lunalovegood's version from 2015-10-08 02:05


Question Answer
D0180 - med Hx, dental Hx, CC, H&N exam, intra-oral ___ tissue exam, dental hard tissue exam, perio probing, ___ analysis, and radiographic examination.soft, occlusal
Name 6 diseases/conditions that can cause perio problems. (hint* sugar, babies, WBC, RENT, Ca blockers, WBC)diabetes mellitus, pregnancy/puberty, leukemia, HIV infection, drug-induced gingival hyperplasia, and leukocyte disorders
Manifestations of perio by systemic disease? periodontal abscesses, inflammation inconsistent with hygiene, pyogenic granuloma, gingival hyperplasia, gingival necrosis, ulceration, bleeding
Name 6 systemic conditions that REQUIRE modification of treatment.bacterial endocarditis, cardiovascular disease, prosthetic joint replacements, bleeding disorders , smoking, immunodeficiency
Treatment MOD? - History of bacterial endocarditis...antibiotics
Treatment MOD? - Immunodeficiency...antibiotics
Treatment MOD? - prosthetic joints...antibiotics
Treatment MOD? - bleeding disorders...platelet/clotting factors
Treatment MOD? - smoking...behavior modification (good luck...)
Treatment MOD? - cardiovascular disease sedation
Name 3 diseases/behaviors that compromise perio therapy.smoking, CVD, and bleeding disorders
7 questions involved in a dental history.CC, frequency of dental visits, oral hygiene practices, past dental treatment, family dental history, history of pain/bleeding, dental hypersensitivity
Dental History: CC, ____ of dental visits, oral hygiene practices, ___ dental treatment (ortho, perio), ___ dental history, history of ___/bleeding, dental _____frequency, past, family, pain, hypersensitivity
What information do you want to gain from a DENTAL HISTORY?diagnosis, relative important of dental health, treatment expectations, anticipated compliance, iatrogenic dental problems, genetic predisposition, and pain control information
Info from Dental History: ____, relative importance of ___ health, treatment ____, anticipated ___, ___ dental problems, ___ predisposition, and ___ control informationdiagnosis, dental, expectations, compliance, iatrogenic, genetic, pain
Assess Inflammation/Etiology 1 - look at ___ color, contour, and consistencygingival
Assess Inflammation/Etiology 2 - ____ (hint* twist it! pull it! ___ it!) BOP (bleeding on pulling)
Assess Inflammation/Etiology 3- ___ indexplaque index
Name 3 ways we assess inflammation/etiology.BOP, plaque index, and gingival color-contour-consistency
Name 4 ways we assess measurements of tissue destruction.Perio probing measurements (PD & CAL), radiographs, mobility, furcation involement
Measurements of Tissue Destruction 1- Perio probing measurements like _________ and ___.PD and CAL
Measurements of Tissue Destruction 2 - ____ findingsradiographic
Measurements of Tissue Destruction 3 - _____ (hint* vroom vroom)mobility
Measurements of Tissue Destruction 4 - ____ involvementfurcation
Gingivitis - gingival coloring is ___ or ____red or bluish hues
Gingivitis - gingival margins are ___ and ____. Margins may be rolled. NOT scalloped and tightly adaptedRounded, thickened (eat too many cookies and your gingiva gets round and thick too!)
Gingivitis - the interdental papilla is _____ (shrunk, enlarged)enlarged (bulging papillary or marginal tissue)
Gingivitis - consistency is _________ and ____ to palpation.soft, friable (friable means crumbly, shatter-y, brittle, fragile)
Gingivitis - consistency may become ____fibrotic
What does the "shelf" department of IKEA and gingivitis have in common?shelf-like areas of gingiva indicate gingivitis
Acute or Chronic Inflammation? - Diffuse puffiness/swelling, vesicles, more indicative of...acute inflammation
Acute or Chronic Inflammation? - Softness/friability, firm/leathery, more indicative of...chronic inflammation
Acute or Chronic Inflammation? - puffiness caused by intra/intercellular edema, rupture of cell walls, ulcerationacute inflammation (not sure what ulceration really means here)
Acute or Chronic Inflammation? - softness/friability, firm leathery caused by edema and fibrosis/epithelial proliferationchronic inflammation
Disclosing Agents - ____ or ____ tablets/solutionsErythrocin or Fuchsin
Disclosing Tablets - instruct Pt. to "Chew, ___, and spit". Very good for ___ use.swish, home
Disclosing Solution - Vaseline pt lips, paint the solution circumferentially at the ___ ___ of the teeth. Rinse thoroughly.gingival
Gingival Inflammation Index - indicator of ____ oral hygiene (recent, daily)daily
Plaque Index - indicator of _____ masterytechnique
Axium - GI and PI both have _________ sites per tooth. BOP has _________ sites per tooth.4, 6
You look at M, D, B, L sites. Your pt. has TEN sites inflamed and TWENTY-FIVE teeth total. What is their inflammation score?10% (10 sites divided by (25 teeth x 4) = 10%)
