Perio final exam notes Flashcards

Question

# 4. Clinical bone morphology Bone definition

Answer 1

* **Specialised** connective tissue * **Mineralised** organic matrix, collagenous and non collagenous **proteins** * Main component **hydroxyapatite**

Answer 2

* Osteoblasts * Osteoclasts

Answer 3

* Misch * Lekholm and Zarb

Answer 4

* **D1 Dense cortical bone** * Anterior mandible * Very hard; excellent primary stability but poor vascularity (slow healing) **D2 Thick cortical bone w/dense trabecular bone** * Posterior mandible, anterior maxilla * Ideal bone for implants (best balance of strength and vascularity) * **D3 Thin cortical bone w/ dense trabecular bone** * Anterior maxilla, posterior mandible * Moderate initial stability; good vascularity **D4 Very thin cortical bone w/ low-density trabecular bone** * Posterior maxilla * Poor initial stability; highest failure risk; * may need wider or longer implants, or bone grafting

Answer 5

* Type 1: mostly **compact** bone; * Type 2: **thick** **cortical** w/ **trabecular** core * Type 3: **thin** **cortical** w/ **more** trabecular bone; * Type 4: **thin** **cortical** w/ **low**-**density** trabecular core.

Answer 6

* **Clinical dental speciality=>** * Studies **theoretical foundations** + **practical applications** of **implants** for the **restoration** of chewing apparatus and its functions=> * **Damaged** as a result of **partial/complete edentulation** + the associated **processes**

Answer 7

* **Medical devices** made of **alloplastic** biomaterial=> * Placed **permanently** in contact with the **internal** environment of the body=> * in order to **restore** the functions and activities of the **damaged** dentition

Answer 8

* A state in which a **clinically asymptomatic, rigid fixation** of the **alloplastic** material in the bone is achieved and maintained=> * During **functional loading**

Answer 9

* Grade 4 commercially **pure** **titanium** (cpTi) * **Titanium**-**zirconium** alloys (Ti-Zr) * **Ti-6Al-4V.**

Answer 10

* **1.5 mm**=> * to **preserve** lateral biologic width and **prevent** bone loss around adjacent structures.

Answer 11

* <1.5 m during the first year * **~0.2 mm** per year afterwards (typical guideline).

Answer 12

**3 mm** between adjacent implants.

Answer 13

* Minimum **1 mm** buccal/lingual=> * in aesthetic zone aim for **2 mm** buccal to **preserve** emergence profile and buccal bone.

Answer 14

* Minimum **1 mm** from the **nasal** **floor** and at least **2 mm** above **inferior** **alveolar** **nerve** * implant body about **5 mm** **anterior** to mental foramen.

Answer 15

* **Mechanical** stability at implant placement=> * dependent on bone **density/quality, implant shape**, and **surgical** **technique**.

Answer 16

* **Biological** stability achieved **after** bone healing (osseointegration)=> * influenced by **bone** **quality**, **implant** **surface**, **patient** **health**, and **loading** **protocol**.

Answer 17

* **Distance osteogenesis** (bone grows from existing bone toward implant) * **Contact osteogenesis** (new bone forms on implant surface).

Answer 18

1. Commercially **pure** **titanium** (cp Ti) — Grades I–IV 2. **Titanium** **alloy** (Ti-6Al-4V) — Grade V

Answer 19

* Titanium: ~90% * Aluminum: 6% * Vanadium: 4%

Answer 20

* ZrO₂: **94–97%** * Y₂O₃ (yttria): **3–5%** (for stabilization)

Answer 21

* Tooth-coloured (aesthetic) * Biocompatible * Corrosion-resistant

Answer 22

* A healing abutment (aka healing cap or cover screw) is **transmucosal component placed on implant**=> * allows **shaping** and **maturation** of peri-implant **soft tissues** before prosthetic procedures - Provides **biological** **seal** during healing phase. ##Footnote Used during second-stage surgery (or immediately in a one-stage approach).

Answer 23

* Cover Screw=> * **Two**-stage surgery * Keeps implant **sealed** under gingiva during osseointegration * Healing Abutment=> * **One**-stage surgery or **after** second-stage uncovering * Transmucosal component **shaping** soft tissue for future prosthesis.

Answer 24

* **One-stage protocol**: placed immediately after implant insertion * protruding through soft tissue. * **Two-stage protocol**: placed during second-stage surgery * after uncovering implant once osseointegration is confirmed (≈3–6 months after placement).

