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242 Cards in this Set
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Type of periodontitis that is a bacterial infection resulting in inflammation of supporting tissue of teeth
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Aggressive Periodontitis
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Aggressive periodontitis is charaterized by rapid distruction of what two tooth structures?
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Aggressive Periodontitis Characterized by Rapid destruction of PDL and supporting bone
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A patient with aggressive periodontitis is at __ risk for tooth loss and has a ___ response to periodontal therapy
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A patient with aggressive periodontitis is at high risk for tooth loss and has a poor response to periodontal therapy
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The amount of biofilm a person have with aggressive periodontitis is?
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Aggressive periodontitis:
-Severity of destruction inconsistent with small Amount of Biofilm present |
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Aggressive peridontist is __ common occuring than chronic perio
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Aggressive peridontist is less common occuring than chronic perio
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Aggressive periodontitis Affects __ of the population and occurs most often in ___
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Aggressive periodontitis: Affects < 1% of the population and occurs most often in black females
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Aggressive periodontitis can be classified as?
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Classified as either localized or generalized aggressive periodontitis
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The clinical features of this is seen in what type of periodontits?
-Bone destruction and rapid attachment loss -Lack of clinical inflammation -Relatively sparse bacterial plaque and biofilm present -Typically patient is otherwise healthy with concerns to systemic condition |
Aggressive Periodontitis clinical features include:
-Bone destruction and rapid attachment loss -Lack of clinical inflammation -Relatively sparse bacterial plaque and biofilm present -Typically patient is otherwise healthy with concerns to systemic condition |
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This type of peridontitis is:
-Formerly called early onset or juvenile periodontitis -Is circumpubertal onset meaning it occurs around puberty |
Localized aggressive periodontitis:
-Formerly called early onset or juvenile periodontitis -Is circumpubertal onset meaning it occurs around puberty |
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Localized Aggressive Periodontitis
-Rapid destruction occurs around the ___ and ___ because they are the 1st too erupt |
Localized Aggressive Periodontitis
-Rapid destruction occurs around the permanent 1st molars and incisors because they are the 1st too erupt |
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Localized Aggressive Periodontitis type of bacteria that is frequently assoicated with?
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Localized Aggressive Periodontitis
-Frequently associated with A.A. bacteria and P. Gingivitis |
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Localized Aggressive Periodontitis is associated with what type of neutrophil function?
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Localized Aggressive Periodontitis
-Associated with abnormal neutrophil function |
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How does the bone loss of look like in an Localized Aggressive Periodontitis patient?
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Localized Aggressive Periodontitis -Bone loss can be in the shape of “ Arc” or look scooped out or U shaped
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Generalized Aggressive Periodontitis
-Affects individuals ___ years old?-Rapid destruction occurs around __ teeth? -Associated with __ bacteria and __ __ -Has ___neutrophil function -Previously known as ___ |
Generalized Aggressive Periodontitis
-Affects individuals under 30 years old -Rapid destruction occurs around most teeth -Associated with A.A. bacteria and P. Gingivalis -Has abnormal neutrophil function -Previously known as Rapidly progressive periodontitis |
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Generalized Aggressive Periodontitis are Associated with system diseases – such as?
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Generalized Aggressive Periodontitis Associated with system diseases – such as insulin dependent diabetes, down syndrome, AIDS
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Generalized Aggressive Periodontitis Someone with this has __antibody response
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Generalized Aggressive Periodontitis Someone with this has poor antibody response
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Generalized Aggressive Periodontitis treatment considerations includes?
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Generalized Aggressive Periodontitis
-Consult with physician - individualized instructions - reinforcement and evaluation of biofilm control - Smoking cessation - Debridement - Removal of local contributing factors - Surgical debridement of soft tissue (periodontist does this) - Perio exam and reevaluation - Due to potential genetic link - eval other family members |
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Periodontitis As A Manifestation of Systemic Disease:
Biofilm initiated periodontal disease, but a form of disease and its progression is dependent on what? |
Periodontitis As A Manifestation of Systemic Disease: Biofilm initiated periodontal disease, but a form of disease and its progression is dependent on the host defenses
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__ __ and __ may modify normal defenses and influence outcome of periodontal disease
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Systemic conditions and environment may modify normal defenses and influence outcome of periodontal disease
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(3) conditions Associated with Hematologic Disorders
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(3) conditions Associated with Hematologic Disorders
1.Acquired Neutopenia 2.Leukemia 3.Multiple Myeloma |
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Associated with Hematologic Disorders - This descibes what type:
-Absence of circulating PMNs in blood - Decreased number of neutrophils - may be congenital |
Associated with Hematologic Disorders: Acquired Neutopenia
- Absence of circulating PMNs in blood - Decreased number of neutrophils - may be congenital |
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Associated with Hematologic Disorders; this descibe what type?
-Circulating abnormal leukocytes - Anemia - interdental papilla can be necrotic |
Associated with Hematologic Disorders:
-Leukemia - Circulating abnormal leukocytes - Anemia - interdental papilla can be necrotic |
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Associated with Hematologic Disorders this descibe what type?
- Plasma cell malignancy - Gingival bleeding is occurring - destruction of alveolar bone - May have Moth eaten appearance |
Associated with Hematologic Disorders:
Multiple Myeloma - Plasma cell malignancy - Gingival bleeding is occurring - destruction of alveolar bone - May have Moth eaten appearance |
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Associated with Genetic Disorders:this type includes:
- Dermatologic disease - Person has HYperkeratinazation – this affects the structural integrity of the protective barriers - A disruption in the immune cells occurs and they operate less efficiently - It is a severe disruption of the periodontium – someone who has this the person loses all their teeth by adulthood |
Papillon – Lefevre Syndrome
- Dermatologic disease - Person has HYperkeratinazation – this affects the structural integrity of the protective barriers - A disruption in the immune cells occurs and they operate less efficiently - It is a severe disruption of the periodontium – someone who has this the person loses all their teeth by adulthood |
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Associated with Genetic Disorders:this type includes:
- Rare inherited form of albinism - Visual difficulties occur - WMC / neutrophil abnormalities occur |
Chediak- Higashi Syndrome
- Rare inherited form of albinism - Visual difficulties occur - WMC / neutrophil abnormalities occur |
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Associated with Genetic Disorders:this type includes:
- Connective tissue disorder - manifested by splitting skin, bleeding tissues - wounds over forehead and chin are often present - may have “ fishmouth appearance” |
Ehlers – Danlos Syndrome (types IV and VIII)
- Connective tissue disorder - manifested by splitting skin, bleeding tissues - wounds over forehead and chin are often present - may have “ fishmouth appearance” |
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Associated with Genetic Disorders:this type includes:
- Rare Hereditary disorder - Decreased alkaline phosphatase – an enzyme that is necessary for proper bone formation - If don’t have enough phosphatase will have premature loss of teeth due to inadequate PDL attachment - resembles aggressive perio |
Hypophosphatasia
- Rare Hereditary disorder - Decreased alkaline phosphatase – an enzyme that is necessary for proper bone formation - If don’t have enough phosphatase will have premature loss of teeth due to inadequate PDL attachment - resembles aggressive perio |
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___ ___ ___ is:
- destructive infections of the periodontal tissues - Involves tissue necrosis - Gingiva tissues are combines with loss of attachment and alveolar bone loss |
Necrotizing Periodontal Disease
- destructive infections of the periodontal tissues - Involves tissue necrosis - Gingiva tissues are combines with loss of attachment and alveolar bone loss |
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Necrotizing Ulcerative Gingivitis (NUG) is a painful infection primarily of __ and __ ___
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Necrotizing Ulcerative Gingivitis (NUG) Painful infection primarily of interdental and marginal gingival
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Necrotizing Ulcerative Gingivitis (NUG) Characterized by ?
