCF, effects seen as early as 8 weeks
clincial signs= redness, edema

Back 80

Pregnancy Associated Gingivitis - elevated levels of progesterone, estrogen, GCF, Prevotella Intermedia

Front 81

Menstrual cycle associated gingivitis has 3 stages what are they

Back 81

3 stages of menstrual cycle associated gingivitis
1- Intermenstrualis (mid cycle)
2- Gingivitis Climacterice (menopausal)
3- Contraceptives

Front 82

___ - has incresed levels of estrogen, progesterone, testerone - fluctuation of hormones - high # of prevotala intermedium -characterized under gingival diseases modified by systemic factors- Endocrine System

Back 82

Puberty associated gingivitis
- increased levels of estrogen, progesterone, testosterone, high # of prevotala intermedium

Front 83

___ is the most common form of gingival disease.
- considered to be an exaggerated response to biofilm (plaque)
- Lesions are initial, early, and established
- bacteria associated is S. mutans, Streptococcus Sanguis, Fusobacterium, Actinomyces Viscosus, Vei Hondla

Back 83

Plaque Induced Gingival Disease * Most common*
- considered to be exaggerated response to biofilm - Reversible
- Lesions are initial, early, established

Front 84

Plaque Induced Gingival disease can be broken down into 4 categories what are they?

Back 84

1. Gingivitis associated with biofilm only with or without local contributing factors
2. GIngival disease modified by systemic factors
3. Gingival disease modified by Medications
4. Gingival disease modified by Malnutrition

Front 85

what does this describe..
•Increase in the number of lymphocytes, macrophages, and plasma cells
•At this stage there can be clinical signs such as Redness, Bleeding, and inflamed tissue
•Have more proliferation
•Happens at 4-7 days after plaque accumulation
•Rete pegs are developing

Back 85

Early Lesion - stage 2
increase # of lymphocytes, macrophages, plasma cells, neutrophils
clinical signs= bleeding, redness, inflamed tissues
proliferation occuring and rete pegs are developing

Front 86

Collagen destruction is occurring
•Causes pseudopockets because the tissue is inflamed
•Bacteria is gram (-) rods the microflora is changing
•Considered to be an acute Stage
•It is reversible

Back 86

Early lesion - stage 2
4 - 7 days
collagen destruction
pseudopockets - tissues are inflamed
bacteria present= gram (-) rods
Acute & reversible

Front 87

Occurs 2 to 3 weeks after plaque accumulation
Has predominance of plasma cells (B cells, antibodies)
widen intercellular spaces – more proliferation
destruction of collagen fiber
Clinicial signs bleeding, erythema, pseudopockets, gingival enlargement, no attachment loss, spongy, red, Reversible

Back 87

ESTABLISHED LESION
stage 3 - reversible
2-3 weeks
predominance of plasma cells b cells and antibodies
widen intercellular spaces
proliferation & destruction of collagen - bleeding, erythema, pseudopocket, gingival enlargement, no attachment loss

Front 88

What stage is this? Do have pocket formation, alveolar bone loss, the Junctional Epithelium is detached and migrates apically
There has been destruction of PDL fibers
- Gram (-) bacteria present

Back 88

Advanced lesion- stage 4
gram - bacteria present
destruction of PDL
Have pocket formation, bone loss, JE is detached and migrates apically

Front 89

In Advanced Lesion (stage 4) what is the 1st principle fiber that will be destroyed

Back 89

Alveolar crestal fiber

Front 90

What are the 3 disorders associated with Blood Dyscrasis?

Back 90

Associated with Blood Dyscrasis
- Leukemic Gingivitis
- Cyclic Neutropenia
- Anemia

Front 91

___ is a malignant condition: overproduction of leukocytes
oral features: tissue is red, tender, spongy, lost of stippling, spontaneous bleeding, purpuric
- has sever perio bone loss and oral ulcerations

Back 91

LEUKEMIC GINGIVITIS
- malignant condition
- overproduction of leukocytes
- severe bone loss&ulcerations
- tissue: red, tender,loss of stippling, spongy, bleeding

Front 92

____ is marked reduction of circulating neutrophils
oral manifestations: gingivitis, bone loss, necrotizing ulcers

Back 92

Cyclic Neutropenia
- marked reduction of circulating neutrophils
- manifestations: gingivitis, bone loss, necrotizing ulcers

Front 93

__ is a decrease number of erythrocytes.
- May have oral atrophy, angular cheilitis, tongue may be demuted and papilla lost, with pale mucous membrane

Back 93

ANEMIA - decrease # of erythrocytes. May have oral atrophy, angular cheilitis, tongue may be demuted & papilla lost w/pale mucous membrane

Front 94

___ is plaque induced
- no specific bacteria associated -excessive production of collagen -enlargement begins in interdental papilla - orally has fibrotic changes tissue become pink, firm, resilent
-Enlargement occurs 1-3months after beginning meds

Back 94

Gingival disease modified by Medications
- no specific bacter, excessive collagen, occurs 1-3months after beginning meds, mechanism of hyperplasia unknown, enlargement begins in interdental papilla, growth results in fibrotic changes, tissue become pink,firm,resilent, appears more exaggerated on labial aspects of anterior

