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Periodontology Board Book
Terms in this set (103)
What are the 4 tissues of the Periodontium?
What are the functions of the PDL? (7)
-transmits occlusal forces to bone
-attaches teeth to bone
-maintains position of gingival tissues
-resists impact of occlusal forces
-supplies nutrients to perio structures
-transmits touch, pain, and pressure sensations
What are fiber bundles?
-Collagenous fibers (sharpey's fibers) that attach cementum to bone
What are the 6 groups of fiber bundles?
Transeptal, Alveolar, Oblique, Horizontal, Apical, Interradicular
What fiber bundles extend inter proximally over the alveolar crest and are embedded into the cementum of two adjacent teeth? **Important for Ortho
What is the largest fiber bundle group which extends from the cementum coronally to bone?
These fiber bundles specifically withstand MASTICATORY stress in a vertical direction...
Which fiber bundle is found only in multi-rooted teeth and extend from the cementum to the bone in areas of furcation?
What are the most predominant cells in the PDL, which are responsible for collagen synthesis and degradation?
What cells are capable of remodeling bone and cementum?
Osteoclasts, Osteoblasts and Cementoblasts
How many disease classifications are there?
8 - Name them :)
What are the two types of Gingival Diseases?
1. Dental Plaque Induced
2. Non-plaque Induced
Which gingival disease is associated with plaque only and what 3 factors can modify it?
-Dental plaque induced
-Modified by systemic factors, medications, nutrition
What are non-plaque induced gingival lesions caused by? (4)
-Viral, Fungal, or Genetic Origins
-Gingival manifestations of systemic conditions (Diabetes)
-Traumatic Lesions (abrasive toothbrushing)
-Foreign body reactions
What are specific causes of gingival inflammation? (2)
-Subgingival margins of restorations
What results from ulcerations at the BASE of the sulcus?
What replaced "Early Onset" Perio?
Which disease classification is associated with hematological disorders? (Acquired Leukopenia or Leukemia)
Periodontitis as a manifestation of systemic diseases
Periodontitis associated with genetic disorders- What are four important genetic disorders associated with this classification? (according to the review)
-Familial and cyclic neutropenia
What are the 2 types of Necrotizing Periodontal Diseases?
-NUP and NUG
Can NUP occur without NUG?
Yes, if the area is already compromised.
What are the (4) microbes most often associated with NUP/NUG? (PPFS)
Spirochetes (esp. T. denticola)
Why is tetracycline often the drug of choice? (2 reasons)
1. Concentrates in the gingival crevicular fluid
2. Has anti-collagenase properties
What are the common clinical findings of NUP/NUG? (5)
1. Punched out papilla
3. Fetid Odor
5. Severe inflammation
What are the 4 abscesses of the periodontium?
Gingival, Periodontal, Pericoronal, Periapical
Which abscess results from the injury to or infection of surface gingival tissue?
Which abscess results when infection spreads deep into perio pocket and drainage is blocked?
may develop after periodontal debridement
Periodontal (Lateral Perio Abscess)
Which abscess develops in inflamed dental follicular tissue overlying the crown of a partially erupted tooth? (most often mandibular third molars)
Which abscess results from pulp infection (usually secondary to decay)?
Which abscess requires a PA and which abscess generally will NOT show up on an x-ray?
What is a mild pupal inflammation usually resulting from placement of a deep restoration and associated with episodic temperature-related pain which improves with the deposition of reparative dentin? hahahahah
-AKA- pulp hyperemia
KNOW that REVERSIBLE PULPITIS is related to....
What is pneumatization?
a condition in which there is a connection from the sinus to an extraction site
-the maxillary sinus can "pneumatic" (extend) into old extraction sites
What are associated with Development or acquired deformations and conditions? (3)
1.Localized tooth related factors
2.Mucogingival deformities and conditions around teeth (gingival rec, lack of attached ging, frenal positions, gingival excess)
What category describes MOST gingivitis?
Chronic plaque-associated gingivitis
Vascular, Rapid development, obvious inflammation, pain, erythema or cyanotic tissues are associated with?
(Acute or Chronic symptoms)
Cellular, Slow development, may appear "normal", may not cause pain, and pallor of tissues are associated with?
(acute or chronic symptoms)
There are 5 steps in plaque formation, what is the first step?
1. Glycoproteins from saliva are absorbed onto the tooth surface.
What is the second step in plaque formation?
2. Bacteria adhere to the acquired pellicle.
What step in plaque formation is this- Bacteria multiply and form mini-colonies; a matrix (exopolysachharides) forms between the bacteria.
STEP THREE, almost have our plaque formed.
What does the bacterial matrix (exopolysachharides) do?
increases plaque mass and thickness
What is step four in plaque formation?
4. Creation of cohesive biofilm
The final step of plaque formation is.......
5. Bacterial detachment (planltonic bacteria)
Simplified plaque formation-
1. glycoproteins absorb onto tooth
2. bacteria adheres to acquired pellicle
3.bacteria multiplies (mini colonies) and matrix forms
4. cohesive biofilm
5. bacterial detachment (planktonic bacteria)
T/F? Plaque causes periodontitis?