Answer 25

- **Impression coping**/**transfer**: connects to implant to record its position. - **Healing abutment:** temporarily removed. - **Implant analog:** attached to coping in impression for lab model. - **Laboratory analog:** embedded in stone model to replicate implant. - **Tray:** open or closed type, custom or stock.

Answer 26

1. **Remove** healing abutment. 2. **Place** closed-tray impression coping and hand-tighten. 3. Make **impression** w/ **PVS** or **polyether**. 4. **Remove** impression; coping **stays** in mouth. 5. **Unscrew** coping, **attach** to implant analog, and **insert** into impression. 6. **Pour** master cast. Advantages: **simple**, **quick**, **no** tray modification. Disadvantages: **less** accurate for multiple or angulated implants.

Answer 27

1. **Perforate** tray above implant for screw access. 2. **Remove** healing abutment and **place** open-tray coping. 3. **Try** in tray; ensure coping screw **projects** through. 4. **Inject** light-body around coping, **fill** tray w/ heavy-body, **seat** tray. 5. After set, **unscrew** coping screws through tray holes. 6. **Remove** tray w/ coping inside impression. 7. **Attach** implant analogs and pour cast. Advantages: **high** accuracy, ideal for **multiple** implants. Disadvantages: **more** **time**-consuming and **technique**-sensitive.

Answer 28

- **Addition silicone (PVS):** most accurate, dimensionally stable. - **Polyether**: excellent detail and rigidity, best for multiple implants. - **Custom trays** recommended to minimize distortion and improve accuracy.

Answer 29

* Implant body * Abutment * Crown

Answer 30

* Additive processes * Subtractive processes

Answer 31

* Modify implant structure by **adding** materials to surface

Answer 32

* Mineral coatings * Plasma spraying * Biocoating with growth factors * Fluoride and particulates * Cements containing Ca-phosphates * Sulphates or carbonates * Hydroxyapetite ## Footnote Hydroxyapetite shown to enhance initial bone cell adaptation or proliferation

Answer 33

* Machining * Acid etching * Sand blasting or combination

Answer 34

* Edentulous ridge covered with **masticatory mucosa**-2-3mm thick * Masticatory mucosa covered w/ **keratinised epithelium** * Outer cortical plates **lamellar bone** and enclose **cancellous bone** * Bone marrow very **vascular** ## Footnote -masticatory mucosa has connective tissue rich in collagen and fibroblasts firmly attached to bone -Cancellous bone contains trabecullae of lamellar bone embedded in bone marrow -Bone marrow contains adipocytes and pluri-potent mesenchymal cells as well

Answer 35

* **Clot** formation * **Ingrowth** of vessels and migration of leukocytes and mesenychmal cells * **Granulation tissue** replaced with provisional matrix * **Fibroplasia** and **angiogenesis** starts * **New bone** formation seen in **first week** of healing * Newly formed woven bone **projects** from lateral wall of cut bony bed * New bone formation also on **implant surface** * In following weeks trabeculae of woven bone **replaced** with mature bone ## Footnote -Clot formation stumulated by thrombocytes->signals->fibroblasts -Provisional matrix rich in vessels, mesenchymal cells and fibres

Answer 36

* Distance osteogenesis/ Appositional bone formation ## Footnote will be replaced by mature bone by remodelling

Answer 37

Contact osteogenesis ## Footnote at a distance from parent bone

Answer 38

* The ability of CNS to **detect** and **interpret** tooth **loading direction of force** and **micro**-**movement**=> * via **mechanoreceptors** in the periodontal ligament (PDL).

Answer 39

* The ability to perceive **mechanical** stimuli through an **osseointegrated** **implant**=> * despite the **absence** of a **periodontal** **ligament**.

Answer 40

Measures plaque thickness at gingival margin

Answer 41

Measures severity of gingival inflammation

Answer 42

Measures bleeding after probing

Answer 43

* Measures presence of bleeding on probing * 0 = no bleeding, 1 = bleeding * % bleeding sites reflects current gingival inflammation

Answer 44

* Measures presence of plaque * % = plaque surfaces ÷ total surfaces × 100 * <20% = good plaque control * Used for patient motivation & monitoring

Answer 45

Periodontal screening by sextant ## Footnote Determines need for full periodontal charting

Answer 46

Epidemiological periodontal assessment ## Footnote Used mainly for population studies, not detailed diagnosis

Answer 47

1. Acquired pellicle 2. Initial collonisation 3. Secondary colonisation 4. Maturation and biofilm growth 5. Plaque mineralisation and calcification

Answer 48

* Formed **instantly** after brushing * **Salivary** and **glycoproteins** * **Thin** film that is attachment site for bacteria

