Perio

Question 1

Perio: how classify disease in examination

Answer 1

1. Disease - chronic periodontitis
2. generalised / localised
3. stage and grade
4. stability
5. modifying factors

Question 2

Perio classification: Generalised or localised? (3)

Answer 2

Question 3

Perio classification: staging?

Answer 3

measures severity

Question 4

Perio classification: Grading?

Answer 4

Measures progression of disease

Question 5

Perio classification: Stability?

Answer 5

measures activity of disease

Question 6

Perio classification: Modifying factors? (4)

Answer 6

1. immune system impairment
   
   • Disease (leukaemia, HIV, PREGNANCY)
   • Genetic conditions (downs syndrome)
2. Local Risk factors
   
   • acquired (plaque, calc, overhang, trauma, ortho)
   • Anatomical (malposition, concavities, root grooves)
3. systemic risk factors
   
   • non modifiable (ageing, genetics/disorders, gender)
   • modifiable
     
     • Smoking (<BF & >immune action)
     • osteoporosis (<bone density)
     • stress (>chemicals = >immune system)
     • obesity / nutrition (see image)
     • drugs (see image)
     • poor controlled diabetes mellitus
     • HIV
     • Hormones

Question 7

Perio: stages of treatment?

Answer 7

Question 8

What are the first two stages of perio treatment?

Answer 8

1. immediate, acute symptoms
   
   • pain
2. systemic phase
   
   • systemic risk factors addressed
   • quit smoking / control diabetes / contact their specialist
   • Antibiotics if systemic effect

Question 9

what are the 3rd (5) and 4th stages of perio treatment?

3 outcomes of stage 4?

Answer 9

re-evaluation 3 months after original treatment

Question 10

What are the 5th and 6th stages of perio treatment?

for the 6th stage - what is carried out at each visit? (3)

Answer 10

recall 3-12 months (tailored to patient) - normally 3 months

Question 11

Perio: what is done before treatment begins with a patient to optimise the outcome of perio treatment?

Answer 11

Explain disease

explain risks

explain risk factors

explain treatments/alternatives and benefits / risks of doing nothing

explain importance of OH

Question 12

Perio: difference between engaging and non-engaging patients

Answer 12

engaging
1. >=50% improvement BOP and Plaque scores OR
2. <=20% plaque AND <=30% bleeding OR
3. met target for personal plan

non-engaging
1. opposite (<50% improvement on both)
2. opposite
3. opposite - patient prefers palliative care (dentist reduces symptoms and they’re happy with that so don’t do own care)

Question 13

What are the 10 types of periodontal tissue conditions?

Answer 13

1. health
2. plaque induced gingivitis
3. non-plaque induced gingival diseases/conditions
4. Periodontitis
5. PerioDONTITIS as manifestation of systemic condition/disease
6. PerioDONTAL tissues effected by systemic disease/condition (non plaque induced)
7. periodontal abscess
8. periodontal-endodontic abscesses
9. necrotic periodontal diseases
10. mucogingival deformities/conditions

Question 14

Perio: what are the conditions for periodontal tissues being at health when:

1. intact periodontium
2. Reduced periodontium

Answer 14

Question 15

Perio: causes of:

1. plaque induced gingivitis (3) / localised measurement?
2. non-plaque induced gingival diseases/conditions (4)

Answer 15

Question 16

perio: What? and examples? for:

1. Issues that are exaggerating factors of perio and make get worse quicker
2. periodontal tissue issue due to systemic disease/condition (non-plaque induced)

Answer 16

Question 17

Perio: Mucogingival deformities / conditions: (recession not caused by plaque)

• causes (2)
• types (3)

Answer 17

Question 18

Necrotising oral disease:

1. Cause
2. Features (4)
3. types (3)
   - causes of 3rd type

Answer 18

Dark triangular ulceration inter-proximally

Question 19

necrotising oral disease:

1. diagnosis (how cant diagnose and common bacterias causing)
2. risk factors (developing / developed countries)

Answer 19

Question 20

necrotising oral disease:

1. two main stages of treatment
2. treatment process stages (6)

Answer 20

.