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Necrotizing Ulcerative Gingivitis (NUG) Characterized by partial loss of interdental papilla
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Necrotizing Ulcerative Gingivitis (NUG) the interdental papilla appears ?
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Necrotizing Ulcerative Gingivitis (NUG) the interdental papilla appears “Punched out”
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Necrotizing Ulcerative Gingivitis (NUG)
-Considered to be a __onset - Relatively __ incidence |
Necrotizing Ulcerative Gingivitis (NUG)
-Considered to be sudden onset - Relatively uncommon incidence |
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known as trench mouth or vincents infection
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Necrotizing Ulcerative Gingivitis (NUG) known as trench mouth or vincents infection
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Necrotizing Ulcerative Gingivitis (NUG) Mostly affects __ __ ages __-__
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Necrotizing Ulcerative Gingivitis (NUG) Mostly affects young adults ages 18-30
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Necrotizing Ulcerative Gingivitis (NUG) how does it appears on the gingiva and where?
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Necrotizing Ulcerative Gingivitis (NUG) Seen as small grey ulcerative lesions that begin at the tips of interdental papilla and spreads to the gingival margin
-consider punch out or cratered lesion -Typically has grayish white pseudomembrane covering the area - Usually have heavy deposits of plaque accumulation |
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Predisposing factor for Necrotizing ulcerative peridontistis
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Predisposing factor for NUP
-Cigarette smoking -Increased levels of personal stress -Poor nutrition & Fatigue -Immune dysfunction or suppression -Pre existing gingivitis or some type of tissue trauma |
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Treatment considerations for Necrotizing ulcerative peridontistis
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Treatment considerations for NUP
-Rinsing with hydrogen peroxide with equal parts of water -Irrigation -Rinse twice daily with 12% Chlorhexidine -Debridement of tooth surfaces -Patient self care instruction -Pain control and antibiotic – penicillin, erythromycilin, flagellen -Therapy as appropriate for management of systemic condition |
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Dental hygiene care for Necrotizing ulcerative peridontistis
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Dental hygiene care for NUP
-Nutritional counseling -Intake of fluids (liquid dietary replacement – Ensure) -Biofilm control -Smoking Cessation -Avoid tobacco, alcohol, and condiments (due to acidity) |
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This is a type of abscess that
is an Acute infection - patient may know cause (ex. Foreign object such as popcorn kernel, fish bone, seed) - Treatment requires removal of etiologic agent - place patient on warm salt water rinses |
Gingival Abscess
Acute infection - patient may know cause (ex. Foreign object such as popcorn kernel, fish bone, seed) - Treatment requires removal of etiologic agent - place patient on warm salt water rinses |
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Type of abscess that:
Also called lateral abscess - Acute inflammation within the periodontal tissues - Develops as a result of bacterial infection - Often seen in deep periodontal pockets and furcation sites - Can also occur as a result of foreign objects that become embedded - Presents as shiny, swollen mass on gingival or mucosa - Finger pressure may produce purulent exudates - Tooth is often tender to percussion, mobile - Treatment: Establish drainage, remove causative agent, analgesic & warm saline rinse, Mucoperiosteal flap, all granulomatous tissue removed, root surface - May occur due to Calculus that is left |
Periodontal Abscess
Also called lateral abscess - Acute inflammation within the periodontal tissues - Develops as a result of bacterial infection - Often seen in deep periodontal pockets and furcation sites - Can also occur as a result of foreign objects that become embedded - Presents as shiny, swollen mass on gingival or mucosa - Finger pressure may produce purulent exudates - Tooth is often tender to percussion, mobile - Treatment: Establish drainage, remove causative agent, analgesic & warm saline rinse, Mucoperiosteal flap, all granulomatous tissue removed, root surface - May occur due to Calculus that is left |
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Type of absces that is-Localized infection involving operculum
-Patient may have dull ache and trismus -Food debris is often found under operculum -Treatment: irrigation with saline solution, iodine, or water -If infection is severe – prescribe antibiotics |
Periocoronal Abscess (periocoronitis)
-Localized infection involving operculum -Patient may have dull ache and trismus -Food debris is often found under operculum -Treatment: irrigation with saline solution, iodine, or water -If infection is severe – prescribe antibiotics |
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Types of bacteria found in Nercrotizing ulcerative gingivitis
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Nercrotizing ulcerative gingivitis
bacteria: high number p, intermediate spirochetes, fusobacteria |
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How does Necrotizing ulcerative peridontistis appears in the mouth?
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Necrotizing ulcerative peridontistis
-ulcerated and necrotic papillary and marginal gingival -covered by yellowish-white or grayish slogh or pseudomembrane -blunting and cratering of papilla -bleeding on provocation or spontaneous bleeding -pain and fetid odor |
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Necrotizing ulcerative peridontistis may be accompanied by _,_,_
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Necrotizing ulcerative peridontistis may be accompanied by fever, malaise, lymphadenopahthy
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Necrotizing ulcerative peridontistis is an extensive necrosis of gingival with rapid destruction of the underlying bone extending past the __ ___
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Necrotizing ulcerative peridontistis extensive necrosis of gingival with rapid destruction of the underlying bone extending past the mucoginigival junction
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Necrotizing ulcerative peridontistis may coexist with other forms of perio such as __ or __
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Necrotizing ulcerative peridontistis may coexist with other forms of perio such as aggressive or chronic (HIV)
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The most current classification of perio disease is based on all the following factors except one. which is the exception? a) age of patient b) clinical presentation c) radiographic survey d) historical data
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a) age of patient
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What term replaced the older term of Adult periodontitis?
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Chronic Periodontitis
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What term replaces the older term Localized Juvenile Periodontitis?
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Localized Aggressive Periodontitis
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Which of the following conditions is listed as a Mucogingival deformity? a) secondary occlusal trauma b) perio abcess c) lack of keratinized gingiva d) allergy to toothpaste e) recurrent oral herpes
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c) lack of keratinized gingiva
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Which one of following features differentiates periodontitis from gingivitis?
a)engorged lamina propria b) redness of gingiva c) loss of connective tissue attachment d) # of bacteria present in the gingival crevice |
c) loss of connective tissue attachment
- is the feature that differentiates periodontitis from gingivitis |
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What periodontal lesion is characterized by chronic gingival inflammation and the presence of plasma cells?
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Established lesion
- is characterized by chronic gingival inglammation and presence of plasma cells |
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What periodontal lesion is characterized by attachment loss and bone resorption?
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Advanced Lesion
- is characterized by attachment loss and bone resorption |
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During the disease process, the Junctional Epithelium transforms into _____
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during disease process the junctional epithelium transforms into POCKET EPITHELIUM
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What lesion features a predominance of plasma cells?