Answer 49

* Within a few hours * **S. Sanguis, S. Oralis**

Answer 50

* **24-72 hours** * More **diverse** microorganisms including **actinomyces, preveotella and fusobacterium** * Adhere to initial colonisers

Answer 51

* After **a few days** * Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola * Gram **negative** and **positive** bacteria

Answer 52

* Over **longer** period * Biofilm **hardens** due to salivary **minerals**

Answer 53

* **Inorganic** (mineral) components * **Organic** (cellular and extracellular matrix) components

Answer 54

* **40-60%** depending on location * **Calcium phosphate crystals** organised into four mineral phases=>**Octacalcium phosphate, hydroxyapatite, whitlockite** and **brushite**

Answer 55

* **85%** cellular and **15%** extracellular matrix * **Cellular density** within calculus **very high** * Extracellular matrix mostly **proteins and lipids** ## Footnote 200,000,000 cells per milligram -Cells primarily bacterial, some fungal-candida and species of archaea

Answer 56

* Green * Orange associated * A-a * Orange * Red

Answer 57

* E.corrodens * Capnocytophagia species -C.gingivalis -C.Ochracea -C.Spitigena ## Footnote E= Eikenella

Answer 58

* C.rectus(Cr) * E.nodatum(En) ## Footnote C=Campylobacter E=Eubacterium

Answer 59

A.Actinomycetemcomitans(Aa)

Answer 60

* P.Intermedia(Pi) * P.micra(Pm) * F. nucleatum(Fn) ## Footnote Pi=Prevotella Pm- Parvimonas Fn=Fusobacterium

Answer 61

* P.gingivalis(Pg) * T.forysthia(Tf) * T.denticola ## Footnote Pg=Porphyromonas Tf=Tannerella Td-Treponema

Answer 62

1. **Initial** lesion (clinically healthy gingiva) 2. **Early** lesion (early stages of gingivitis) 3. **Established** lesion chronic gingivitis) 4. **Advanced** lesion (gingivitis progesses to periodontitis)

Answer 63

* Diabetes * Hormonal=>Puberty, pregnancy, menopause, oral contraceptives * Tobacco smoking * Osteoporosis * HIV * Leukemia

Answer 64

* **CCB**- Nifidipine * **Phenytoin**-Anticonvulsant * **Cyclosporin**-Immunosuppresant

Answer 65

* **Vasoconstriction**->False Bop * **Deeper** pocket depths-AL * **Decreased** salivary flow-xerostomia * **Fibrotic gingival appearance** w/ little inflammation and edema * **Poorer** oral hygiene * **Impaired** PMN phagocytosis * **Poorer healing**

Answer 66

* **Decreased** salivary flow * **Predisposition** to candidiasis, burning mouth, abcess formation * **Impaired healing**=>poor leukocyte function, reduction in growth and proliferation of CT=> * Hyperglycemic environment

Answer 67

* **Impaired immune system**=>infection susceptibility * **Dry mouth** * Red band **gingivitis** * PD bone **loss**

Answer 68

* Increased **bleeding** * **Paleness** of mucosa * Gingival **hyperplasia**, **petechiae** and **hemorrhages** ## Footnote Petechia=>small red or purple spot on the skin, conjunctiva, retina, and mucous membranes=>haemorrhage of capillaries

Answer 69

* Injury to periodontal tissues from **excessive occlusal forces**. * **Does NOT** initiate gingivitis or periodontitis but **can accelerate destruction** if inflammation is present.

Answer 70

* Primary: **excessive force** on tooth w/ **normal periodontal support** → mobility and widened PDL but no attachment loss. * Secondary: **normal** or **excessive** **force** on tooth w/ **reduced** **support** → increased mobility and faster attachment loss if inflammation present.

Answer 71

* Acute: **sudden force** (e.g. high filling) → pain on biting tenderness and sudden mobility. Chronic: **gradual forces** (e.g. bruxism) → mobility, fremitus wear facets and tooth migration.

Answer 72

Widened periodontal ligament (PDL) space ± thickened lamina dura.

Answer 73

* Control inflammation first w/ **OHI** and **scaling/root planing** then **occlusal adjustment or night guard** if needed. * Exception: adjust immediately if acute high restoration.