FALSE, but may initiate it but is not the only factor.
What are the nature and severity of periodontal diseases related to? (2 things)
1. Virulence of bacteria
2. Host response
What is the hallmark sign of acute inflammation?
(vasodilation of the peripheral circulation)
Why does fibrotic tissue appear highly stippled?
due to increase in cellular and fibrous components
What is the distinct rounding and enlargement of the gingival margins found in the acute inflammatory response? (type of gingival contour)
Organisms as disease progresses: HEALTH
-non-motile, gram positive, aerobic, cocci
Organisms as disease progresses: DISEASE
-motile, gram negative, anaerobic, rods
What organisms grow in environments containing atmospheric levels of OXYGEN?
Which organisms grow in environments which lack oxygen?
Which organisms are found in periodontal pockets AND the sulcus?
What is the most common periopathogen?
What are the two most common periopathogens associated with perio inflammation during pregnancy?
P. intermedia and C. rectus
What organism is associated with NUP/NUG and pregnancy (gingivitis?) ?
Which organism is thought to play a critical role in biofilm formation?
Most bacteria found in periodontally diseased sites are what shape?
ROD. (because they just ram themselves in there) hahaha
What makes up the bulk of plaque biofilm and functions to hold the bacteria together in a biofilm?
Where are glycoproteins found?
When does subg plaque form and what organisms increase?
-motile, gram- rods and spirochetes
What organisms increase in supra plaque?
generally cocci predominant gram +
What is densely intertwined, has non-motile, cocci and filament organisms, and may become calculus?
(type of plaque)
Non-adherent (planktonic) plaque consists of...
motile rods and spirochetes
-increases in acute infections
Which oral physiotherapy aid is most suited for the removal of loosely adherent plaque (planktonic) ?
Which bacterial product is associated with gram - bacteria and can harm PMNs?
What are bacterial waste products?
What is hyaluronidase?
What is collagenase produced by?
What is penicillinase also known as?
What are the four stages of periodontal lesions?
2-4 days after brushing seizes
-NO CLINICAL CHANGES
-Vasodilation of small capillaries
-Increase in leukocytes (PMNs)
-Increase in gingival fluid flow
Initial Lesion- Stage One
4-7 days after no brushing
-Clinical signs of GINGIVITIS appear
-leukocyte infiltration into conn. tissue
-sulcular lining develops
PMNs in sulcus
Early Lesion (Gingivitis) - Stage 2
2-3 weeks after no brushing
-erythema of gingiva
-plasma cells become prominent
-gingival enlargement (increase probing depths)
-widened intercellular spaces in pocket lining
Established Lesion- Stage 3
Transition from Gingivitis to Periodontitis
-JE becomes detached from root surface as it migrates apically
Advanced Lesion- Stage 4
What are the anatomical events of Periodontal Disease Progression? (what happens? 4 things)
-Increased probing depths
-Increased attachment loss
-Increased bone resorption
-Attachment level changes (with time)
Inflammation begins with... (what do the blood vessels do?)
In the acute inflammatory process, vasodilation immediately follows .... ?
What is the movement of cells to the site of inflammation termed?
What is the most prevalent cell in acute inflammation?
Neutrophil (polymorphonuclearcyte or PMN)
What are the most active cells in a perio pocket?
What is a deficiency of neutrophils (PMNs) called?
Which cell arrives first to the site of inflammation?
What is the best indicator of damage to the periodontium?
What is characterized as apical migration of the JE?
Scaling in shallow pockets can lead to what?
Does clinical attachment loss include recession?
When is the re-eval following the initial periodontal therapy?
What is the FIRST thing to assess at the re-eval appt?
Is the degree of inflammation still present
What type of defect is the base of the pocket coronal to the alveolar bone?
What type of defect is the base of the pocket apical to the crest of alveolar bone?
Which defect would be easier to treat, 1 wall or 3 wall?
What could radiographic widening of PDL indicate?
What is indicated by a vertical loss of tissue or papilla and is caused by improper flossing technique?
T/F- Hairy Leukoplakia is caused by smoking.
False- Hairy Leukoplakia= HIV
Black Hairy Tongue= Smoking
What is the main reason people receive regenerative procedures?
To treat intrabony defects
What are the four stages of fibrous repair?
1. Blood Clotting
Prostaglandins cause what..
Swellling, Pain and Inflammation
Leukotrienes cause what?
Inflammation, Bronchoconstriction, Airway Obstruction, increases cellular infiltration and Cytokine release
Leukotrienes are derived from what?
Leukocytes- Especially MAST CELLS
What are three characteristics of dehiscence?
1. Gingival Recession
2. Alveolar Bone loss
3. Root Exposure
How can you distinguish fenestration from dehiscence?
Fenestration is bordered by alveolar bone
THIS SET IS OFTEN IN FOLDERS WITH...
BOARD PREP: PERIODONTOLOGY
Clinical dental hygiene III Test 3
Ch. 8 Vitamins
NDBHE Short Form
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