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Advanced lesions
- features a predominance of plasma cells |
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Which feature describes gingivitis? a) occurs primarily in children b) extensive attachment loss c) bone loss does not occur d) primary risk factors include pathogenic bacteria & calculus
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Bone loss does not occur
- is a feature that describes gingivitis |
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All of following medications are contributing risk factors in causing gingival enlargement except one? which is the exception? a) phenytoin b) cyclosporin c) ibuprofen
d) nifedipine e) valporic acid |
c) ibuprofen
- phenytoin, cyclosporin, nifedipine, & valporic acid are all contributing risk factors in causing gingival enlargement |
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What periodontal disease is described by having inflammation of the gingiva without loss of clinical connective tissue attachment?
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Dental Plaque- Induced Gingivitis
- a type of perio disease that is described by having inflammation of gingiva w/o loss of clinical connective tissue attachment |
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What bacteria is found in high numbers in pregnancy gingivitis?
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Prevotella Intermedia
- bacteria found in high numbers in pregnancy gingivitis |
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What systemic disease features gingival involvement due to elevated glucose levels?
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Diabetes
- a condition that features gingival involvement due to elevated glucose levels |
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Which one of the following features describes chronic periodontitis? a) it occurs primarily in kids b) no connective tissue attachment loss occurs c) bone loss doesn't occur d) risk factors include pathogenic bacteria & smoking
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Risk factors include pathogenic bacteria and smoking
- a feature that describes chronic periodontitis |
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Which form of periodontitis is associated with a chemotactic defective in the polumorphonuclear leukocytes?
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Localized Aggressive Periodontitis
- form of perio that is associated with a chemotactic defective in the polymorphonuclear leukocytes |
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What bacteria is found in high numbers in localized aggressive periodontitis?
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Actinobacillus Actinomycetemcomitans A.A.
- bacteria that is found in high # in localized aggressive periodontitis |
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Which one of following types of poclet has its base located apical to the alveolar crest as evidenced on radiograph?
a) gingival b) psuedo c) suprabony d) Infrabony |
d) Infrabony
- type of pocket that has its base located apical to alveolar crest as evidenced on a radiograph |
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Which statement describes an HIV (+) patient with necrotizing perio disease? a) higher prevalence in females than males b) higher incidence of skin lesions
c) microbial profile is similar in noninfected periodontally involved patients d) geographic distribution shows a higher prevalence in the eastern US |
c) Microbial profile is similar in noninfected periodontally involved patients
- describes an HIV pt with necrotizing perio disease |
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which bacterium present in NUG patients may penetrate periodontal tissues?
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SPIROCHETES
- the bacterium present in NUG pt may penetrate periodontal tissues |
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Both Necrotizing Ulcerative gingivitis (NUG)& Necrotizing ulcerative periodontitis (NUP) are categorized under the title _____
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Necrotizing ulcerative diseases
- what NUG & NUP are caregorized under |
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NUG may be the first clinical sign of an underlying systemic disease such as ____
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Human Immunodeficiency virus infection (HIV)
- NUG may be 1st clinical sign of HIV |
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Which of following diseases must be differentiated from NUG? a) Herpes simplex type 2 b) primary herpetic gingivostomatitis c) actuve necrotizing ulcerative gingivitis d) Acquired immunodeficiency syndrome
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b) Primary herpetic gingivostomatitis
- disease that must be differentiated from NUG |
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What is most common bacterium found in the purulent exudate of a tooth with a periodontal abscess?
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Porphyromas Gingivalis
- most common bacterium found in the purulent exudate of tooth with perio abscess |
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A gingival abscess is localized to the ____
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interdental papilla
- where the gingival abscess is localized |
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Which of following is a clinical feature of a perio abscess?
a) fibrotic gingiva b) edematous gingiva c) gingival recess d) firm gingiva |
b) edematous gingiva
- a clincial feature of a perio abscess |
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Which of following is a compication from a pericoronal abscess? a)gingival recession b) trismus c) attrition d) furcation defect e) fibrotic gingiva
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b) trismus
- a complication from a pericoronal abscess |
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What is occurring when a pocket is probed on a tooth with an acute periodontal abscess?
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Incision and drainage is occurring when a pocket is probed on a tooth with an acute perio abscess
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___ appears 2-4 days after the inflammation appears.
- Has an increase in GCF - has more migration of PMNs to the area - Has an acute stage |
INITIAL LESION
- stage 1 - has an increase in GCF - appears 2-4 days after inflammation appears - has more migration of PMNs to the area - Has an acute stage |
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___ is not clinically visible at this stage it is subclinical
- bacteria that is present is mainly gram + cocci - It is reversible |
INITIAL LESION
- subclinical- not clinically visible at this stage - bacteria that is present is mainly gram + cocci - it is reversible |
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___ is the inflammatory response of gingiva to biofilm &is aggravated by poorly controlled glucose levels
Clinical signs= well demarcated gingival swelling and is soft, red, irregular, and hemorragnic surface of hyperplastic tissue is bulbous or papulunodular |
Diabetes Mellitus Associated Gingivitis = well demarcated gingiva is red , soft , increased gingival levvel in gingival fluid that could change microflora
Bacteria present: Actinomyces Sp. ; Polphymonas Gingivalis ; Prevotella intermedia ; A. A. ; Caphocytophaga ; Anaerobic Vibrios |
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___ is found in pregnancy associated gingivitis
- Form of inflammatory hyperplasia - The growth is exaggerated response to irritation - Appears bright red, fleshy, & soft - base is polypoid or pedunculated -most frequently arises in the interdental papilla |
Pyogenic Granuloma
- form of inflammatory hyperplasia - exaggerated response to irritation -Appears red, fleshy, soft --base is pedunculated-- most frequent arises in inderdental papilla |
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___ has elevated levels of progesterone, estrogen, prevotella intermedia , GCF, effects seen as early as 8 weeks
clincial signs= redness, edema |
Pregnancy Associated Gingivitis - elevated levels of progesterone, estrogen, GCF, Prevotella Intermedia
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Menstrual cycle associated gingivitis has 3 stages what are they
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3 stages of menstrual cycle associated gingivitis
1- Intermenstrualis (mid cycle) 2- Gingivitis Climacterice (menopausal) 3- Contraceptives |
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___ - has incresed levels of estrogen, progesterone, testerone - fluctuation of hormones - high # of prevotala intermedium -characterized under gingival diseases modified by systemic factors- Endocrine System
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Puberty associated gingivitis
- increased levels of estrogen, progesterone, testosterone, high # of prevotala intermedium |
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___ is the most common form of gingival disease.
- considered to be an exaggerated response to biofilm (plaque) - Lesions are initial, early, and established - bacteria associated is S. mutans, Streptococcus Sanguis, Fusobacterium, Actinomyces Viscosus, Vei Hondla |
Plaque Induced Gingival Disease * Most common*
- considered to be exaggerated response to biofilm - Reversible - Lesions are initial, early, established |
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Plaque Induced Gingival disease can be broken down into 4 categories what are they?
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1. Gingivitis associated with biofilm only with or without local contributing factors
2. GIngival disease modified by systemic factors 3. Gingival disease modified by Medications 4. Gingival disease modified by Malnutrition |
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what does this describe..