Front 95

Gingival Disease modified by Medications occur in a patient taking ....
1. ___- anticeisure- 50% incidence of overgrowth
2. ___- antirejection- 30% incidence of overgrowth
3. ___- Calcium channel blocker- 15% incidence of overgrowth
4. Contraceptives- no specific bacteria is associated

Back 95

1. PHENYTOIN (dilantin)
-anticeisure : 50%
2. CYCLOSPORIN (Sandiuumen) - antirejection
30% incidence
3. NIFEDIPENE (Procardia) -Calcium Channel Blocker - 15%

Front 96

___ is plaque induced
- may have an impact on the host's ability to protect itself
- orally: you see bright red, swollen, bleeding gingiva
- nutritional defencies affect immune system function

Back 96

Gingival disease modified by Malnutrition
- Orally: bright red, swollen, bleeding gingival

Front 97

__ is defect in collagen formation- helps in formation of fibroblast & collagen
Clinical findings: hemorrhage, bluish red gingival, widened PDL & tooth mobility, slow wound healing, bleeds easily

Back 97

VITAMIN C (Absorbic Acid)
-defect in collagen formation
- clinical findings: hemorrhage, bluish red gingival, widened PdL, tooth mobility, slow wound healing, bleeding easily

Front 98

___ : clinical findings: blue/purple mucosa, glossitis, Angular cheilosis, enlarged fungiform papilla, atrophy of filiform papilla, burning sensation - May look like geographic tongue

Back 98

RIBFLAVIN - B2
Clinical Findings: Blue/ Purple Mucosa, Glossitis, Angular Cheilosis, Enlarged fungiform papilla, atrophy of filiform papilla, burning sensation

Front 99

___ = clinical findings: Glossitis, ulcerations & atrophy of papilla , cheilosis, burning sensations

Back 99

NIACIN - B3
clinical findings: Glossitis, ulcerations & atrophy of papilla , cheilosis, burning sensations

Front 100

Failure of bones to heal
- Radiographically you will see loss of alveolar bone and/or loss of lamina dura
- helps build bone

Back 100

calcium & vitamin d

Front 101

- Thickening of epithelium, underlying muscle atrophy, impaired taste

Back 101

Zinc
Vitamin C & zinc Help with the tissues healing process

Front 102

Smooth edematous tongue, angular cheilosis, fissures

Back 102

Protein
- Smooth edematous tongue, angular cheilosis, fissures

Front 103

___ - Have increased in prevalence due to STD
- Oral lesions may be secondary due to systemic infection or may occur through direct infections & appear as fluid filled ulcers
- include Gingival diseases of Specific Bacterial Origin, Viral Origin, Fungal Origin, Genetic Origin, manifestation of systemic conditions

Back 103

Non Plaque Induced Gingivits

Front 104

___ = has onset of puplic lesion, fever, includes gram (-) organism, orally: skin lesions are sm papules that turn into pustules, have cold sores, pharyngitis, swollen, purulent
- to determine have to have culture from pharynx, blood, uretha, rectum

Back 104

NEISSERIA GONORRHEA
- onset of pulpic lesions
skin lesions sm. papules that turn into papules
orally you see cold sores pharyngitis

Front 105

__ is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @site of entry (chancre)
- can occur on genitals or orally on lips, tongue, gingival, palate,tonsils

Back 105

TREPONEMA PALLIDUM (syphillis) - is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @ site of entry (chancre)

Front 106

__ have vesicles that may present as an acute condition
**acutely inflamed, diffused, red, swollen gingiva
**increased bleeding & occasional gingival abcsess formation **Symptoms: fever, malaise, pain

Back 106

STREPTOCOCCAL LESION
- vesicles present as acute condition -have been associated with group B hemolytic streptococcal infections -increased bleeding & occasional gingival abcess formation -acutely inflamed, red,diffused, swollen gingiva
- symptoms: fever,pain,malaise

Front 107

___ may be caused by a variety of DNA & RNA viruses
- most common type is the herpes virus
- Lesions frequently related to reactivation of latent

Back 107

Gingival disease of Viral Origin

Front 108

__ is when a DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop
- Patient may have fever,swollen lymph nodes, malaise
- tends to affect kids under 10

Back 108

Primary Herpetic Gingivostomatitis
= DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop
- Patient may have fever,swollen lymph nodes, malaise - takes 14 days to run its course

Front 109

Recurrent oral herpes has areas of ___,____,& __

Back 109

Recurrent oral herpes has areas of Erythema, Ulceration, and Possible Necrosis

Front 110

Failure of bones to heal
- Radiographically you will see loss of alveolar bone and/or loss of lamina dura
- helps build bone

Back 110

calcium & vitamin d

Front 111

- Thickening of epithelium, underlying muscle atrophy, impaired taste

Back 111

Zinc
Vitamin C & zinc Help with the tissues healing process

Front 112

Smooth edematous tongue, angular cheilosis, fissures

Back 112

Protein
- Smooth edematous tongue, angular cheilosis, fissures

Front 113

___ - Have increased in prevalence due to STD
- Oral lesions may be secondary due to systemic infection or may occur through direct infections & appear as fluid filled ulcers
- include Gingival diseases of Specific Bacterial Origin, Viral Origin, Fungal Origin, Genetic Origin, manifestation of systemic conditions