Answer 74

* Bacterial * Viral * Fungal * Gingival manifestation of immunosuppresion * Gingival lesion of genetic origin * Mucocutaneous disorders * Allergic lesions * Traumatic lesions

Answer 75

Inflammatory lesion from reaction between dental plaque biofilm and host immune response

Answer 76

🔹Smoking 🔹Changed in sex hormones 🔹Malnutrition 🔹Specific diseases and conditions 🔹Systemic drugs

Answer 77

* Calculus * Caries * Orthodontic anomalies * Deep pits and fissures * Crowded teeth * Recession * Furcations * Fractures * Radices * Frenulum attachments(papilla and papilla penetrating) * Exogenous tooth discolouration * Mucogingival abnormalities(congenital or acquired defects)

Answer 78

* Caused by dental treatment * Poorly adapted restorations(crowns, bridges, fillings) * Fixed orthodontic appliances and retainers * Mouth breathing-> xerostomia/hyposalivation

Answer 79

* **Puberty** associated gingivitis * **Menstrual cycle** associated gingivitis * **Pregnancy** associated gingivitis

Answer 80

* Increaed **plasma hormone levels**(increased bleeding, gingival overgrowth, exudate and GCF) * Estrogen affects **salivary peroxidases** * Increased growth of **seletive pathogens** * Estrogen increases **inflammation** * Estrogen affects degree of **keratinisation of CT ground substance** * **Pregnancy granuloma** can develop * **Gingivitis** in response to low plaque levels ## Footnote -salivary perioxidases active against mo -Increased risk in 2nd and 3rd trimesters

Answer 81

* Steroid hormones=>increased inflammatory mediators * Gingivitis ## Footnote Gingivitis in repsonse to relatively low levels of plaque

Answer 82

* Overt gingival changes rare w/ menstrual cycle * Increased exudate/inflammatory exudate * Not clinically observable

Answer 83

* Decreased **salivary flow** * Predisposition to **candidiasis**, **burning** **mouth**, **abscess** **formation** * **Impaired** **healing**=>poor leukocyte function * Reduction in **growth and proliferation of CT**=>hyperglycemic environment ## Footnote * Level of diabetic control important in determining extend of periodontal disease

Answer 84

* **Abnormal proliferation of leukocytes** in blood and marrow * Increased **bleeding** * **Paleness** of mucosa * **Swollen**, **glazed**, **spongy** tissues=>deep **red** to **purple** * **Gingival** **enlargement**=>interdental papilla folllowed by marginal and attached

Answer 85

* Anticonvulsants(pheyntoin, sodium valproate) * Immunosuppressants(cyclosporin A) * Calcium channel blockers(Nifidepine, verapamil) ## Footnote -Phenytoin causes gingival enlargment in 50% of users

Answer 86

1. Periodontal health, gingival diseases and conditions 2. Periodontitis 3. Periodontal manifestations of systemic diseases and developmental and acquired conditions 4. Peri-implant diseases and conditions

Answer 87

* Necrotising gingivitis * Necrotising periodontitis * Necrotising stomatitis ## Footnote -Acute -Recurrent -Chronic

Answer 88

* Destructive inflammatory gingival condition * **Limited to gingival tissue** w/ no loss of attachment

Answer 89

* Loss of attachment(gingiva, PDL, Alveolar bone)

Answer 90

Progession of the disease beyond the MGJ

Answer 91

* **Eliminate** disease activity=>scaling if possible * **Hydrogen** **peroxide** use * Chemical plaque control=>**CHX 0.2% x2 daily** * **Antibiotics**=>**Metronidazole** **250mg** **x3**/**day**, **penicillins**, **tetracyclines** * HIV patients=>**antimycotic**->**miconazole** * **Regular** **apppoitments** and motivation ## Footnote patient should use gentle burshing technqiue

Answer 92

**Localised purulent inflammation** of periodontal tissues

Answer 93

* **Gingival abscess**=>marginal gingiva and interdental tissues * **Periodontal abscess**=>infection localised to periodontal pocket=> * Destruction of PDL and alveolar bone * **Pericoronal abscess=>**associated w/ crown of partially erupted tooth * **Periapical abscess**=>Forms at root tip * **Acute** * **Chronic**

Answer 94

* **Localised acute** inflammatory lesion * **Red, smooth** and sometimes **painful** swelling * Aetiology-**Plaque, trauma, foreign body** impaction ## Footnote Involves marginal and interdental gingiva

Answer 95

* In patients w/ **untreated periodontitis** * Major cause of tooth loss * Can occur=>after **periodontal surgery, recurrent disease, tooth perforation, foreign body** impaction * **Diabetes** predisposing factor