You look at M, D, B, L sites. Your pt. has SIXTY-FOUR sites with plaque and THIRTY-TWO teeth. What is their plaque score?50% (64 sites divided by (32 teeth x 4) = 50%)
Perio Probing Examination 1- probing ___ ___ (PD)pocket depth
Perio Probing Examination 2- _______ (GM-CEJ)recession
Perio Probing Examination 3- _________ ___ _________ (CAL) -4- _________ _________ ___ (BOP)clinical attachment level, bleeding on probing
Perio Probing Examination 5- width of ___ ___attached gingiva
PD, recession (GM-CEJ), CAL, BOP and the width of attached gingiva are all part of the perio probing examination. They estimate ___ destruction, measure ____, and are essential for diagnosis and determination of treatment needs.tissue, inflammation
Does a healthy sulcus have a probing depth?yes (remember, gingival margin to the base of the pocket)
Periodontal pocket - ___ migration of junctional epithelium and loss of ___ bone.apical, alveolar
A normal sulcus is _________-_________ mm.1-3mm
A pathologically deepened sulcus is equal to or greater than __mm.4mm
Distance between GINGIVAL MARGIN and CEJ measures ...gingival recession (GM-CEJ)
If the GINGIVAL MARGIN is 2mm below the CEJ, the gingival recession number is ___ (positive/negative)positive (GM-CEJ)
If the GINGIVAL MARGIN is 1mm above the CEJ, the gingival recession number is ____ (negative/positive)negative (GM-CEJ)
Why does Varun like the 4-5, 9-10 and 14-15mm markings on the perio probe the best?dark marks (DARK MARKS! the dark bands of the perio prob)
PSR probe - ball ends detects _________.calculus
PSR probe - lower part of thick band ___mm - top of thick band __mm3.5mm and 5.5 mm
BOP - _________ (more/less) reproducible sign of inflammation than visual alterations.more
BOP - cell ___, collagen ___ connective tissue (rich/poor)cell rich, collagen poor
T/F - BOP - greater percentage of inflamed CTT
Pocket depth + recession = ___CAL
Pocket depth = 6mm Gingival margin is 3mm ABOVE CEJ. CAL?3
Pocket depth = 4mm Gingival margin at CEJ. CAL?4
Pocket depth = 3mm Gingival margin 3mm BELOW CEJ. CAL?6
If you enter GM-CEJ and PB into axium, what will it auto calculate?CAL
Determines treatment needs...PD
Estimates tissue destruction, essential for diagnosis...CAL
Measures inflammation...BOP
T/F - Factors Affecting PD - size & shape of probe, probe markings, probing PRESSURE, gingival inflammation, probe ANGULATION, reproducibility of measurement location, and errors in measurement recording. T
(Gingival Margin to Mucogingival Jxn distance) - (GM to pocket depth distance) = ...width of attached gingiva
Distance from the base of the pocket to the mucogingival junction is...width of attached gingiva
Use a Nabor's probe to assess ... furcation involvement (one of the curvy ones)
Hamp's Index has Class 1, Class 2, Class 3. 1 - just kinda in furcation -2- ___ through -3- all the way throughhalfway
Axium: Maxillary furcations on B record B. M or D record ______. Mandibular furcations B record B and L record L. lingual
Radiograph - bone crest to CEJ distance - _________-_________ mm normal and greater than ___mm periodontitis.1-2mm normal, greater than 4mm periodontitis
T/F - radiographs - assess bone loss, horizontal vs vertical, furcation radiolucencies, root resorption, WIDENED PDL SPACE, overhangs and caries, calculus, TOOTH/ROOT FRACTURES, ENDO THERAPY, and hard tissue lesions.T


Question Answer
Perio Tx Planning - #1 Identify problems -CC, history, clinical examination #2 Establish a ____ #3 ___ options #4 Desired/selected outcomesdiagnosis, treatment (process - clinical findings, diagnosis, perio prognosis, perio problem list, perio tx plan)
Treatment planning phases - #1 ____ phase #2 ____-____ phase #3 _____ phase #4 _____ phase (what it is, why that is, let's fix this, let's stay this way)systemic, cause-related, corrective, supportive
T/F - Perio problems list can include systemic conditions, predisposing risk factors, clinical findings (like overhangs), and secondary etiological factors.T
Oh no problem! - prosthetic valve?antibiotic prophylaxis
Oh no problem! - coumadin therapy?medical consult, monitor INR (INR healthy person = 1.0 - INR coumadin stable - 2.0-4.0 - INR coudmadin NOT so good >5.0)
Oh no problem! - bisphosphonate therapy?non-surgical treatment option? (used for osteoporosis, mixed with surgical dentistry can cause osteonecrosis of jaw, use aggressive non-surgical perio over surgical)
What do we want HbA1C lower than?8%
Oh no problem! - Dilantin therapy?medical consult - alternative drug (used for seizures, causes gingival hyperplasia)
Oh no problem! - Ca channel blockers?medical consult - alternative drug
Oh no problem! - IL-1b genotype positive?stricter maintenance control (because we'll totally know every patient's genotype...)