Back 113

Non Plaque Induced Gingivits

Front 114

___ = has onset of puplic lesion, fever, includes gram (-) organism, orally: skin lesions are sm papules that turn into pustules, have cold sores, pharyngitis, swollen, purulent
- to determine have to have culture from pharynx, blood, uretha, rectum

Back 114

NEISSERIA GONORRHEA
- onset of pulpic lesions
skin lesions sm. papules that turn into papules
orally you see cold sores pharyngitis

Front 115

__ is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @site of entry (chancre)
- can occur on genitals or orally on lips, tongue, gingival, palate,tonsils

Back 115

TREPONEMA PALLIDUM (syphillis) - is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @ site of entry (chancre)

Front 116

__ have vesicles that may present as an acute condition
**acutely inflamed, diffused, red, swollen gingiva
**increased bleeding & occasional gingival abcsess formation **Symptoms: fever, malaise, pain

Back 116

STREPTOCOCCAL LESION
- vesicles present as acute condition -have been associated with group B hemolytic streptococcal infections -increased bleeding & occasional gingival abcess formation -acutely inflamed, red,diffused, swollen gingiva
- symptoms: fever,pain,malaise

Front 117

___ may be caused by a variety of DNA & RNA viruses
- most common type is the herpes virus
- Lesions frequently related to reactivation of latent

Back 117

Gingival disease of Viral Origin

Front 118

__ is when a DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop
- Patient may have fever,swollen lymph nodes, malaise
- tends to affect kids under 10

Back 118

Primary Herpetic Gingivostomatitis
= DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop
- Patient may have fever,swollen lymph nodes, malaise - takes 14 days to run its course

Front 119

Recurrent oral herpes has areas of ___,____,& __

Back 119

Recurrent oral herpes has areas of Erythema, Ulceration, and Possible Necrosis

Front 120

___ begins with malaise & sore throat
- is a generalized rash that follows from macules to vesicles
-Orally: may have scattered vesicles that rupture
-Clinical phase 2-3 weeks

Back 120

VARICELLA ZOSTER (chickenpox)
-may have scattered vesicles that rupture
generalized rash follows from macules to vesicles

Front 121

___ is - more common in immunocompromised or in whom the normal oral flora has been disrupted
- Appears red, white, and ulcerated lesions

Back 121

Gingival disease of fungal origin

Front 122

MOST COMMON INFECTION IN THE MOUTH
- occurs in patient with AIDS
- Present as erythema of attached gingival and referred to as linear gingival erythema or HIV associated virus
- can be one of the 1st signs of AIDS

Back 122

Acute pseudomembraneous candidiasis (Candida)
** Most common infection in the mouth**
- occurs in patient with AIDS
- Present as erythema of attached gingival and referred to as linear gingival erythema or HIV associated virus
- can be one of the 1st signs of AIDS

Front 123

___ o Can also be seen under prosthetic devices
o Seen in individuals using topical steroids, with decreased salivary flow, seen in those who have increased salivary glucose(diabetic patient) & those who use inhalers, have asthma, or emphysema
o Buccal Mucosa is most frequent site this can affect

Back 123

CANDIDA ALBICANS
o Buccal Mucosa is most frequent site this can affect
Can also be seen under prosthetic devices
o Seen in individuals using topical steroids, with decreased salivary flow, seen in those who have increased salivary glucose(diabetic patient) & those who use inhalers, have asthma, or emphysema

Front 124

____ is - Usually chronic
- appear as white patches on gingival, tongue, oral mucous membrane

Back 124

Candida Infections
- Usually chronic
- appear as white patches on gingival, tongue, oral mucous membrane

Front 125

___ is Unique pattern of candida infection
- HIV related gingivitis but this can occur in someone that is immunocompromised
- distinct band of erythema along margin
- extends 2-3 mm

Back 125

= Linear Gingival Erythema
- Unique pattern of candida infection
- HIV related gingivitis but this can occur in someone that is immunocompromised
- distinct band of erythema along margin
- extends 2-3 mm

Front 126

___ is Infection produced by fungal organism
o One of the most common fungal infection in the US
o It is spread through dust from birds, bat droppings, or contaminated soil
o Orally the affected area may mimic carcinoma
o May present chronic ulcerations with rolled or raised border that appear as thickened white plaque
o Person may have no symptoms or mild flu like symptoms such as fever / headache

Back 126

Histoplasmosis
o Infection produced by fungal organism
o It is spread through dust from birds, bat droppings, or contaminated soil
o Orally the affected area may mimic carcinoma

o May present chronic ulcerations with rolled or raised border that appear as thickened white plaque

Front 127

__ is lesion on genetic origin
- inherited in autosomal dominant
- superimposed inflammatory reaction
- characterized by generalized firm, collagenous overgrowth of gingival tissue
- can delay eruption or extend over teeth
- Hyperplastic gingival firm, normal color,
- Rare