Answer 96

* **Amoxicillin**=>500mg-1g(loading dose) then 500mg x3/day for 3 days->re-evaluation after 3 days * **Penicillin** **allergy**=> **clindamycin**-600mg loading dose then 300mg x4/day for 3 days * **Azithromycin**-1g loading dose then 500mg x4/day for 3 days ## Footnote Re-evaluation to dettermine need for continued use

Answer 97

Inflammatory process in tissues surrounding implant

Answer 98

* **Reversible** inflammatory process=> * Soft tissue **surrounding** functioning implant

Answer 99

Inflammatory process characterised by **loss of peri-implant bone**

Answer 100

* Patient hygiene routine * Subgingival debridement * Irrigation * Antimicrobial mouthwash-CHX

Answer 101

* Non surgical periodonatal therapy * GBR and bone graft techniques * Bone implant removal if bone loss extended to apical half

Answer 102

* To assess **alveolar** **bone** **loss** * **pattern** of destruction * **calculus**/**overhangs** * **furcation** involvement * **disease** **progression** and **treatment** **outcomes**. They show past destruction not current activity.

Answer 103

* **Bitewing** radiographs. * Best for **interproximal** and **crestal** bone levels. * **Vertical** **bitewings** are preferred in **periodontitis**.

Answer 104

* **Early** to **moderate** interproximal bone loss * **crestal** bone height * **CEJ** position * **calculus** and **overhanging** restorations.

Answer 105

* **Advanced** periodontitis assessment of **root** **morphology** * **vertical**/**angular** defects * **furcation** **involvement** * **periapical** pathology and **trauma** from occlusion.

Answer 106

* Provides a **general** **overview** of dentition and bone levels=> * is **not** **accurate** for early or detailed periodontal diagnosis.

Answer 107

* “Implant examination includes **history**, **soft** **tissue** assessment, **probing** for **bleeding** and **pocket** **depth**, **mobility** testing, and **radiographic** **evaluation** of bone levels. * Healthy implants are **immobile** with **no** **bleeding** * Peri-implant mucositis **shows inflammation w/out bone loss** * while peri-implantitis shows **inflammation w/ progressive bone loss and possible mobility.**

Answer 108

* Good/secure * Doubtful * Irrational to treat ## Footnote -Simple therapy and secure abutments for function -Comprehensive therapy -Extracted

Answer 109

* Periodontal * Endodontic * Dental * Functional

Answer 110

* Furcation involvement=1 or 2 * Angular bony defects * Horizontal bone defect reaching 2/3 of root

Answer 111

* Recurrent abcess * Combined endo and periodonal lesion * Attachment loss to apex * Furcation involvement= 3

Answer 112

* Large post or screw obturations * Incomplete root canal * Peri-apical pathology

Answer 113

Perforations in apical half of root

Answer 114

* Extensive root caries * Doesn’t extend to root canal

Answer 115

* Extensive root caries=>extends to root canal * Vertical root fractures 2/3 of root * Oblique fractures into middle third of tooth

Answer 116

* Third molars only without antagonist * Grade 3 mobility * Periodontitis and caries

Answer 117

6 week to 6 months

Answer 118

* Periodontal risk assessment * Full periodontal status

Answer 119

* Age * Number of implants * Number of sites per tooth/implant * No. of bop positive sites * No. of sites w/ pocket depths >5mm * No. of missing teeth * % alveolar bone loss * Systemic genetic diseases * Smoking(environmental factors)

Answer 120

* Non smoker * Former smoker * Occasional smoker * Smoker * Heavy smoker

Answer 121

1. Identify conditions, diseases and medications that **contribute to periodontal disease** 2. Identify conditions, diseases and medications that **can endanger the patient during treatment** 3. Diseases and conditions that are **dangerous to medical staff**

Answer 122

* Puberty * Pregnancy * Menopause

Answer 123

* Diabetes * Vitamin C deficiency * Leukemia

Answer 124

* Immunosuppressants-Cyclosporin * CCB-Nifidipine * Anticonvulsants-Phenytoin

Answer 125

Allergies(latex/asthma)

Answer 126

* Endocarditis=> * Debridement may exacerbate condition

Answer 127

Anticoagulants(aspirin)

Answer 128

Psychological

Answer 129

* All infectious diseases * Viral hepatitis * Covid

Answer 130

* To achieve a clean infection free oral cavity free of plaque and calculus * Removal of all plaque retentive factors * Extraction of irrational to treat teeth * Debridement-Scaling and root planing

Answer 131

10-14 days

Answer 132

6 weeks to 3 months

Answer 133

up to 6 months

Answer 134

* **Restore function and health of periodontium=>** * Surgical treatment * Orthodontics * Prosthetic treatment * Conservative(RCT) * Periodontal surgery * Implant placement * Re-evaluation after surgery

