← Periodontics Final Review Ch 11 Export Options Alphabetize Word-Def Delimiter Tab Comma Custom Def-Word Delimiter New Line Semicolon Custom Data Copy and paste the text below. It is read-only. Select All A traditional clinical diagnosis is made by measuring the CAL and the loss of alveolar bone Presence of ____________ is an indicator of inflammation has the clinical advantage of being more objective than assesment of gingival color and texture bleeding Gingival bleeding is a good indicator of the presence of _____________lesion in the CT at the base of the sulcus inflammatory lesion The severity of bleeding increases with an increase in the size of _____________ ________ inflammatory infiltration What is the most widely used diagnostic tool for the clinical assesment of CT destruction in periodontitis? Periodontal probing The use of periodontal probe presents limitations in the terms of _________ and ____________ measurments sensitivity and reprocducibility If the tissue is inflamed it offers ______ resistance to the probe penetration less In healthy gingiva the tissue will demonstrate and increased _____________ to perio probing resistance In health apical extent of the probe penetrates ______ to the middle portion of the JE middle When there is inflammation the probe can go through the JE into __________levels deeper. What workshop attempts to address the problems associated with probing by supporting the use of standardized automated preassure sensitive or controlled forced probes? The national instiute of dental craniofacial research Which system combines advantages of constant probing force electronic measurment and storage of data therefore eliminating errors associated with hand recording of measurements. Florida probe system Assesment of CAL provides information relating to the gain or loss of __________ ________ __________ to the root surface CT attatchment CAL provides information of the past not what is ________happening currently Radiographic assesment provide useful information of the __________bone levels but do not accuretly reflect the bone buccally or lingually interproximal bone levels ____________-volume of alveolar bone must be damaged befor the loss is evident and detectable on radiographs substantial volume Is the use of adjuctive testing indicated for all patients? no those that dont' respond to traditional regiments or those that demonstrate signs of aggressive atypical forms of periodontitis would be good canidates for supplemental testing How can advanced diagnostic methods be helpful? identify periodontal pathogens, discover patients at risk for developing perio diseases, determine mode of treatment, montior success of perio therapy directed at suppression or eradicated specific periodontal pathogens. What are the three groups used in adjuctive tests? Gingival Crevicular Fluid Assays, Microbial tests, Genetic assays Which test invoves puting paper points into pockets to identify inflammatory host markers? GCF assays Can GCF assay strips evaluated in a dental office specify a specific bacteria? NO Which test involves removing supragingival plaque, take samples of subgingival bacteria with current and place in transport fluid and transported to a licenced labaratory to maintain bacteria viability and the most common pathogens are identified, only test that can determin antimicrobial sensitivity of cultured bacteria only detects living bacteria? Microbial tests Which test shows the presence of Interleukin 1 cytokine production. Genetic Assays T/F interlukin 1 does not cause periodontal disease directly but is predisposes the patient to the disease process by increasing inflammation when bacteria are present True What is the test available that determines if a patient has IL-1 genotype? PST periodontal suseptibility testing Genetic assays of IL-1 is performed by taking finger stick blood sample sending to lab An IL-1 gene positive patient is how many times more likely to develope or have advanced periodontal disease than a gene negative patient? 7 times more likely A _____________ is a nonbiologic (artificial) device surgically inserted into the jaw bone to replace missing tooth or provide support for a prosthetic denture? dental implant ___________ are portion of implant that is surgically placed into the bone. acts as root of the implant implant fixture __________ is the post that protrudes through the tissue into the mouth and acts to support restorative prosthesis crown or denture. abutment ________the superstructure replacement crown or denture that is either screwed, cemented or snapped to the abutment prosthetic What are the tissues that surround the dental implant? peri-implant tissues What does the epithelium adapt to , to create a biological seal? titanium abutment post Does the JE adhere to implant surfaces and have simular biologic features to epithelial tooth interface of natural tooth? yes What seperates the inner tissues from the outside environment for both implants and teeth? JE perimucosal seal What forms around the implant lined with sulcular epithelium? a sulcus Does the implant have cementum that the gingival fibers and the PDL can insert into? NO Can the gingival fibers or PDL insert into the titanium surfaces like it would cementum? NO So what can happen to the bone since the gingival fibers and the PDL cannot insert into the titanium surface like cementum? periodontal pathogens can destroy