Back 127

HEREDITARY GINGIVAL FIBROMATASIS
- inherited autosomal dominant
characterized by generalized firm, collagenous overgrow of gingival tissue
-can delay or extend over teeth

Front 128

o Appear as desquamative lesions, ulcerations on gingival or both
o Includes skin disease
o Gingival may appear blotchy red, and has blister, vesicles , or slough
o Abnormality of immune system
o No bacteria associated

Back 128

Manifestation of systemic conditions

Front 129

___ are disorders that involve the mucous membrane of mouth as well as the skin.
These include: Linchen Planus, Pemphigoig, Pemphigus Vulgaris, Erythema Multiforme, Lupus Erthematosus , drug induced lupus

Back 129

Mucocutaneous Disorders

Front 130

- affects the skin and oral cavity
- has plaque like white lesions with a Lacey Like pattern
- occurs in painful, atrophic, ulcerative, or bulbous forms
- Reticular white lesions are the most frequent
- Erosive linchen planus frequently affects the gingival
- can also appear on the hard palate, lateral & dorsal of the tongue, alveolar ridge, and gingival
- Mostly Appears on the buccal mucosa
- can also be erosive
is an inflammatory disorder of unknown cause

Back 130

Linchen Planus
- has plaque like white lesions with a lacey like pattern
- reticular white lesion most frequent
- appears mostly on buccal mucosa
- reticular white lesion most frequent

Front 131

• Condition that is autoimmune in its origin
• It is a distinct vesiculobullous disorder of the elderly
• Affects the mucous membrane
• Lesions occur on any intraoral tissue
• Gingival most common target
• Features: blistering and loss of epithelial surface in response to trauma
• Leaves raw, painful erythemous ginginval surface
• May affect mucosal tissue
• Histological separation of surface epithelium from underlying connective tissue by split just beneath epithelial basale cell layer

Back 131

Pemphigoid
- most affects elderly
- hidtological separation of surface epithelium from underlying connective tissue by split just beneath epithelial basale cell layer

Front 132

- Histologic- separation of cells of epithelium & blistering within the epithelium above the basale cell layer
- Most severe form of pemphigus
- Skin lesions manifest as large bulla that rupture and leave eroded, weeping wounds
- Oral lesions: blisters develop & burst quickly leaving painful eroded areas with irregular borders
- Gingival desquamative lesions without margins are common
- Lesions are considered to be intraepithelial
- Autoimmune

Back 132

Pemphigus Vulgaris
- Histologic- separation of cells of epithelium & blistering within the epithelium above the basale cell layer
- skin lesion manifest as bulla that rupture leaving eroding weeping wounds

Front 133

 Acute inflammatory mucocutaneous disorder
 Appear as : ** Distinct large lesion of skin “ target like” also called bullseye lesion
 Lesion appears as central dusky red zone surrounded by a raised circumferential erythematous zone
 Mouth lesions appear as bulla that burst rapidly leaving erosions and ulcerations the develop a grayish pseudopocket

Back 133

Erythema Multiforme
- Target like bullseye lesion
 Mouth lesions appear as bulla that burst rapidly leaving erosions and ulcerations the develop a grayish pseudopocket

Front 134

 Most common in women and blacks
 Oral: central erythematous erosions or ulcerations surrounded by radiating keratotoic striation (striae)
 Gingiva appears erythematous
 Microscopic: Atrophy of rete ridges and degeneration of basale layer of epithelium
 Typically on the face it will appear as a butterfly rash that run across the bridge of nose
 Can affect the kidney and the heart

Back 134

Lupus Erythematosus
- butterfly rash
gingive appears erythematous
- the central erythematous erosions or ulcerations surrounded by radiating keratotoic striation (striae)
- atrophy of rete ridges & degeneration of basale layer of epithelium

Front 135

Drug Induced Lupus
From taking....
o ____ – antihypertensive - TB
o ____- antiarrhythmic
o ___- antibiotic

Back 135

Drug Induced Lupus
From taking....
o Hydralazin – antihypertensive - TB
o Proainamind- antiarrhythmic
o Isoniazid- antibiotic

Front 136

___ • Clinical manifestations: red, erythematous, gingivitis, ulcerations, bleeding with brushing or flossing, tissue sloughing, chelitis
• Reactions attribute to : toothpaste, mouthwash, Gun, Food Additives, Flavoring agents (cinnamon)
• May have soreness or burning tongue

Back 136

ALLERGIC REACTION
• Usually result of an additive
• Clinical manifestations: red, erythematous, gingivitis, ulcerations, bleeding with brushing or flossing, tissue sloughing, chelitis
• Some people are allergic to resortative materials such as: Mercury, Nickel, Acryclic
- may have soreness or burning tongue

Front 137

III. Traumatic Lesions
___- produced by artificial, self inflicted, person scratching tooth, toothbrush lesion
___- produced by health professional- I caused it – ex. Overcountered crowns , etc
___l- damage to gingival- minor burns from hot food or drinks

