Term
| What is the periodondtium composed of? |
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Definition
Gingiva
Attachment apparatus:
Periodontal ligament
Cementum
Alveolar bone |
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Term
| What is the bone into which the PDL inserts? |
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Definition
| Alveolar bone proper (aka supporting bone) |
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Term
What type of epithelium line the cheeks?
What type of epithelium is attached gingiva? |
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Definition
nonkeratinized
keratinized |
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Term
What is it called when the alveolar mucosa attaches to gingival tissue?
Is this on the palate? |
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Definition
mucogingival junction
No-all keratinized tissue |
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Term
What is the gingiva that is bound down tot he bone, adjacent to the teeth?
What is the gingiva that makes up the wall of the periodontal sulcus or periodontal pocket? |
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Definition
attached gingiva
free gingiva |
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Term
| What is the difference between a periodontal sulcus and a periodontal pocket? |
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Definition
Sulcus- expected to be there in healthy gingiva
pocket- groove is deepened and have lost some attachment in disease |
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Term
What is the epithelium that faces the tooth surface/makes up inside wall of sulcus?
Is it keratinized? |
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Definition
Sulcular epithelium
NOT keratinized (attached and free gingiva is keratinized) |
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Term
| What is the epithelial tissue attached by a hemidesmosome to a hard tissue surface that forms the gingival seal? |
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Definition
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Term
What is the interproximal dip of the interdental papilla into a valley at the contact point?
Why is it important in our exam? |
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Definition
Col
determines the angle we will probe because want to be directly under the contact point (where the periodontal pocket is deepest) |
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Term
| Will you angle more parallel for an incisor or a molar? |
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Definition
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Term
When we are measuring keratinized gingiva buccolingally we are measuring (width or thickness)?
When we are measuring keratinized gingiva apical coronally (gingival margin to mucogingival junction) we are measuring (width or thickness)? |
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Definition
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Term
| Is a patient with a short width of keratinized tissue (more or less) likely to have gingival recession? |
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Definition
more likely
(it is also easier to reverse gingival recession on a patient with a long width of keratinized tissue than short) |
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Term
| What is the fluid that washes things out of the periodontal groove? |
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Definition
| gingival crevicular fluid |
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Term
| What is the normal depth of a periodontal sulcus? |
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Definition
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Term
| Does everyone have the same tolerance for an amount of bacteria? |
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Definition
No
Everyone has different tolerance to amount of bacteria (can be hyperreactive to small amt of bacteria, or underreact to large amount of bacteria) |
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Term
| Periodontitis always starts with _______. |
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Definition
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Term
| Why is there an increase or coronal movement of the gingival margin in gingivitis? |
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Definition
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Term
| What is it considered when you have destroyed the attachment apparatus? |
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Definition
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Term
Is gingivitis reversible?
Is periodontitis? |
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Definition
yes
no (can only manage/arrest progression of disease) |
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Term
| What are you measuring when looking at the location of the gingival margin to the base of the periodontal pocket? |
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Definition
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Term
| What are you measuring when looking at the location of the CEJ to the base of the periodontal pocket? |
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Definition
| attachment level (how much attachment has been lost) |
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Term
| What would you see after pulling the gingiva away from the tooth/probing in order to decide that there is subgingival inflammation? |
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Definition
| calculus/tartar (calcified plaque, it's brown because it mixes with pigments from blood so we know it's sub gingival inflammation, looks like rings around teeth) |
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Term
| In periodontal disease, when measuring, do you round down or up? |
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Definition
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Term
What is the primary etiology of periodontitis?
What does disease progression depend on? |
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Definition
BACTERIAL PLAQUE (necessary to initiate disease)
host response |
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Term
| What all is seen in periodontitis? |
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Definition
-Bacterial plaque
-Inflammation extends beyond the gingiva into surrounding tissue
-Apical migration of junctional epithelium (seal between soft tissue and hard tissue) = attachment loss
-Pocket formation
-Bone Loss |
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Term
| Can you tell if a patient has periodontal disease by looking at them? What must you do? |
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Definition
No
Must probe- important to do a comprehensive exam on your patient |
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Term
| What all is involved in a periodontal examination? |
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Definition
Oral hygiene (Plaque Index)
Gingival health
Periodontal Probing
Furcation analysis
Mucogingival examination
Mobility
Occlusal analysis
Radiographic examination |
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Term
| What all must you look at when looking at gingival health? |
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Definition
Color (Erythema)
Texture (Edema)
Bleeding upon probing
Gingival Index |
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Term
| How many measurements are taken per tooth when probing depth? |
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Definition
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Term
| What is the measurement from the CEJ to the gingival margin? |
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Definition
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Term
| Is gingival overgrowth positive or negative recession? |
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Definition
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Term
If you have a 7 mm pocket and 1 mm recession, what is the attachment level?