•Increase in the number of lymphocytes, macrophages, and plasma cells •At this stage there can be clinical signs such as Redness, Bleeding, and inflamed tissue •Have more proliferation •Happens at 4-7 days after plaque accumulation •Rete pegs are developing |
Early Lesion - stage 2
increase # of lymphocytes, macrophages, plasma cells, neutrophils clinical signs= bleeding, redness, inflamed tissues proliferation occuring and rete pegs are developing |
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Collagen destruction is occurring
•Causes pseudopockets because the tissue is inflamed •Bacteria is gram (-) rods the microflora is changing •Considered to be an acute Stage •It is reversible |
Early lesion - stage 2
4 - 7 days collagen destruction pseudopockets - tissues are inflamed bacteria present= gram (-) rods Acute & reversible |
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Occurs 2 to 3 weeks after plaque accumulation
Has predominance of plasma cells (B cells, antibodies) widen intercellular spaces – more proliferation destruction of collagen fiber Clinicial signs bleeding, erythema, pseudopockets, gingival enlargement, no attachment loss, spongy, red, Reversible |
ESTABLISHED LESION
stage 3 - reversible 2-3 weeks predominance of plasma cells b cells and antibodies widen intercellular spaces proliferation & destruction of collagen - bleeding, erythema, pseudopocket, gingival enlargement, no attachment loss |
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What stage is this? Do have pocket formation, alveolar bone loss, the Junctional Epithelium is detached and migrates apically
There has been destruction of PDL fibers - Gram (-) bacteria present |
Advanced lesion- stage 4
gram - bacteria present destruction of PDL Have pocket formation, bone loss, JE is detached and migrates apically |
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In Advanced Lesion (stage 4) what is the 1st principle fiber that will be destroyed
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Alveolar crestal fiber
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What are the 3 disorders associated with Blood Dyscrasis?
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Associated with Blood Dyscrasis
- Leukemic Gingivitis - Cyclic Neutropenia - Anemia |
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___ is a malignant condition: overproduction of leukocytes
oral features: tissue is red, tender, spongy, lost of stippling, spontaneous bleeding, purpuric - has sever perio bone loss and oral ulcerations |
LEUKEMIC GINGIVITIS
- malignant condition - overproduction of leukocytes - severe bone loss&ulcerations - tissue: red, tender,loss of stippling, spongy, bleeding |
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____ is marked reduction of circulating neutrophils
oral manifestations: gingivitis, bone loss, necrotizing ulcers |
Cyclic Neutropenia
- marked reduction of circulating neutrophils - manifestations: gingivitis, bone loss, necrotizing ulcers |
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__ is a decrease number of erythrocytes.
- May have oral atrophy, angular cheilitis, tongue may be demuted and papilla lost, with pale mucous membrane |
ANEMIA - decrease # of erythrocytes. May have oral atrophy, angular cheilitis, tongue may be demuted & papilla lost w/pale mucous membrane
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___ is plaque induced
- no specific bacteria associated -excessive production of collagen -enlargement begins in interdental papilla - orally has fibrotic changes tissue become pink, firm, resilent -Enlargement occurs 1-3months after beginning meds |
Gingival disease modified by Medications
- no specific bacter, excessive collagen, occurs 1-3months after beginning meds, mechanism of hyperplasia unknown, enlargement begins in interdental papilla, growth results in fibrotic changes, tissue become pink,firm,resilent, appears more exaggerated on labial aspects of anterior |
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Gingival Disease modified by Medications occur in a patient taking ....
1. ___- anticeisure- 50% incidence of overgrowth 2. ___- antirejection- 30% incidence of overgrowth 3. ___- Calcium channel blocker- 15% incidence of overgrowth 4. Contraceptives- no specific bacteria is associated |
1. PHENYTOIN (dilantin)
-anticeisure : 50% 2. CYCLOSPORIN (Sandiuumen) - antirejection 30% incidence 3. NIFEDIPENE (Procardia) -Calcium Channel Blocker - 15% |
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___ is plaque induced
- may have an impact on the host's ability to protect itself - orally: you see bright red, swollen, bleeding gingiva - nutritional defencies affect immune system function |
Gingival disease modified by Malnutrition
- Orally: bright red, swollen, bleeding gingival |
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__ is defect in collagen formation- helps in formation of fibroblast & collagen
Clinical findings: hemorrhage, bluish red gingival, widened PDL & tooth mobility, slow wound healing, bleeds easily |
VITAMIN C (Absorbic Acid)
-defect in collagen formation - clinical findings: hemorrhage, bluish red gingival, widened PdL, tooth mobility, slow wound healing, bleeding easily |
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___ : clinical findings: blue/purple mucosa, glossitis, Angular cheilosis, enlarged fungiform papilla, atrophy of filiform papilla, burning sensation - May look like geographic tongue
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RIBFLAVIN - B2
Clinical Findings: Blue/ Purple Mucosa, Glossitis, Angular Cheilosis, Enlarged fungiform papilla, atrophy of filiform papilla, burning sensation |
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___ = clinical findings: Glossitis, ulcerations & atrophy of papilla , cheilosis, burning sensations
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NIACIN - B3
clinical findings: Glossitis, ulcerations & atrophy of papilla , cheilosis, burning sensations |
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Failure of bones to heal
- Radiographically you will see loss of alveolar bone and/or loss of lamina dura - helps build bone |
calcium & vitamin d
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- Thickening of epithelium, underlying muscle atrophy, impaired taste
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Zinc
Vitamin C & zinc Help with the tissues healing process |
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Smooth edematous tongue, angular cheilosis, fissures
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Protein
- Smooth edematous tongue, angular cheilosis, fissures |
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___ - Have increased in prevalence due to STD
- Oral lesions may be secondary due to systemic infection or may occur through direct infections & appear as fluid filled ulcers - include Gingival diseases of Specific Bacterial Origin, Viral Origin, Fungal Origin, Genetic Origin, manifestation of systemic conditions |
Non Plaque Induced Gingivits
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___ = has onset of puplic lesion, fever, includes gram (-) organism, orally: skin lesions are sm papules that turn into pustules, have cold sores, pharyngitis, swollen, purulent
- to determine have to have culture from pharynx, blood, uretha, rectum |
NEISSERIA GONORRHEA
- onset of pulpic lesions skin lesions sm. papules that turn into papules orally you see cold sores pharyngitis |
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__ is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @site of entry (chancre) - can occur on genitals or orally on lips, tongue, gingival, palate,tonsils |
TREPONEMA PALLIDUM (syphillis) - is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @ site of entry (chancre) |