Back 137

Factitious
Iatrogenic
Accidental

Front 138

____ injury
- most common aspirin burns.
- a painful white area of epithelial necrosis

Back 138

chemical injury

Front 139

____ injury
-toothbrush trauma
- Gouge or scratching teeth
- Food impaction – wedge production
- The injury can destroy the band of attachment

Back 139

Physical Injury

Front 140

__ is an inflammatory disease of supporting tissues.
- Caused by specific group of microorganisms
- result in progressice destruction of PDL & alveolar bone
- clinically detectable by CAL lost, pocket formation & change in alveolar bone density and height

Back 140

PERIODONTITIS

Front 141

__ is previously called adult onset of periodontitis
- Considered to be Episodic/ random burst,periods of quiescence and rapid progression
- Nonsystemic factors (smoking, stress) can modify progression of disease
o Bacteria associated...
- Strong Evidence for Etiology = Actinobacillus Actinomycetemcomitans (A.A.), Porpyromonas gingivalis, Bacteroides forsythus (Tannerella forsythensis)
- Moderate Evidence for Etiology = Campylobacter rectus, Eubacterium nodatum, Fusobacterium nucleatum, Prevotella intermedia, Peptostreptococcus micros, Streptococcus intermedius – complex, Treponema denticola, Capnocytophaga Species

Back 141

CHRONIC PERIODONTITIS

Front 142

What are some of the characteristics of Chronic Periodontitits?

Back 142

• Gingiva slight / moderately swollen
• Color is pale pink / red to magenta
• Loss of stippling
• Blunted or rolled margins
• Flattened or cratered papilla
• Sometimes thickened , fibrotic tissue may obsure the underlying inflammatory changes- this depends on the repair process (tends to occur in smokers)

Front 143

What are some signs and symptoms of chronic perio?

Back 143

o Usually painless
o Bleeding on probing
o Periodontal pockets
o Bone loss: furcation involvement
o Subgingival calculus present
o Tooth mobility
o Suppuration
o Shiny appearance without orange peel look to it

Front 144

what is etiology of chronic periodontitis?

Back 144

Etiology of chronic perio:
Considered to be multifactorial
- Biofilm is the primary factor ; however the host is a factor as well
- Interaction between the biofilm and host
- Pathogenic bacteria is needed for process- the bacteria have to be prominent there so a change in microflora occurs
- Bacteria alone is not sufficient for progression
- Research indicates host’s own immune response is major determinant of severity

Front 145

___ Is defined by....
1-2 mm of CAL (recession + probing depth)
3-4 mm of Pocket depth
2 mm or less of alveolar crestal bone lost
- Possible class 1 furcation involvement – deepens on the tooth anatomy
 Loss of attachment is evident by gingival recession; blunting of interdental papilla
Inflammation evident by bleeding on probing
Periodontal pockets are evident

Back 145

EARLY PERIODONTITIS
Also called slight or mild periodontitis
Case type 2

Front 146

Radiographic: what will be seen with early periodontitis ?
case type 2

Back 146

o Fuzziness & discontinuity of lamina dura
o Triangulation or funneling occurring (it is a wedge shaped & radiolucent area)
o Bone resorption along endosteal margins
o Nutrient canals
o Has alveolar crestal bone loss – 2mm or less
o Center of crestal portion is fuzzy & cup shaped
o Interproximal calculus
o Discontinuity of the lamina dura

Front 147

____ Defined as....
3-4 mm CAL
4-6mm in pocket depth
3-4 mm alveolar bone loss
Class 1 or 2 furcation

Back 147

Moderate Periodontitis
Case type 3

Front 148

What will you see radiographically with moderate periodontitis? case type 3

Back 148

- Widening of the PDL space
- Triangulation or funneling is present which is the beginning of angular / vertical bone loss
- Horizontal & distinct vertical bone loss
- Nutrient Canals

Front 149

____ is Defined as....
- Greater than 5 mm of CAL
- Greater than or equal too 6mm of pocket depth
- Greater than or equal too 5mm of bone loss

Back 149

Advanced / Severe Periodontitis
Case type 4

Front 150

What will you see radiographically with Advanved / Severe Perio
Case type 4?

Back 150

Radiographically will see...
- Major destruction of alveolar bone
- Around 50% of bone loss is occurring
- can have a possible osseous defect
- Have Horizontal and possible vertical bone loss

Front 151

____ results from failure of clinician and / or patient to control plaque
- Signs and symptoms of perio reappear after therapy sometimes due to that the patient did not respond favorably

Back 151

Recurrent/ Refractory Periodontitis
Case type 5

Front 152

what is etiology of recurrent / refractory periodontitis case type 5?

Back 152

o Abnormal host response
o Unusual pathogenic and virulent bacteria
o Failure to eliminate biofilm retentive factors such as overhanging margins
o Studies describe impaired PMN chemotaxis & phagocytosis

Front 153

What are some treatment methods for chronic periodontitis?