bone more rapidly along dental implant along natural tooth. So where are the CT fiber bundles in the gingival located when it comes to an implant? parallel to the implant surface or encircling the implant but they DO NOT insert directly into the implant surface what is the term for the direct contact of the bone with the implant surface? osseointegration Osseointegration resembles the term _________coined by schroeder and defined by Branemark functional ankylosis What are the most commonly used implants? Root formed This type of implant provides osseous anchorage through formation of an intitmat lattice between the titanium surface and bone Root formed endosseous Most implant lengths are 7 to 16 mm longs What are the length selections of implants based on? bone height proximity to vital structures like sinus and nerve trunks The implant diameter ranges from 3-6 mm Diameter of the implant is based on the volume of available bone at the implant site. What is the most dominat form of endosseous implant used today? cylindric What type of implant do we not see as often today? Subperiosteal Which type of implants have metal frams that sit on bone and protrude through gingiva as an anchor to prosthesis? Subperiosteal Which type of implant has posts that protrude through gingiva provide anchorage for prosthesis, and can ONLY BE used on mandible. Transosteal What should be avoided when giving an implant to a patient? trauma to bone, overheating or excessive forces Bone cells are irreversibley damaged if heated about _____ degrees celsius for one minute. 47 so coolant is required during surgery What are three surgical procedures? Submerged, Non submerged, imediate implant placement Submerged is two stage protocol requires two surgical procedures before __________ restoration The first surgical procedure in submerged stage is when the implant is placed and ________ is closed over the implant tissue The second surgical procedure in submerged stage is after healing period of ___ to ___ months. the implant is exposed and abutment is placed and soft tissue healing takes place for about ___ to ___ wks befor restorative procedures are done 3 to 6 months, 3-4 wks This stage is the immediate placement of implant after a tooth is extracted, presence of infection and lack of bone are contradictions in immediate placement. Immediate implant placement after extraction This stage requires one surgical procedure implant is placed and tissue are closed around the healing abutment implant heals for 3 to 6 months then the abutment is removed and final restoration is placed. non submerged protocol Branemark originally adviced ____ months healing for mandible and ___ months healing for maxilla 3, 6 What are probing depths for healthy implant patients 3-5 mm Should you probe a patient who has had implants put in 3 to 6 months prior to appointment? no Bone loss should not exceed ____ mm anually after the first year after loading the absence of peri implant radiolucencies and associated conditions 0.2mm Radiographs should be taken at ___,____ and ____ months and then every ___to ___years there after unless clinical symptoms are seen 6, 12, 36 months and 2-3 years ____ is a collective term for inflammatory reactions in the tissue surrounding the implant peri implant disease _____ is a reversible inflammatory reaction in the soft tissues surrounding a functioning implant. peri implant mucositis __________ is a inflammatory reaction that affect soft and hard tissues around the implant leading to loss of supporting bone on functioning implants. peri implantitis What is the primary microbial etiological agents in microbiology of peri implant disease? plaque biofilm Can the same pathogenic bacteria that interfere with natural teeth be detrimental to dental implants? yes What are the anatomical differences between implants and teeth implants do not have a PDL and CT gingival fibers are not inserted into cementum. Is the inflammatory disease more rapid around implants compared to natural tooth? yes Inflammation within the peri implant tissues have a tendency to spread circumferentially Early implant failures result from failure to achieve osseointegration What can be a cause for failure to acheive osseointegragation host tissue factors, bacterial contamination of wounds, poor surgical technique or instability of implant at installation (not enough bone or poor quality of bone ) Late implant failures include mechanical overload and peri implant infection One late implant failure is when there is excessive occlusal force generated form improper placement/angle of implant prothesis design or parafunctional activity may cause damage to alveolar bone. Mechanical overload One late implant failure is when there is given the microbial association, treatment of peri implant infections follows same sequence of events of perio disease in natural tooth. peri implant infection. What type of instruments are considered safe to use on implants plastic, nylon, titanium, graphite or gold-plated curretes. What type of polishing agents should be avoided in implants? coarse polishing agents. What is a good choice to use with rubber cups and implants? tin oxide What assesments should a DH make when evaluating an implant what should we look for? loose screws, abutment fracture unseating attatcment on overdenture. Patients should be instructed to avoid what for home care aids? Metal homecare aids.