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__ have vesicles that may present as an acute condition
**acutely inflamed, diffused, red, swollen gingiva **increased bleeding & occasional gingival abcsess formation **Symptoms: fever, malaise, pain |
STREPTOCOCCAL LESION
- vesicles present as acute condition -have been associated with group B hemolytic streptococcal infections -increased bleeding & occasional gingival abcess formation -acutely inflamed, red,diffused, swollen gingiva - symptoms: fever,pain,malaise |
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___ may be caused by a variety of DNA & RNA viruses
- most common type is the herpes virus - Lesions frequently related to reactivation of latent |
Gingival disease of Viral Origin
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__ is when a DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop - Patient may have fever,swollen lymph nodes, malaise - tends to affect kids under 10 |
Primary Herpetic Gingivostomatitis
= DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin - gingiva may have ulcers & vesicles that develop - Patient may have fever,swollen lymph nodes, malaise - takes 14 days to run its course |
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Recurrent oral herpes has areas of ___,____,& __
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Recurrent oral herpes has areas of Erythema, Ulceration, and Possible Necrosis
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Failure of bones to heal
- Radiographically you will see loss of alveolar bone and/or loss of lamina dura - helps build bone |
calcium & vitamin d
|
|
- Thickening of epithelium, underlying muscle atrophy, impaired taste
|
Zinc
Vitamin C & zinc Help with the tissues healing process |
|
Smooth edematous tongue, angular cheilosis, fissures
|
Protein
- Smooth edematous tongue, angular cheilosis, fissures |
|
___ - Have increased in prevalence due to STD
- Oral lesions may be secondary due to systemic infection or may occur through direct infections & appear as fluid filled ulcers - include Gingival diseases of Specific Bacterial Origin, Viral Origin, Fungal Origin, Genetic Origin, manifestation of systemic conditions |
Non Plaque Induced Gingivits
|
|
___ = has onset of puplic lesion, fever, includes gram (-) organism, orally: skin lesions are sm papules that turn into pustules, have cold sores, pharyngitis, swollen, purulent
- to determine have to have culture from pharynx, blood, uretha, rectum |
NEISSERIA GONORRHEA
- onset of pulpic lesions skin lesions sm. papules that turn into papules orally you see cold sores pharyngitis |
|
__ is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @site of entry (chancre) - can occur on genitals or orally on lips, tongue, gingival, palate,tonsils |
TREPONEMA PALLIDUM (syphillis) - is an insidious infection caused by spirochete
- primary stage is marked by development of ulceration @ site of entry (chancre) |
|
__ have vesicles that may present as an acute condition
**acutely inflamed, diffused, red, swollen gingiva **increased bleeding & occasional gingival abcsess formation **Symptoms: fever, malaise, pain |
STREPTOCOCCAL LESION
- vesicles present as acute condition -have been associated with group B hemolytic streptococcal infections -increased bleeding & occasional gingival abcess formation -acutely inflamed, red,diffused, swollen gingiva - symptoms: fever,pain,malaise |
|
___ may be caused by a variety of DNA & RNA viruses
- most common type is the herpes virus - Lesions frequently related to reactivation of latent |
Gingival disease of Viral Origin
|
|
__ is when a DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin
- gingiva may have ulcers & vesicles that develop - Patient may have fever,swollen lymph nodes, malaise - tends to affect kids under 10 |
Primary Herpetic Gingivostomatitis
= DNA virus w/ propensity to infect the epithelium initial infection is subclinical - replication of virus causes generalized swelling, redness, pain at the margin - gingiva may have ulcers & vesicles that develop - Patient may have fever,swollen lymph nodes, malaise - takes 14 days to run its course |
|
Recurrent oral herpes has areas of ___,____,& __
|
Recurrent oral herpes has areas of Erythema, Ulceration, and Possible Necrosis
|
|
___ begins with malaise & sore throat
- is a generalized rash that follows from macules to vesicles -Orally: may have scattered vesicles that rupture -Clinical phase 2-3 weeks |
VARICELLA ZOSTER (chickenpox)
-may have scattered vesicles that rupture generalized rash follows from macules to vesicles |
|
___ is - more common in immunocompromised or in whom the normal oral flora has been disrupted
- Appears red, white, and ulcerated lesions |
Gingival disease of fungal origin
|
|
MOST COMMON INFECTION IN THE MOUTH
- occurs in patient with AIDS - Present as erythema of attached gingival and referred to as linear gingival erythema or HIV associated virus - can be one of the 1st signs of AIDS |
Acute pseudomembraneous candidiasis (Candida)
** Most common infection in the mouth** - occurs in patient with AIDS - Present as erythema of attached gingival and referred to as linear gingival erythema or HIV associated virus - can be one of the 1st signs of AIDS |
|
___ o Can also be seen under prosthetic devices
o Seen in individuals using topical steroids, with decreased salivary flow, seen in those who have increased salivary glucose(diabetic patient) & those who use inhalers, have asthma, or emphysema o Buccal Mucosa is most frequent site this can affect |
CANDIDA ALBICANS
o Buccal Mucosa is most frequent site this can affect Can also be seen under prosthetic devices o Seen in individuals using topical steroids, with decreased salivary flow, seen in those who have increased salivary glucose(diabetic patient) & those who use inhalers, have asthma, or emphysema |
|
____ is - Usually chronic
- appear as white patches on gingival, tongue, oral mucous membrane |
Candida Infections
- Usually chronic - appear as white patches on gingival, tongue, oral mucous membrane |
|
___ is Unique pattern of candida infection
- HIV related gingivitis but this can occur in someone that is immunocompromised - distinct band of erythema along margin - extends 2-3 mm |
= Linear Gingival Erythema
- Unique pattern of candida infection - HIV related gingivitis but this can occur in someone that is immunocompromised - distinct band of erythema along margin - extends 2-3 mm |
|
___ is Infection produced by fungal organism
o One of the most common fungal infection in the US o It is spread through dust from birds, bat droppings, or contaminated soil o Orally the affected area may mimic carcinoma o May present chronic ulcerations with rolled or raised border that appear as thickened white plaque o Person may have no symptoms or mild flu like symptoms such as fever / headache |
Histoplasmosis
o Infection produced by fungal organism o It is spread through dust from birds, bat droppings, or contaminated soil o Orally the affected area may mimic carcinoma o May present chronic ulcerations with rolled or raised border that appear as thickened white plaque |
|
__ is lesion on genetic origin
- inherited in autosomal dominant - superimposed inflammatory reaction - characterized by generalized firm, collagenous overgrowth of gingival tissue - can delay eruption or extend over teeth - Hyperplastic gingival firm, normal color, - Rare |
HEREDITARY GINGIVAL FIBROMATASIS
- inherited autosomal dominant characterized by generalized firm, collagenous overgrow of gingival tissue -can delay or extend over teeth |
|
o Appear as desquamative lesions, ulcerations on gingival or both
o Includes skin disease o Gingival may appear blotchy red, and has blister, vesicles , or slough o Abnormality of immune system o No bacteria associated |