Answer 135

Prevent re-infection and disease recurrence

Answer 136

* Anamnesis * Extra and intra-oral status * Indexes * Scaling * Periodontal status * Periodontal risk assessment

Answer 137

* High risk-3 months * Medium risk- 6 months * Low risk- 12 months

Answer 138

* **Horizontal** * **Vertical** (Leonard) * **Circular** (Fones) * **Bass** (Sulcular) * **Stillman** (vibratory * **Charters** (interdental areas) * **Roll technique** * **Scrubbing** * **Modified bass/stillman**

Answer 139

* Effective for **subgingival** plaque removal * Brush **oblique** towards apex * Filament tips directed into sulcus at **45 degree** angle * **Short strokes** w/ back and forth motion keeping brush filaments in sulcus * On **lingual** surfaces of **anteriors**-brush **vertical**

Answer 140

* **Massaging**, **stimulating** gingiva and cleaning **cervical** areas * **Recession** * Brush head **oblique** towards apex * Filaments **partly** on gingival margin and on tooth surface * **Light** pressure w/**rotary** movements ## Footnote Maintain contact of filaments w/ tooth surface

Answer 141

* Cases w/ **receded** interdental papillae->Filaments penetrate area * Brush **oblique** w/ filaments towards **occlusal** and **insicsal** surfaces * **Light** pressure to force filaments into interproximal embrassure

Answer 142

* Brush head in **oblique** direction towards apex * Filaments **partly** at gingival margin and on tooth surface * Sides of filaments **pressed** lightly against ginigva * brush head **rolled** over gingiva and teeth in **occlusal** direction

Answer 143

* **After** activation of brush in back and forth direction-> **rolled** over gingiva and teeth in **occlusal** direction * Filaments can then **penetrate** interdentally

Answer 144

* Antiadhesive * Antimicrobial * Plaque removal * Antipathogenic

Answer 145

* Acts at **pellicule surface** * Interferes w/ bacterial **matrix** formation

Answer 146

* Inhibits **primary** plaque proliferation * **Bactericidal**

Answer 147

* destroy bacterial matrix * **Mechanical** removal-brush combined w/**antimicrobial** mouthwash

Answer 148

* Antibiotics * Enzymes * Bis bigaunide antiseptics * Quaternary ammonium compounds * Phenols+essential oils * Natural products * Flourides * Metal salts * Oxidising agents * Detergents * Alcohols * Salicylamide ##Footnote Angry Elephants Bring Quite Powerful New Fancy Magical Old Drunk Angry Scientists

Answer 149

* **Antimicrobial** * Penicillin * Vancomycin

Answer 150

* **Plaque removal** * **Antimicrobial** * Protease * Lipase * Oxidase

Answer 151

* **Antimicrobial** * Chlorhexidine

Answer 152

* **Antimicrobial** * Cetylpyridium chloride

Answer 153

* **Antimicrobial** * **Anti-inflammatory** * Thymol * Eucalyptol * Triclosan

Answer 154

* **Antimicrobial** * Sanguinarine

Answer 155

* **Antimicrobial** * Sodium flouride

Answer 156

* **Antimicrobial** * Tinto * Zinc

Answer 157

* **Antimicrobial** * Hydrogen peroxide

Answer 158

* **Antimicrobial** * Sodium sulphate

Answer 159

* **Inhibition** * Delmopinol

Answer 160

* **Good** tactile sensation * **Minimal** aerosal production * Modified curettes=>**increase** efficiency ## Footnote -Modified curettes- w/extended shanks =>deep pockets -Mini-bladed currettes=>narrow pockets developed to increase efficiency

Answer 161

* Working part(blade) * Shank * Handle

Answer 162

**Scaling** and root **debridement**

Answer 163

* **Spoon** shaped blade * **Two** cutting edges * Two edges united by **rounded** toe ## Footnote Length and angulation of shank, dimensions of blade differ between different brands

Answer 164

**Supragingival** debridement or scaling in **shallow** pockets

Answer 165

* **Curved** or **straight** blade * **Triangular** in cross section * **Two** cutting edges

Answer 166

* **Supragingival** scaling * Blade can be positioned at **four** different inclincations in relation to shank-**F, L, D, M**

Answer 167

* **One** cutting edge * Blade turned at **100 degree** angle to shank w/ cutting edge beveled at **45 degree angle**