Are caries, bad esthetics, abandoned roots, occlusal trauma/fremitus, crown fracture, and mal-aligned teeth (3rd molars) all included under perio problems?yes (plus plaque, inflammation, recession, calculus, PD, BOP, defective restorations, furcations, and mobility)
Oh no problem! - PD less than or equal to 5mm?scaling and root planing (SRP)
Oh no problem! - PD >6mm ?surgical perio therapy
Oh no problem! - mobility, fremitus?occlusal adjustment, splint
Oh no problem! - perio abscess ?SRP and antibiotics
Oh no problem! - gingival overgrowth?gingivectomy (not to be confused with the eradication of gingers!)
Oh no problem! - mucogingival defect?free gingival graft, connective tissue graft
Oh no problem! - furcation involvement?open flap debridgement, guided tissue regeneration, or extract
Oh no problem! - poor oral hygiene, BOP, or calculus?OHI and SRP
T/F - Some perio secondary etiological factors include - overhangs, caries at gingival margin, open contacts, malaligned teeth, and root sensitivity.T (recontour, replace or restore, F therapy, diet analysis. For malaligned ortho or special OHI. For roots desensitizing toothpaste or F varnish.)
You made a Tx plan in Axium. The faculty has approved it. If you get the patient to approve it, is the Tx plan a binding contract?No! And tell patient this.
Sequencing - FIRST do ___ - ____ treatment like OHI, SRP, overhangs/caries, endo tx, and EXTs.Cause-related treatment
Sequencing - SECOND Re-evaluate _________-_________ weeks later.4-6 weeks later
Sequencing - THIRD ___ ___ for any pockets > than 6mmsurgical therapy
Sequencing - ALONGSIDE THIRD any needed _________ restorative restorative therapy (even though it LITERALLY says take care of caries in the first part I DON'T KNOW. If I had to guess 1st due Class 5 caries, later do any other caries)
Sequencing - FOURTH Re-evaluate
Sequencing - FIFTH ___/____ pros therapyfixed/removable
Sequencing - LAST Perio ____ interval every _________ months.maintenance every 3 months
Complicated Sequence - #1 Emergency Tx #2 _________, OHI, Open Flap Debridement #3 Operative #4 Ortho #5 Provisional Restorations #6 _________ ___ - Osseous therapy, then mucogingival therapy, then implants. #7 Re-Evaluate - function, esthetics, occlusion, phonetics. #8 Final restorations, final preosthetic treatment #9 Final prosthesis #10 Maintenance.SRP, Perio surgery


Question Answer
Oral Health in America - General Surgeon - 2000 - Causal relationship smoking and periodontitis SUFFICIENT. Causal relationship smoking and ___ surface caries SUGGESTIVE. root
Fiorie 2008 - Effective Things! - Person-to-person contact, pharmocotherapy, medicine + ____, and this is evidence-based, cost effective, and covered by all insurance plans.counseling (ways to stop smoking I presume)
Tobacco - chronic condition - repeated intervention - EVERY Pt. should be offered ____ (brief, burdensome) intervention. brief (yes patients - treatment, no patients - motivate)
What are the 5 A's of tobacco intervention?Ask, Advise, Assess, Assist, Arrange Follow-up (smoke? let's quit. Willing? let's do this. Follow-up)
Advise - personalize advise to quit by relating health status of patient and family, especially ___.children
Assist - set a quit date (within _________ weeks)2 weeks
Assist - set a quit date, tell others - gather support, remove all tobacco from home, anticipate challenges, recommend ___medications
Cold turkey - stop immediate. Tapering - reduce each day. Postponing - restrict amount of ___ for tobacco use.time
T/F - Pharm for tobacco - Bupropion SR, Nicotine gum, Nicotine inhaler, Nicotine nasal spray, Nicotine patch, VareniclineT (second line - clonidine and nortiriptyline)
What are the 5 R's to motivate patients to quit smoking?relevance, risk, rewards, roadblocks, repetition
Roadblocks - common ones include ___ symptoms, weight gain, fear of ____, and lack of support.withdrawal, failure
Repetition - possibility of quitting ___ (increases, decreases) with each attempt.increases
Cessation Materials - American Cancer Society ___ ___ - AHA ___ _________ ___ - American Lung Association ___ ___ ___ and Health Promotion Resource Center _________ ___ ___.ACS Smart move, AHA Call It Quits, ALA Freedom From Smoking, HPRC Quit Smoking Kit

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