Manifestation of systemic conditions
|
|
___ are disorders that involve the mucous membrane of mouth as well as the skin.
These include: Linchen Planus, Pemphigoig, Pemphigus Vulgaris, Erythema Multiforme, Lupus Erthematosus , drug induced lupus |
Mucocutaneous Disorders
|
|
- affects the skin and oral cavity
- has plaque like white lesions with a Lacey Like pattern - occurs in painful, atrophic, ulcerative, or bulbous forms - Reticular white lesions are the most frequent - Erosive linchen planus frequently affects the gingival - can also appear on the hard palate, lateral & dorsal of the tongue, alveolar ridge, and gingival - Mostly Appears on the buccal mucosa - can also be erosive is an inflammatory disorder of unknown cause |
Linchen Planus
- has plaque like white lesions with a lacey like pattern - reticular white lesion most frequent - appears mostly on buccal mucosa - reticular white lesion most frequent |
|
• Condition that is autoimmune in its origin
• It is a distinct vesiculobullous disorder of the elderly • Affects the mucous membrane • Lesions occur on any intraoral tissue • Gingival most common target • Features: blistering and loss of epithelial surface in response to trauma • Leaves raw, painful erythemous ginginval surface • May affect mucosal tissue • Histological separation of surface epithelium from underlying connective tissue by split just beneath epithelial basale cell layer |
Pemphigoid
- most affects elderly - hidtological separation of surface epithelium from underlying connective tissue by split just beneath epithelial basale cell layer |
|
- Histologic- separation of cells of epithelium & blistering within the epithelium above the basale cell layer
- Most severe form of pemphigus - Skin lesions manifest as large bulla that rupture and leave eroded, weeping wounds - Oral lesions: blisters develop & burst quickly leaving painful eroded areas with irregular borders - Gingival desquamative lesions without margins are common - Lesions are considered to be intraepithelial - Autoimmune |
Pemphigus Vulgaris
- Histologic- separation of cells of epithelium & blistering within the epithelium above the basale cell layer - skin lesion manifest as bulla that rupture leaving eroding weeping wounds |
|
Acute inflammatory mucocutaneous disorder
Appear as : ** Distinct large lesion of skin “ target like” also called bullseye lesion Lesion appears as central dusky red zone surrounded by a raised circumferential erythematous zone Mouth lesions appear as bulla that burst rapidly leaving erosions and ulcerations the develop a grayish pseudopocket |
Erythema Multiforme
- Target like bullseye lesion Mouth lesions appear as bulla that burst rapidly leaving erosions and ulcerations the develop a grayish pseudopocket |
|
Most common in women and blacks
Oral: central erythematous erosions or ulcerations surrounded by radiating keratotoic striation (striae) Gingiva appears erythematous Microscopic: Atrophy of rete ridges and degeneration of basale layer of epithelium Typically on the face it will appear as a butterfly rash that run across the bridge of nose Can affect the kidney and the heart |
Lupus Erythematosus
- butterfly rash gingive appears erythematous - the central erythematous erosions or ulcerations surrounded by radiating keratotoic striation (striae) - atrophy of rete ridges & degeneration of basale layer of epithelium |
|
Drug Induced Lupus
From taking.... o ____ – antihypertensive - TB o ____- antiarrhythmic o ___- antibiotic |
Drug Induced Lupus
From taking.... o Hydralazin – antihypertensive - TB o Proainamind- antiarrhythmic o Isoniazid- antibiotic |
|
___ • Clinical manifestations: red, erythematous, gingivitis, ulcerations, bleeding with brushing or flossing, tissue sloughing, chelitis
• Reactions attribute to : toothpaste, mouthwash, Gun, Food Additives, Flavoring agents (cinnamon) • May have soreness or burning tongue |
ALLERGIC REACTION
• Usually result of an additive • Clinical manifestations: red, erythematous, gingivitis, ulcerations, bleeding with brushing or flossing, tissue sloughing, chelitis • Some people are allergic to resortative materials such as: Mercury, Nickel, Acryclic - may have soreness or burning tongue |
|
III. Traumatic Lesions
___- produced by artificial, self inflicted, person scratching tooth, toothbrush lesion ___- produced by health professional- I caused it – ex. Overcountered crowns , etc ___l- damage to gingival- minor burns from hot food or drinks |
Factitious
Iatrogenic Accidental |
|
____ injury
- most common aspirin burns. - a painful white area of epithelial necrosis |
chemical injury
|
|
____ injury
-toothbrush trauma - Gouge or scratching teeth - Food impaction – wedge production - The injury can destroy the band of attachment |
Physical Injury
|
|
__ is an inflammatory disease of supporting tissues.
- Caused by specific group of microorganisms - result in progressice destruction of PDL & alveolar bone - clinically detectable by CAL lost, pocket formation & change in alveolar bone density and height |
PERIODONTITIS
|
|
__ is previously called adult onset of periodontitis
- Considered to be Episodic/ random burst,periods of quiescence and rapid progression - Nonsystemic factors (smoking, stress) can modify progression of disease o Bacteria associated... - Strong Evidence for Etiology = Actinobacillus Actinomycetemcomitans (A.A.), Porpyromonas gingivalis, Bacteroides forsythus (Tannerella forsythensis) - Moderate Evidence for Etiology = Campylobacter rectus, Eubacterium nodatum, Fusobacterium nucleatum, Prevotella intermedia, Peptostreptococcus micros, Streptococcus intermedius – complex, Treponema denticola, Capnocytophaga Species |
CHRONIC PERIODONTITIS
|
|
What are some of the characteristics of Chronic Periodontitits?
|
• Gingiva slight / moderately swollen
• Color is pale pink / red to magenta • Loss of stippling • Blunted or rolled margins • Flattened or cratered papilla • Sometimes thickened , fibrotic tissue may obsure the underlying inflammatory changes- this depends on the repair process (tends to occur in smokers) |
|
What are some signs and symptoms of chronic perio?
|
o Usually painless
o Bleeding on probing o Periodontal pockets o Bone loss: furcation involvement o Subgingival calculus present o Tooth mobility o Suppuration o Shiny appearance without orange peel look to it |
|
what is etiology of chronic periodontitis?
|
Etiology of chronic perio:
Considered to be multifactorial - Biofilm is the primary factor ; however the host is a factor as well - Interaction between the biofilm and host - Pathogenic bacteria is needed for process- the bacteria have to be prominent there so a change in microflora occurs - Bacteria alone is not sufficient for progression - Research indicates host’s own immune response is major determinant of severity |
|
___ Is defined by....
1-2 mm of CAL (recession + probing depth) 3-4 mm of Pocket depth 2 mm or less of alveolar crestal bone lost - Possible class 1 furcation involvement – deepens on the tooth anatomy Loss of attachment is evident by gingival recession; blunting of interdental papilla Inflammation evident by bleeding on probing Periodontal pockets are evident |
EARLY PERIODONTITIS
Also called slight or mild periodontitis Case type 2 |
|
Radiographic: what will be seen with early periodontitis ?
case type 2 |
o Fuzziness & discontinuity of lamina dura
o Triangulation or funneling occurring (it is a wedge shaped & radiolucent area) o Bone resorption along endosteal margins o Nutrient canals o Has alveolar crestal bone loss – 2mm or less o Center of crestal portion is fuzzy & cup shaped o Interproximal calculus o Discontinuity of the lamina dura |
|
____ Defined as....
3-4 mm CAL 4-6mm in pocket depth 3-4 mm alveolar bone loss Class 1 or 2 furcation |
Moderate Periodontitis
Case type 3 |
|
What will you see radiographically with moderate periodontitis? case type 3
|
- Widening of the PDL space
- Triangulation or funneling is present which is the beginning of angular / vertical bone loss - Horizontal & distinct vertical bone loss - Nutrient Canals |
|
____ is Defined as....
- Greater than 5 mm of CAL - Greater than or equal too 6mm of pocket depth - Greater than or equal too 5mm of bone loss |
Advanced / Severe Periodontitis
Case type 4 |
|
What will you see radiographically with Advanved / Severe Perio
Case type 4? |
Radiographically will see...