Answer 168

**Smoothing** roots in areas of stubborn deposits

Answer 169

1. **Ultrasonic** scalers 2. **Sonic** scalers ## Footnote 1. Convert **electrical** **current** into mechanical energy in form of high frequency **vibrations** 2. Use **air** **pressure** to create **mechanical** vibration

Answer 170

3000-8000 Hz

Answer 171

18000-45000

Answer 172

1. **Piezoelectric** scaler 2. **Magnetostrictive** scaler ## Footnote 1. **Alternating** electrical current causes **dimensional** change in handpiece-> vibrations 2. Current produces **magnetic** **field** that causes instrument **vibration**

Answer 173

25000-30000 ## Footnote Can reach upto 45000

Answer 174

25000-30000 ## Footnote can reach upto 45000

Answer 175

Linear ## Footnote Only lateral side of scaling tip used

Answer 176

Elliptical ## Footnote All surfaces of scaling tip are active

Answer 177

* Procedure that aims to remove **plaque** and **calculus** from tooth surface * **Supra** and or **subgingival** instrumentation

Answer 178

* Root scaling * Root planning

Answer 179

* Removal of **soft** and **hard** deposits on the root * Can be done with **hand** and **ultrasonic** instruments

Answer 180

Removal of **necrotic** **cementum** and **dentine** to achieve **smooth** root

Answer 181

80 degrees

Answer 182

**Cratering** and **roughening** of root surface

Answer 183

**Ineffective** removal and **burnishing** of subgingival calculus deposits

Answer 184

* LA * Check root surface w/ probe * Instrument held in **modified** **pen** **grasp** and **inserted** into pocket * On insertion- face of blade **parallel** to and in **light** **contact** w/ root surface * Proper **finger** **rest**(fulcrum) * After insertion to base of pocket-instrument **turned** to cutting position(shank **parallel** to long axis of root) * Blade moved in **coronal** direction * Probe inserted again to check for calculus

Answer 185

* **Eliminate biofilm** from tooth surfaces * Create environment that enables host to **prevent microbial colonisation** w/ oral hygiene methods

Answer 186

* Hand instruments * Ultrasonic and sonic scalers * Ablative laser therapy * Reciprocating instruments

Answer 187

**Surgical removal** of gingival tissue to eliminate **periodontal pockets.**

Answer 188

**Surgical reshaping of gingiva** to create normal physiological contours.

Answer 189

Gingivectomy removes tissue to eliminate pockets while gingivoplasty reshapes gingiva for contour.

Answer 190

* **Suprabony** periodontal pockets. * **Gingival enlargement**=> inflammatory or drug induced.

Answer 191

For **reshaping** **gingival** **contour** and **aesthetic** improvement.

Answer 192

Poor plaque control.

Answer 193

* Pocket elimination * improved access for cleaning and reduced inflammation.

Answer 194

Excisional New Attachment Procedure.

Answer 195

To **remove pocket epithelium** and promote **new** **attachment**.

Answer 196

Internal bevel incision.

Answer 197

**Diseased** pocket epithelium and **inflamed** tissue.

Answer 198

* **Moderate** periodontal pockets * need for **new** **attachment** w/ minimal gingival removal.

Answer 199

A periodontal flap repositioned **apically** to **reduce** **pocket** **depth**.

Answer 200

Root exposure and sensitivity.

Answer 201

A **conservative periodontal flap** surgery for **access** and **root** **debridement**.

Answer 202

Access for **scaling** and **root** **planing** w/ minimal gingival removal.

Answer 203

Three incisions.

Answer 204

Internal bevel incision.

Answer 205

Crevicular incision to the bone.

Answer 206

Interdental incision to remove pocket lining.

Answer 207

* Granulation tissue removal * scaling and root planing.

Answer 208

Repositioned to its original position and sutured.

Answer 209

* Class 0 * Class 1 * Class 2 * Class 3

Answer 210

No furcation involvement

Answer 211

Horizontal direction, probe travels less than 3mm ## Footnote through one or two entrances

Answer 212

Horizontal direction, probe travels more than 3mm ## Footnote -Probe doesnt go through whole furcation -Only in one entrane

Answer 213

Horizontal, probe travels more than 3mm making through and through lesion ## Footnote two or more entrances

Answer 214

1. Less than 3mm in vertical direction 2. 3-6mm in vertical direction 3. More than 6mm in vertical direction

Answer 215

* Nabers probe * 1 for upper * 2 for upper and lower

Answer 216

* Scaling and root planing=> * Furcation plasty

Answer 217

* Furcation plasty * Tunnel preparation * Root resection * Tooth extraction * GTR for mandibular molars