Back 153

 Consult with physician with concerns if patient has systemic factors
 Individualized instructions – reinforcement and evaluation of adequate biofilm control
Smoking cessation
Debridement
Use of Antimicrobial agents
Removal of local contributing factors
Reevaluation- typically 4-6 weeks after scaling

Front 154

All the following parts of the periodontium are affected by occlusal truma except one which one?

Back 154

gingiva

Front 155

which one of the following definitition pertains to primary occlusal trauma?

Back 155

a. normal adequate

Front 156

all the followings are signs and symptoms are found in occlusal trauma except one

Back 156

occlusal erosions

Front 157

which one of the following radiographic signs is evident in occlusal trauma

Back 157

widening of peridodontal ligament space

Front 158

occlusal trauma in combination with chronic inflammatory peridontitis may result in greater tooth mobility and alveolar bone loss because occlusal trauma cause periodontal pocket formation

Back 158

statement correct but reason i s not

Front 159

Two days after the patient receives an amalgam restorations, he reports back to the office complainig of pain and losseness of tooth. which on eof the following treatment would be appropriate?

Back 159

reduce the height of the restoration

Front 160

which one of the following factors is the primary cause of secondary occlusal trauma?

Back 160

tooth with severe bone loss

Front 161

a patient complains of soreneses in the jaw upon wakening in the moring. she is having stressful problems at work. she complains that some of her lower teeth are wearing down, which one of the following conditions does this patient most likely have?

Back 161

parafunctional habit

Front 162

a pt. returned for a 2 week follow up visit from perio surgery complaining of tooth mobility. there was no mobility before the surgery was done. which one of the following should be explain to pt?

Back 162

mobility will decrease in time

Front 163

which one of the following conditons is best treated with a night guard?

Back 163

clenching and grinding

Front 164

Reliance on clinical experience, intuition, poorly designed studies alone can result in false conclusions and less than optimum care due to factors such as:
a.Bias
b.Placebo effect
c.Nocebo effect
d.b and c
e.All of the above

Back 164

Answer: all the above

Front 165

Consecutive controlled case studies provide a level of evidence of:

Back 165

Previous clinical success

Front 166

The American Academy of Periodontology Guidelines for Periodontal Therapy Position Paper states the goals of periodontal therapy include all of the following except:

Back 166

Restoring the periodontal attachment level to its original level

Front 167

Probing pocket depth (PPD) is a measurement of the distance between:

Back 167

The gingival margin and the base of the probable pocket

Front 168

Furcation involvement is:a.A marker of past disease
b.Does not reliably predict future disease progression
c.a and b

Back 168

Answer: c

Front 170

Consecutive controlled case studies provide a level of evidence of:

Back 170

Previous clinical success

Front 171

The American Academy of Periodontology Guidelines for Periodontal Therapy Position Paper states the goals of periodontal therapy include all of the following except:

Back 171

Restoring the periodontal attachment level to its original level

Front 172

Probing pocket depth (PPD) is a measurement of the distance between:

Back 172

The gingival margin and the base of the probable pocket

Front 173

Furcation involvement is:a.A marker of past disease
b.Does not reliably predict future disease progression
c.a and b

Back 173

Answer: c. a and b

Front 174

The Oral Risk Assessment (ORA) and Early Intervention System provide the following methodology to organize patient care:a.Collection of relevant medical and dental information
b.Assessment and assimilation of the collected information
cRecommendation of professional therapies and home care procedures and products
d.Evaluation of treatment and healthcare outcomes
e.All of the above

Back 174

Answer:e. All the Above

Front 175

The term “adult periodontitis” has been replaced by the term “chronic periodontitis.”
True or false

Back 175

True

Front 176

Chronic periodontitis incidence and severity is related to all of the following except:

Back 176

Toothpaste choice

Front 177

Clinical attachment loss (CAL) of 1-2 mm is considered to be slight.True or false

Back 177

True

Front 178

Alveolar bone remodels in response to:a.Directional forces b.Host response
c.Hormones
d.Glucocorticoids
e.Various disease states
f.All of the above

Back 178

Answer: f. All the above

Front 179

If bone loss forms an angular infrabony defect:

Back 179

Bone grafting may be helpful

Front 180

The following statements accurately describe bone except:

Back 180

Bone is a static structure

Front 181

Bone resorption can be reduced by which of the following:a.Estrogen
b.Interferon
c.Bisphosphonates
d.None of the above
e.All of the above

Back 181

Answer: All the above

Front 182

Deep, narrow infrabony defects with more bony walls have the worst chance to gain attachment following periodontal surgery. true or false

Back 182

False

Front 183

It is recommended to determine patients’ surgical needs prior to assessing patients’ response to non-surgical therapies. true or false

Back 183

False

Front 184

Disrupting plaque biofilm is best accomplished through:

Back 184

Routine brushing and flossing

Front 185

The exact amount of time needed to optimally perform scaling and root planing has been scientifically determined.
True or false

Back 185

False

Front 186

Rinsing and irrigating with antimicrobials:

Back 186

May help control gingivitis

Front 187

Locally-delivered sustained-release antimicrobials all contain antibiotics.
True or false

Back 187

False

Front 188

Systemic antibiotics feature all of the following except:

Back 188

A routine benefit in chronic periodontitis

Front 189

Subantimicrobial systemic dosing of doxycycline
a.As an adjunct to SRP, has been shown to reduce PPD better than SRP alone
b.Has been shown to have tolerability similar to placebo
c.Inhibits the activity of collagenase
d.Is appropriate for use during pregnancy
e.All of the above
f.a, b and c

Back 189

Answer: F. a,b,and c

Front 190

The goal of osseous surgery is to: a.Restore lost attachment
b.Re-contour bone
c.Allow increase access for routine plaque control
d.a and b
e. b and c

Back 190

Answer: e.b and c

Front 191

Barriers may be used in regenerative surgery to:a.Prevent epithelial tissues from growing within the bony defect
b.Modulate the host response
c.Guide periodontal ligament cells to grow within the bony defect
d.a and c
e.b and c

Back 191

answer: d. a and c

Front 192

Non-resorbable barriers a.Remain in place as long as needed
b.Require removal at a later surgery
c. a and b

Back 192

Answer: c. a and b

Front 193

Bony defects with fewer wall generally have more predictable bone fill results.
true or false?

Back 193

false

Front 194

Autografts

Back 194

Can be obtained from intra-oral or extra-oral sites

Front 195

Allografts a. Are freeze-dried
b. Utilize the patient’s own bone
c. May be demineralized
d. a and c

Back 195

Answer: D a and c

Front 196

Xenografts

Back 196

Are obtained from animal sources

Front 197

Synthetic bone a.May be processed from calcium carbonate
b.Facilitates the body’s regenerative process
c.Is replaced by new bone over time
d.All of the above

Back 197

Answer: d all the above

Front 198

Biological growth factors are used with synthetic bone materials to simulate the osteogenic properties of an autograft. True or false?

Back 198

True

Front 199

Classification of Furcation involvement: Which grade?
Pocket formation into the fluting of the furca but the interradicular bone is intact. No gross or radiographic evidence of bone loss.
Recorded on the chart as open triangle with no base

Back 199

Grade I Involvement:
Pocket formation into the fluting of the furca but the interradicular bone is intact. No gross or radiographic evidence of bone loss.
Recorded on the chart as open triangle with no base

Front 200

Classification of Furcation involvement: Which grade?
Interradicular bone is destroyed on one or more aspects of the furcation, but a portion of alveolar bone and periodontal ligament remains intact
Get in but not all the way through
Recorded as open triangle

Back 200

Grade II Involvement:
Interradicular bone is destroyed on one or more aspects of the furcation, but a portion of alveolar bone and periodontal ligament remains intact
Get in but not all the way through
Recorded as open triangle

Front 201

Classification of Furcation involvement: Which grade?
Furcation is occluded by gingiva but the interradicular bone has been destroyed so that a probe can be passed through from one surface to another
Recorded as solid triangle
Through and through

Back 201

Grade III involvement
Furcation is occluded by gingiva but the interradicular bone has been destroyed so that a probe can be passed through from one surface to another
Recorded as solid triangle
Through and through

Front 202

Classification of Furcation involvement: Which grade?
Periodontium is destroyed to such a degree that the furcation is open and exposed and clinically visible
Recorded as solid triangle

Back 202

Grade IV involvement
Periodontium is destroyed to such a degree that the furcation is open and exposed and clinically visible
Recorded as solid triangle

Front 203

Localized tooth related factors that modify or predispose to plaque induced gingival disease/periodontitis

Back 203

Localized tooth related factors that modify or predispose to plaque induced gingival disease/periodontitis
Tooth anatomic factors-concavities max laterals
oEnamel pearls
Dental restorations
oOverhangs with localized factors
oPlace subgingival
Root factures
oDue to injury due to accident

Front 204

Mucogingival deformities and conditions around teeth

Back 204

Gingival recession
oBecause a lot of recession inadequate attach gingival
Lack of keratinized gingival
Decreased vestibular depth
oDue to someone who has missing teeth and alveolar ridge not where it suppose to be
Abberant frenum/muscle position
oIf its too high or low
Gingival excess
o inconsistent margin

Front 205

Mucogingival deformities on endentulous ridges

Back 205

Vertical, horizontal ridge deficiency
Lack of keratinized tissues
Tissue enlargement
Aberrant frenum/muscle position
Decreased vestibular depth

Front 206

Occlusal trauma
Primary
Injury due to ?
Normal or slight bone loss
Etiology: ?
Pocket: ?
Bone Height:?
Mobility: ?
Treatment options:?

Back 206

Occlusal trauma
Primary
Injury due to attachment apparatus-excessive Occlusal force
Normal or slight bone loss
Etiology: excessive Occlusal forces
Pocket: No
Bone Height: normal or slight bone loss
Mobility: adapted
Treatment options: selective grinding, appliances, monitor without treatment

Front 207

Occlusal trauma
Seondary
Normal or excessive force cause injury in periodontium with reduced bone support
oPerson already has disease process going on
oPerson already has inadequate bone
Bone levels are inadequate to support forces
Tooth less resistant to Occlusal loading
bone loss?
Etiology: ?
Pocket: ?
Bone Height:?
Mobility: ?
Treatment options:?