- Major destruction of alveolar bone - Around 50% of bone loss is occurring - can have a possible osseous defect - Have Horizontal and possible vertical bone loss |
|
____ results from failure of clinician and / or patient to control plaque
- Signs and symptoms of perio reappear after therapy sometimes due to that the patient did not respond favorably |
Recurrent/ Refractory Periodontitis
Case type 5 |
|
what is etiology of recurrent / refractory periodontitis case type 5?
|
o Abnormal host response
o Unusual pathogenic and virulent bacteria o Failure to eliminate biofilm retentive factors such as overhanging margins o Studies describe impaired PMN chemotaxis & phagocytosis |
|
What are some treatment methods for chronic periodontitis?
|
Consult with physician with concerns if patient has systemic factors
Individualized instructions – reinforcement and evaluation of adequate biofilm control Smoking cessation Debridement Use of Antimicrobial agents Removal of local contributing factors Reevaluation- typically 4-6 weeks after scaling |
|
All the following parts of the periodontium are affected by occlusal truma except one which one?
|
gingiva
|
|
which one of the following definitition pertains to primary occlusal trauma?
|
a. normal adequate
|
|
all the followings are signs and symptoms are found in occlusal trauma except one
|
occlusal erosions
|
|
which one of the following radiographic signs is evident in occlusal trauma
|
widening of peridodontal ligament space
|
|
occlusal trauma in combination with chronic inflammatory peridontitis may result in greater tooth mobility and alveolar bone loss because occlusal trauma cause periodontal pocket formation
|
statement correct but reason i s not
|
|
Two days after the patient receives an amalgam restorations, he reports back to the office complainig of pain and losseness of tooth. which on eof the following treatment would be appropriate?
|
reduce the height of the restoration
|
|
which one of the following factors is the primary cause of secondary occlusal trauma?
|
tooth with severe bone loss
|
|
a patient complains of soreneses in the jaw upon wakening in the moring. she is having stressful problems at work. she complains that some of her lower teeth are wearing down, which one of the following conditions does this patient most likely have?
|
parafunctional habit
|
|
a pt. returned for a 2 week follow up visit from perio surgery complaining of tooth mobility. there was no mobility before the surgery was done. which one of the following should be explain to pt?
|
mobility will decrease in time
|
|
which one of the following conditons is best treated with a night guard?
|
clenching and grinding
|
|
Reliance on clinical experience, intuition, poorly designed studies alone can result in false conclusions and less than optimum care due to factors such as:
a.Bias b.Placebo effect c.Nocebo effect d.b and c e.All of the above |
Answer: all the above
|
|
Consecutive controlled case studies provide a level of evidence of:
|
Previous clinical success
|
|
The American Academy of Periodontology Guidelines for Periodontal Therapy Position Paper states the goals of periodontal therapy include all of the following except:
|
Restoring the periodontal attachment level to its original level
|
|
Probing pocket depth (PPD) is a measurement of the distance between:
|
The gingival margin and the base of the probable pocket
|
|
Furcation involvement is:a.A marker of past disease
b.Does not reliably predict future disease progression c.a and b |
Answer: c
|
|
|
|
|
Consecutive controlled case studies provide a level of evidence of:
|
Previous clinical success
|
|
The American Academy of Periodontology Guidelines for Periodontal Therapy Position Paper states the goals of periodontal therapy include all of the following except:
|
Restoring the periodontal attachment level to its original level
|
|
Probing pocket depth (PPD) is a measurement of the distance between:
|
The gingival margin and the base of the probable pocket
|
|
Furcation involvement is:a.A marker of past disease
b.Does not reliably predict future disease progression c.a and b |
Answer: c. a and b
|
|
The Oral Risk Assessment (ORA) and Early Intervention System provide the following methodology to organize patient care:a.Collection of relevant medical and dental information
b.Assessment and assimilation of the collected information cRecommendation of professional therapies and home care procedures and products d.Evaluation of treatment and healthcare outcomes e.All of the above |
Answer:e. All the Above
|
|
The term “adult periodontitis” has been replaced by the term “chronic periodontitis.”
True or false |
True
|
|
Chronic periodontitis incidence and severity is related to all of the following except:
|
Toothpaste choice
|
|
Clinical attachment loss (CAL) of 1-2 mm is considered to be slight.True or false
|
True
|
|
Alveolar bone remodels in response to:a.Directional forces b.Host response
c.Hormones d.Glucocorticoids e.Various disease states f.All of the above |
Answer: f. All the above
|
|
If bone loss forms an angular infrabony defect:
|
Bone grafting may be helpful
|
|
The following statements accurately describe bone except:
|
Bone is a static structure
|
|
Bone resorption can be reduced by which of the following:a.Estrogen
b.Interferon c.Bisphosphonates d.None of the above e.All of the above |
Answer: All the above
|
|
Deep, narrow infrabony defects with more bony walls have the worst chance to gain attachment following periodontal surgery. true or false
|
False
|
|
It is recommended to determine patients’ surgical needs prior to assessing patients’ response to non-surgical therapies. true or false
|
False
|
|
Disrupting plaque biofilm is best accomplished through:
|
Routine brushing and flossing
|
|
The exact amount of time needed to optimally perform scaling and root planing has been scientifically determined.
True or false |
False
|
|
Rinsing and irrigating with antimicrobials:
|
May help control gingivitis
|
|
Locally-delivered sustained-release antimicrobials all contain antibiotics.
True or false |
False
|
|
Systemic antibiotics feature all of the following except:
|
A routine benefit in chronic periodontitis
|
|
Subantimicrobial systemic dosing of doxycycline
a.As an adjunct to SRP, has been shown to reduce PPD better than SRP alone b.Has been shown to have tolerability similar to placebo c.Inhibits the activity of collagenase d.Is appropriate for use during pregnancy e.All of the above f.a, b and c |
Answer: F. a,b,and c
|
|
The goal of osseous surgery is to: a.Restore lost attachment
b.Re-contour bone c.Allow increase access for routine plaque control d.a and b e. b and c |
Answer: e.b and c
|
|
Barriers may be used in regenerative surgery to:a.Prevent epithelial tissues from growing within the bony defect
b.Modulate the host response c.Guide periodontal ligament cells to grow within the bony defect d.a and c e.b and c |
answer: d. a and c
|
|
Non-resorbable barriers a.Remain in place as long as needed
b.Require removal at a later surgery c. a and b |
Answer: c. a and b
|
|
Bony defects with fewer wall generally have more predictable bone fill results.
true or false? |
false
|
|
Autografts
|
Can be obtained from intra-oral or extra-oral sites
|
|
Allografts a. Are freeze-dried
b. Utilize the patient’s own bone c. May be demineralized d. a and c |
Answer: D a and c
|
|
Xenografts
|
Are obtained from animal sources
|
|
Synthetic bone a.May be processed from calcium carbonate
b.Facilitates the body’s regenerative process c.Is replaced by new bone over time d.All of the above |
Answer: d all the above
|
|
Biological growth factors are used with synthetic bone materials to simulate the osteogenic properties of an autograft. True or false?
|
True
|
|
Classification of Furcation involvement: Which grade?
Pocket formation into the fluting of the furca but the interradicular bone is intact. No gross or radiographic evidence of bone loss. Recorded on the chart as open triangle with no base |
Grade I Involvement:
Pocket formation into the fluting of the furca but the interradicular bone is intact. No gross or radiographic evidence of bone loss. Recorded on the chart as open triangle with no base |
|
Classification of Furcation involvement: Which grade?
