NBDHE Periodontology Flashcards - Key Concepts and Definitions

What is periodontology?

the study of the diagnosis, treatment and prevention of diseases affecting the periodontium

What are the tissues of the periodontium?

periodontal ligament, gingiva, cementum, alveolar bone

Sharpey's fibers are fiber bundles that are?

attached and embedded in cementum and bone

The PDL is a ______ tissue complex, made of fiber bundles and cells

connective

Fiber groups

Inderdental ligament

Hold teeth in interproximal contact with each other

transseptal fibers

Fiber groups

Apical to junctional epithelium

Resists tilting and horizontal forces

alveolar crest fibers

What is the most numerous type of fiber?

oblique fibers

Fiber groups

resists intrusive or verticle masticatory forces

Prevents tooth from being jammed into bony socket

Oblique fibers

FIber groups

Resists horizontal and tilting forces

horizontal fibers

Fiber groups

resists extrusive forces

prevents tooth from being lifted out of socket

apical fibers

Fiber groups

Found only in multirooted teeth

stabilized tooth root

interradicular fibers

Fiber groups

Gingival fibers (not part of PDL)

circular fibers

Fiber groups

circles fibers

maintain gingival integrity

circular fibers

What is the primary cell of the PDL?

fibroblasts

What cells produces bone?

osteoblasts

What cells resorbs bone (breaks down)?

osteoclasts

What cells produces cementum?

cementoblasts

What cells resorbs (breaks down) cementum?

cementoclasts

Characteristics of healthy gingiva?

firm, light pink, fills interproximal space, knife edged, gingival margin on enamel, 1-3mm gingival sulcus

Characteristics of unhealthy gingiva?

spongy, swollen, red, bleeds upon probing, bulbous, festooned, recession, hyperplastic, deep pockets or probing depths

Most gingivitis is ?

Chronic plaque associated gingivitis

Characteristics of acute gingivitis?

develops rapidly, obvious inflammation, may be painful, neutrophil is most prevalent cell

Characteristics of chronic gingivitis?

develops slowly, may appear normal, not usually painful

Gingival color

Light, coral pink

normal

Gingival color

erythema

Redness associated with inflammation

Gingival color

cyanosis

bluish, highly vascular (often found around crown)

Gingival color

pallor

lighter than normal, associated with anemia, leukemia, fibrotic tissue

Gingival surface texture

stippled

attached gingiva is often stippled, marginal gingiva is not

Gingival surface texture

edematous

gloss appearance due to increased fluid, edema is result of vasodilation of peripheral circulation

Gingival surface texture

fibrotic

increase in cellular and fibrous components, may present with pallor

What is a Stillman's cleft?

vertical loss of tissue, caused by improper flossing

What is festoon?

inner tube like swelling at gingival margin due to inflammation and increased cell number

What % of patients taking Phenytoin have hyperplasia?

50%

What % of patients taking Cyclosporin have hyperplasia?

30%

What are some other causes of gingival enlargement other than medications?

mouthbreathing, periodontal inflammation, genetic/hereditary factors, systematic conditions including leukemia and hormonal imbalance

What is hyperplasia?

increase in number of cells

What is hypertrophy?

increase in cell size

What is dehiscence?

a loss of alveolar bone, usually on facial aspect of tooth root

What is fenestration?

a window like opening in the bone, bordered by alveolar bone on the coronal aspect of the tooth

Plaque formation steps?

1. Glycoproteins from saliva are adsorbed to the tooth surface, forming the acquired pellicle

2. Bacteria the adhere (attach) to the acquired pellicle

3. Bacteria multiply to form colonies on the tooth, creating a biofilm

4. As plaque grows, bacteria detach from the biofilm and become "planktonic" bacteria (free)

5. Later, calculus forms from the mineralized plaque biofilm

Cocci are round/spherical shaped bacteria found in?

early plaque formation

Bacilli are rod shaped bacteria most common type found in?

periodontal disease

Spirochetes are spiral shaped bacteria often associated with?