Back 207

Occlusal trauma
Secondary
Moderate/severe bone loss
Etiology: normal or excessive forces
Pocket: No/Yes Periodontal pockets may be present, but due to periodontal destruction rather than the occlusal trauma
Bone height: reduced height (moderate severe)
Mobility: progressive
Treatment: Splinting, selective grinding, extraction, orthodontic, monitor appliances ex: night guard

Front 208

Which of the following is the strongest indication of a correlation between stress and periodontal disease

Back 208

ANUG

Front 209

A significant possible complication of smoking is

Back 209

refactory periodontitis

Front 210

nutritional deficiencies are considered risk factors for periodontal disease because they:

Back 210

lower the host reponse

Front 211

oral side effects of a deficiency in vitamine B6 (pyridoxine) include all the following excepts

Back 211

candidiasis

Front 212

a deficiency in this vitamine, which is reponsible for the biodynthesis of collagen, will adversely affect periodontal connective tissues and wound healing:

Back 212

vitamin C

Front 213

When vitamine D deficiency occur in adults, the resulting effects on the periodontium include all the following excepts:

Back 213

hyperplasia of the gingiva

Front 214

Oxygen-free radicals may play a role in teh tissue destruction associated with all the following, except:

Back 214

systemic lupus erythematosus

Front 215

During puberty an adolescent is more susceptible to the deveolpment of gingivitis because of:

Back 215

altered capillary permeability

Front 216

recent evidence indicates that desquamative gingivitis is most likely a feature of all the following except:

Back 216

menopause

Front 217

the rationale for the prevalence of periodontal disease in patients with diabetes mellitus includes all of the following except:

Back 217

increased fibrosis of the peridontal tissue

Front 218

mulitple periodontal abscesses, velvety red gingivae, and marginal proliferation of the gingivae are common oral manifestions of:

Back 218

uncontrolled diabetes

Front 219

The most common form of gingivites among patients with AIDS is:

Back 219

linear gingival erythema

Front 220

Which microorganisms are seen more frequently in NUG?

Back 220

spirochete species

Front 221

When a pt has been diagnosed with rapidly progressive periodontitis, one would expect to see which of the following combination of microorganisms?

Back 221

P.gingivalis, P.intermedia, A. actinomycetemcomitans

Front 222

According to page and schroeder within 4 to 7 days after plaque accumulation the lesion that occur is the

Back 222

early lesion

Front 223

histologically, when a lesion extends into the PDL and alveolar bone, it is classified as

Back 223

advance lesions

Front 224

clinical signs and symptoms of the occlusal traumatism include

Back 224

radiograohic signs of widen PDL space and clincial evidence of tooth mobility

Front 225

damage that occur when the amount of alveolar bone is normal but there are excessive occlusal forces present is referred to as

Back 225

primary occlusal traumatism

Front 226

most signigicant feature of chronic gingivitis is

Back 226

bleeding in response to probing

Front 227

a deficiency in vitamine c cauases all the following except

Back 227

gingival inflammation

Front 228

localized enlarge interdental gingiva that form tumor like growths may accompany

Back 228

leukemic or pregnancy gingivitis

Front 229

desquamative gingivites frequently is linked with all of the following except

Back 229

pregnancy

Front 230

desquamative gingivitis is most commonly seen in

Back 230

menopausal women

Front 231

occcasionally severe enlargement of the entire gingiva including both facial and lingual surfaces occur with no apparant explaination. this conditon is:

Back 231

rare hereditary or familial condion

Front 232

rapid tissue destruction commonly associateed with acute gingival disease is primarily caused by large number of

Back 232

PMNL

Front 233

19 years old college student present for emergency exam complains pain in the gingiva, spontaneous bleeding, and bad metallic tase in his mouth. during inspectio, a fetid ordor, puch out papilla covered with a gray pseduo membrane, and spontanous bleeding. pt most likely have?

Back 233

NUG

Front 234

Microorganism most commonly associated with NUG

Back 234

spirochetes

Front 235

most common form of peridontitis which is characterized by periodontal pocket formation, bone loss, eventually tooth mobility, with no abnormalities of the host defense system is:

Back 235

chronic periodontitis

Front 236

aggressive peridontal disease include any of the following except

Back 236

refactory periodontitis

Front 237

which of the following form of peridontal disease most likely to be manifestation of systemic disease?

Back 237

prepubertal periodontitis

Front 238

microorganism most commonly associated with juvenile periodontitis is

Back 238

a. actinomycetemcomitans

Front 239

of the more aggressive periodontal disease, which one of the following seems to be most closely linked iwth juvenile peridontitis?

Back 239

rapidly progressive periodontitis

Front 240

systemic condition characterized by hyperkeratontoic skin lesions of the palms, soles, knees, and elbows, severe destruction of the periodontium

Back 240

papillon-lefevre syndrom

Front 241

risk factor most consistently associated with rrefractory periodontitis is

Back 241

smoking

Front 242

The AAP classifies early adult periodontitis as:

Back 242

case type 2