Interradicular bone is destroyed on one or more aspects of the furcation, but a portion of alveolar bone and periodontal ligament remains intact Get in but not all the way through Recorded as open triangle |
Grade II Involvement:
Interradicular bone is destroyed on one or more aspects of the furcation, but a portion of alveolar bone and periodontal ligament remains intact Get in but not all the way through Recorded as open triangle |
|
Classification of Furcation involvement: Which grade?
Furcation is occluded by gingiva but the interradicular bone has been destroyed so that a probe can be passed through from one surface to another Recorded as solid triangle Through and through |
Grade III involvement
Furcation is occluded by gingiva but the interradicular bone has been destroyed so that a probe can be passed through from one surface to another Recorded as solid triangle Through and through |
|
Classification of Furcation involvement: Which grade?
Periodontium is destroyed to such a degree that the furcation is open and exposed and clinically visible Recorded as solid triangle |
Grade IV involvement
Periodontium is destroyed to such a degree that the furcation is open and exposed and clinically visible Recorded as solid triangle |
|
Localized tooth related factors that modify or predispose to plaque induced gingival disease/periodontitis
|
Localized tooth related factors that modify or predispose to plaque induced gingival disease/periodontitis
Tooth anatomic factors-concavities max laterals oEnamel pearls Dental restorations oOverhangs with localized factors oPlace subgingival Root factures oDue to injury due to accident |
|
Mucogingival deformities and conditions around teeth
|
Gingival recession
oBecause a lot of recession inadequate attach gingival Lack of keratinized gingival Decreased vestibular depth oDue to someone who has missing teeth and alveolar ridge not where it suppose to be Abberant frenum/muscle position oIf its too high or low Gingival excess o inconsistent margin |
|
Mucogingival deformities on endentulous ridges
|
Vertical, horizontal ridge deficiency
Lack of keratinized tissues Tissue enlargement Aberrant frenum/muscle position Decreased vestibular depth |
|
Occlusal trauma
Primary Injury due to ? Normal or slight bone loss Etiology: ? Pocket: ? Bone Height:? Mobility: ? Treatment options:? |
Occlusal trauma
Primary Injury due to attachment apparatus-excessive Occlusal force Normal or slight bone loss Etiology: excessive Occlusal forces Pocket: No Bone Height: normal or slight bone loss Mobility: adapted Treatment options: selective grinding, appliances, monitor without treatment |
|
Occlusal trauma
Seondary Normal or excessive force cause injury in periodontium with reduced bone support oPerson already has disease process going on oPerson already has inadequate bone Bone levels are inadequate to support forces Tooth less resistant to Occlusal loading bone loss? Etiology: ? Pocket: ? Bone Height:? Mobility: ? Treatment options:? |
Occlusal trauma
Secondary Moderate/severe bone loss Etiology: normal or excessive forces Pocket: No/Yes Periodontal pockets may be present, but due to periodontal destruction rather than the occlusal trauma Bone height: reduced height (moderate severe) Mobility: progressive Treatment: Splinting, selective grinding, extraction, orthodontic, monitor appliances ex: night guard |
|
Which of the following is the strongest indication of a correlation between stress and periodontal disease
|
ANUG
|
|
A significant possible complication of smoking is
|
refactory periodontitis
|
|
nutritional deficiencies are considered risk factors for periodontal disease because they:
|
lower the host reponse
|
|
oral side effects of a deficiency in vitamine B6 (pyridoxine) include all the following excepts
|
candidiasis
|
|
a deficiency in this vitamine, which is reponsible for the biodynthesis of collagen, will adversely affect periodontal connective tissues and wound healing:
|
vitamin C
|
|
When vitamine D deficiency occur in adults, the resulting effects on the periodontium include all the following excepts:
|
hyperplasia of the gingiva
|
|
Oxygen-free radicals may play a role in teh tissue destruction associated with all the following, except:
|
systemic lupus erythematosus
|
|
During puberty an adolescent is more susceptible to the deveolpment of gingivitis because of:
|
altered capillary permeability
|
|
recent evidence indicates that desquamative gingivitis is most likely a feature of all the following except:
|
menopause
|
|
the rationale for the prevalence of periodontal disease in patients with diabetes mellitus includes all of the following except:
|
increased fibrosis of the peridontal tissue
|
|
mulitple periodontal abscesses, velvety red gingivae, and marginal proliferation of the gingivae are common oral manifestions of:
|
uncontrolled diabetes
|
|
The most common form of gingivites among patients with AIDS is:
|
linear gingival erythema
|
|
Which microorganisms are seen more frequently in NUG?
|
spirochete species
|
|
When a pt has been diagnosed with rapidly progressive periodontitis, one would expect to see which of the following combination of microorganisms?
|
P.gingivalis, P.intermedia, A. actinomycetemcomitans
|
|
According to page and schroeder within 4 to 7 days after plaque accumulation the lesion that occur is the
|
early lesion
|
|
histologically, when a lesion extends into the PDL and alveolar bone, it is classified as
|
advance lesions
|
|
clinical signs and symptoms of the occlusal traumatism include
|
radiograohic signs of widen PDL space and clincial evidence of tooth mobility
|
|
damage that occur when the amount of alveolar bone is normal but there are excessive occlusal forces present is referred to as
|
primary occlusal traumatism
|
|
most signigicant feature of chronic gingivitis is
|
bleeding in response to probing
|
|
a deficiency in vitamine c cauases all the following except
|
gingival inflammation
|
|
localized enlarge interdental gingiva that form tumor like growths may accompany
|
leukemic or pregnancy gingivitis
|
|
desquamative gingivites frequently is linked with all of the following except
|
pregnancy
|
|
desquamative gingivitis is most commonly seen in
|
menopausal women
|
|
occcasionally severe enlargement of the entire gingiva including both facial and lingual surfaces occur with no apparant explaination. this conditon is:
|
rare hereditary or familial condion
|
|
rapid tissue destruction commonly associateed with acute gingival disease is primarily caused by large number of
|
PMNL
|
|
19 years old college student present for emergency exam complains pain in the gingiva, spontaneous bleeding, and bad metallic tase in his mouth. during inspectio, a fetid ordor, puch out papilla covered with a gray pseduo membrane, and spontanous bleeding. pt most likely have?
|
NUG
|
|
Microorganism most commonly associated with NUG
|
spirochetes
|
|
most common form of peridontitis which is characterized by periodontal pocket formation, bone loss, eventually tooth mobility, with no abnormalities of the host defense system is:
|
chronic periodontitis
|
|
aggressive peridontal disease include any of the following except
|
refactory periodontitis
|
|
which of the following form of peridontal disease most likely to be manifestation of systemic disease?
|
prepubertal periodontitis
|
|
microorganism most commonly associated with juvenile periodontitis is
|
a. actinomycetemcomitans
|
|
of the more aggressive periodontal disease, which one of the following seems to be most closely linked iwth juvenile peridontitis?
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rapidly progressive periodontitis
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systemic condition characterized by hyperkeratontoic skin lesions of the palms, soles, knees, and elbows, severe destruction of the periodontium
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papillon-lefevre syndrom
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risk factor most consistently associated with rrefractory periodontitis is
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smoking
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The AAP classifies early adult periodontitis as:
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case type 2
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