NUG/NUP

Aerobic bacteria?

require oxygen to grow, are NOT found in perio pockets

Anaerobic bacteria?

grow in absence of oxygen, found in perio pocket and gingival sulcus

Facultative anaerobic bacteria?

can grow with or without oxygen

Gram + bacteria

S. mitis, S. oralis, S. sanguis, S. mutans, A. viscous

Gram - bacteria

P. gingivalis, T. denticola, T. forsythia, F. nucleatum, C. rectus, P. intermedia, A. actinomycetemcomitans

Bacterial species associated with NUG/NUP

T. denticola, P. intermedia, P. gingivalis Fusobacterium

Adherent plaque may mineralize and become?

calculus

Nonadherent plaque is also called?

planktonic plaque

Bacterial products often contribute to?

tissue destruction

Events occurring as periodontal disease progresses:

increased probing depths, increased attachment loss, increased bone resorption

What is the best indicator of damage to the periodontium?

CAL

To measure CAL?

1. measure pocket depth first

2. Measure how much recession is present

3. Add two numbers together (subtract if gingival enlargment)

Early/incipient, probe penetrates furca no more than 1mm

Class I

Moderate, probe penetrates more than 1mm, but not completely through

Class II

Severe, probe will pass completely through furcation, in maxillary molars, probe passes through MB and DB touches palatal root

Class III

Furcation clearly visible, probe pass completely through, due to loss of attachment and recession

Class IV

Width of attached gingiva is widest where?

anterior teeth

Width of attached gingiva is narrowest where?

premolar area

Slight mobility, up to 1mm horizontally?

class I

Moderate mobility, 1-2mm horizontally?

class II

Severe mobility >2mm horizontally or vertical?

class III

What is suprabony pocket?

above alveolar crest of bone

What is infrabony pocket?

base of pocket is below alveolar crest

Infrabony pockets are treated with?

regenerative procedures

Can occlusal trauma cause periodontal disease?

no

What is primary occlusal trauma?

excessive force on a tooth with normal bone support

What is secondary occlusal trauma?

injury as result of forces applied to a tooth that has previously experienced bone or attachment loss

Non plaque induced gingival diseases?

primary herpes, recurrent herpes, aphthous ulcers

Aggressive periodontitis often associated with?

Aa (aggregatibacter actinomycetemcomitans)

Gingival abscess?

results from injury to or infection of the surface gingival tissue

Periodontal abscess?

results when infection spreads deep into pocket, and drainage is blocked. may develop after periodontal debridement

Pericoronal abscess?

develops in inflamed dental follicular tissue, overlying the crown of a partially-erupted tooth. *does not show on radiographs

Periapical abscess?

results from infection of tooth pulp

Stage I of periodontal lesion

initial lesion, no clinical changes, vasodilation, 2-4 days

Stage II of periodontal lesion

early lesion, clinical signs of gingivitis appear, 4-7 days

Stage III of periodontal lesion

established lesion, increased probing depths, 2-3 weeks

Stage IV of periodontal lesion

advanced lesion, transition from gingivitis to periodontitis, irreversible, 3 weeks + to years

Transient vasoconstriction is FIRST, then

vasodilation

What is transient?

temporary

What is hyperemia?

an excess of blood in the vessels in the tissues

What is margination?

the movement of WBCs to the periphery of vessel walls

What is pavementing?

WBCs line the wall of the vessel

What is diapidesis?

process by which neutrophils squeeze between endothelial cells in the vessel wall

What is emigration?

cells move into the tissues from blood vessel

What is chemotaxis?

movement of cells to site of inflammation

What are neutrophils main function?

phagocytosis

Macrophages characterize?

chronic inflammation

Interleukins increase?

vascular permeability, attract PMNs

Prostaglandins cause?

pain and inflammation

Leukotrienes cause?

bronchoconstriction

Vitamin C deficiency?

Scurvy

Protein deficiency?

Kwashiorkor

What bacteria associated with pregnancy gingivitis?

Prevotella intermedia and campylobacter rectus

Cancer patients may present with

xerostomia, mucositis, dysgeusia, increased risk of fungal and viral infection

Patients with HIV may present with?

Linear gingival erythema, NUP, Aphthous ulcers, Kaposis sarcoma

What bony wall defect has best prognosis?

3 wall defect

What bony wall defect has worst prognosis?

1 wall defect