Question 21

4 types of periodontal tissue lesions?

Answer 21

1. gingival abscess
2. pericoronal abscess
3. Periodontal lesion/abscess?
4. endodontic-periodontal lesion

Question 22

Perio: what are gingival and pericoronal abscesses?

Answer 22

1. gingival = forms between tooth and gingiva, closer to crown than periapical but not as close as periodontal one
2. pericoronal abscess = forms in gingiva surrounding partially erupted / impacted tooth

Question 23

Periodontal lesions

1. General types (2)
2. cause
3. signs/symptoms (8)
4. treatment (4)

Answer 23

Question 24

endodontic-periodontal lesion

what and link?
classifications/causes?
types (2)
signs/symptoms?
treatment?

Answer 24

Question 25

endodontic-periodontal lesion: anatomy causing link? (5)

Answer 25

Question 26

what disease does periodontits increase the risk factor of? (6) why?

Answer 26

As causes systemic immune system heightening so can effect the following:

Question 27

Perio: general patient process from stage 1 to 4

Answer 27

1. - education - OHI - risk factor control - PMPR 6-8 weeks - gums heal 2. - step 1 again - re-evaluation (image) !!! - pocket chart (RSD >4mm pockets)!!!!!! 3. - repeat 1 &2 - >6mm pockets = perio surgery 4. Maintenance - 3 month intervals (OHI as required / sub/supra scaling) - annual pocket charts

Question 28

when is it okay to carry out subgingival scaling?

Answer 28

ONLY when pocket >4mm less = risks further loss of attachment

Question 29

BPE information 1. rules? 2. how? 3. scores? 4. treatment for each score?

Answer 29

1. sextant must have 2 or more teeth, worst score each sextant, 8s not counted unless missing molar 2. CPITN probe (3.5 -5.5 band +ball tip 0.5mm), pressure = 20-25g 3. 0,1,2,3,4,* 4. image

Question 30

6PPC information 1. how? 2. process? 3. types 4. what both types record

Answer 30

1. PCP12 probe (two bands 3-6, 9-12mm), 6 points of each tooth, go from middle of page where teeth diagrams are, dot for bleeding, higher gingival margin compared to ECJ = negative score 2. - record missing teeth - quadrant 1 buccal each 3 points from posterior to midline, gingiva compared to ECJ and pocket depths until midline - check for bleeding - same but from midline to posterior on palatal - then buccal of second quadrant from midline then posterior palatally - repeat for lowers starting on left - measure MOBILITY - see image 3. complete and abbreviated/review chart 4. complete = gingival margin relative to ECJ, then Pockets, then add together to get loss of attachment = BOP, Furcations, MOBILITY abbreviated = pockets >4mm, BOP, furcation, mobility = good as fast and shows area for attention but bad as doesn't show progression of attachment losss = used when localised perio

Question 31

what are ramfjord's teeth what if not present

Answer 31

16 21 24 36 41 44 use similar alternative or note as N

Question 32

modified plaque and bleeding scores 1. how 2. when both recorded 3. why

Answer 32

1. Ramfjord's teeth plaque - scoring = 2 for visible plaque, 1 for on probe, 0 for none - across 3 areas of each tooth - P, B and IP. score = score divided by max score (37) bleeding - scoring = 4 surfaces, 1 for bleeding, 0 for non, then divided by max (24) 2. recorded at every visit apart from clinical assessment first visit 3. identifies engaging patients as can assess OH

Question 33

what growth / tumour can affect the gingiva when a women is pregnant?

Answer 33

Pregnancy epulis

Question 34

what should be done if a patient has necrotising oral disease, yet they have no predisposing factors?

Answer 34

Get a HIV test as could be the only probable cause

Question 35

difference in meaning between marginal bleeding and bleeding from the base of a pocket?

Answer 35

margin = how well patient brushing and OH pocket = how much inflammation currently there