If you have a 5 mm pocket and 3 mm of gingival overgrowth, what is the attachment level? |
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Definition
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Term
| What is probing depth + recession |
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Definition
| clinical attachment level |
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Term
| Is it more likely to successfully treat a patient with a probing depth of 7mm and no recession or a patient with a patient with a probing depth of 2mm and 5mm of recession? |
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Definition
| a patient with a probing depth of 2 mm and 5 mm recession because they can actually clean the tooth with a toothbrush while the other patient has a deep pocket they can't get to |
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Term
| On a maxillary molar, will you approach the furcation probe from the buccal or palatal when measuring the mesial and distal furcation? Why? |
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Definition
| from the palate (1 root in the back so mesial and distal furcation is closest) |
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Term
What grade are the following furcation analysis?
a) Probe goes through and through
b) incipient, can barely go in a dimple
c) More than incipient, but probe doesn't go through and through
d) can see through it, above gingival margin |
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Definition
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Term
How many furcation analysis would you do on a mandibular molar?
Maxillary molar? |
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Definition
2 for mandibular (buccal and lingual)
3 for maxillar (1 buccal and 2 disto and mesio palatal) |
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Term
| When doing a mucogingival assessment, what do you want to look at? |
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Definition
width of keratinized gingiva (measure thickness only after numbing patient)
location of the mucogingival junction |
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Term
| What is the defect when a tooth that has no attached gingiva, may have keratinized gingiva but it’s all free gingiva |
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Definition
| mucogingival defects (probe goes beyond mucogingival junction) |
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Term
| What do you measure mobility with? |
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Definition
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Term
Based on the Miller mobility scale, identify the mobility.
-Moderately more than normal mobility ( 0.5-1mm BL)
-Severe mobility faciolingually (>1 mm) and/or mesiodistally, combined with vertical displacement, depressible in the socket
-Slightly more than normal (<0.5 mm BL)
-Normal mobility |
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Definition
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Term
| When evaluating occlusion and periodontal disease, what do you want to look at? |
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Definition
Bruxers
Clinchers
Wear facets
Excessive wear
Circumferential defects |
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Term
| Can heavy occlusal forces alone cause bone loss? |
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Definition
| No- only in presence of inflammation can it speed up attachment loss |
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Term
| What are the 2 types of occlusal dysfunction or occlusal trauma? |
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Definition
primary occlusal trauma-excessive occlusal force on an intact periodontium
secondary-normal or excessive occlusal force on a reduced periodontium |
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Term
What is the type of bone that is uniform on all the teeth in the quadrant?
What is the type of bone loss that is high on one tooth and low on another, angle to the bone that does not correspond to a line from CEJ to CEJ |
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Definition
horizontal
vertical or angular |
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Term
| Can we graft horizontal or vertical bone loss? |
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Definition
| vertical (affects our treatment standpoint) |
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Term
| If we can see furcation invasion on a radiograph but can't feel it, what grade is it? |
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Definition
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Term
| What all do you look for during a radiograph examination? |
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Definition
Evaluation of the mineralized tissues
Bone loss (Horizontal, Vertical or angular)
Furcation invasion
Periapical pathology
Caries
Pathology |
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Term
| Would you want to use a periapical, panoramic, or bitewing when looking at crestal bone and inter proximal caries? |
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Definition
| bitewing (vertical is better than horizontal so we can see attachment loss) |
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Term
| Would you want to use a periapical, panoramic, or bitewing when looking at a tooth and surrounding tissues? |
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Definition
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Term
| What happens if there is poor angulation of the radiograph? |
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Definition
| We can under/over estimate bone loss (needs to be parallel) |
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