Answer 218

* **Elimination of interradicular defect** * Tooth substance **removed**(odontoplasty) * Alveolar crest **remodelled** at level of furcation entrance(osteoplasty) * Mainly at **buccal** and **lingual** furcations

Answer 219

* Furcation area **widened**-removal of interradicular bone * Alveolar bone crest **recontoured** * **F2 and F3 in mandibular molars** ## Footnote F2 and F3 in mandibular molars(short root trunk, wide seperation angle, long divergence between mesial and distal roots)

Answer 220

Sectioning of **root complex** and **maintenaince** of all roots

Answer 221

**Sectioning** and **removal** of **one** or **two** roots of multi-rooted tooth

Answer 222

* Conditions where **pulp** and **periodontium** diseased **simultaneously** * Disease may arise from **one** or **both** sites

Answer 223

* Endodontic treatment * Periodontal therapy following endodontic treatment if necessary

Answer 224

* Occurence of sudden pain * Marginal inflammation * Increased probing depth * Suppuration * Increased mobility * Loss of fibrous attachment

Answer 225

* Penicillins * Metronidazole-Ntroimidazoles * Tetracyclines * Macrolides * Cindamycin * Cephalosporins and local antibiotics.

Answer 226

Penicillins especially amoxicillin.

Answer 227

Metronidazole nitroimidazole group.

Answer 228

Tetracyclines.

Answer 229

Amoxicillin and metronidazole.

Answer 230

Allergic reactions.

Answer 231

Tetracycline, doxycycline and minocycline.

Answer 232

Azithromycin, erythromycin and clarithromycin.

Answer 233

In **penicillin** **allergic** patients and **aggressive** **periodontitis**.

Answer 234

For **severe** **infections** or **penicillin** **allergic** patients.

Answer 235

Cephalexin.

Answer 236

Minocycline, doxycycline gel and chlorhexidine chips.

Answer 237

* **Regenerating** periodontal structures **lost** due to periodontal disease=> * **Barrier** **membranes** direct growth of **new** bone and periodontal ligament=> * On **root** **surface** previously exposed due to disease

Answer 238

* **Complete** **restoration** of periodontal tissue to **original state=>** * **Formation** of alveolar bone, functionally aligned periodontal ligament, and new cementum

Answer 239

* **Non-absorbable materials**=> * Polytetrafluoroethylene (PTFE) * Expanded polytetrafluoroethylene (e-PTFE)=> * Often reinforced w/ titanium * Perforated titanium foil * **Bioabsorbable materials**=> * **Natural** materials=>Collagen membranes from porcine or bovine origin * **Synthetic** materials=> Polylactic acid, copolymers of polylactic acid, polyglycolic acid, PEG

Answer 240

* **Polylactate** acid and its copolymers * **Polyglycolic** acid and its copolymers * **Polyglactin** (Vicryl) * **PEG**

Answer 241

* **Porcine** origin=>Jason membrane and Collprotect membrane * **Bovine** origin=>Geistlich Bio-Gide®

Answer 242

* **Autologous grafts** (autografts)=>patient’s own body * **Isografts**=>genetically identical species * **Allografts**=>different individuals of same species * **Xenografts**=>different species * **Synthetic grafts** (alloplasts)=> synthetic materials * **Composite grafts**=>combination of different graft materials

Answer 243

* **Same** individual * Osteogenic (4 weeks) osteoconductive and osteoinducive (2-4weeks) potential * **Extraoral**=> * Iliac crest, tibia, fibula, ribs * **Intraoral**=> * Chin, exostoses, torus * Ramus, tuberosity

Answer 244

* Genetically identical species

Answer 245

* **Same** species * **Osteoinductive** potential * **DFDBA**=>deminineralised freeze dried bone allograft * **FDBA**=>freeze dried bone allograft * **Frozen**

Answer 246

* **Synthetic** * **Osteoconductive** * Hydroxyapatite * Calcium phosphate cements(CPC) * Beta-tricalcium phosphate(TCP) * Biphasic alloplastic materials * Bioactive glasses * Synthetic polymers

Answer 247

* **Different** species * **Osteoconductive** and **osteoinducive** potential * Bovine derived * Porcine derived * Coralline calcium carbonate

Answer 248

* **Osteogenesis**=>new bone by cells in graft * **Osteoinduction**=>new bone through differentiation of mesenchymal cells into osteoprogenitor cells * **Osteoconduction**=>new bone by providing a scaffold for bone growth

Perio final exam notes Flashcards

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