the tissues that invest and support the teeth, such as the gingiva and alveolar bone:
periodontium
what three landmarks of the alveolar bone are included in the normal anatomic landmarks?
lamina dura
alveolar crest
periodontal ligament space
in health, the lamina dura around the roots appear as a dense __________ line
radiopaque
the normal healthy alveolar crest is located approximately____-_____ mm apical to the CEJ of adjacent teeth
1.5-2
does the shape and density of the alveolar crest vary between the anterior and posterior regions in the mouth?
yes
the anterior regions of the alveolar crests are ____ and ______, but in the posterior it appears _________ , smooth and _________ to a line between adjacent CEJ's.
sharp and pointed
flat
parallel
which appears slightly less radiopaque? the anterior or posterior alveolar crest?
posterior
a normal periodontal ligament space appears as a thin _________ line between the root of the tooth and __________ ________
radiolucent
lamina dura
what does periodontal mean?
around the tooth
a group of diseases that affects the tissues around the teeth:
periodontal disease
superficial inflammation of the gingiva to the destruction of the supporting bone and periodontal ligament is:
periodontal disease
how will gingival tissues affected by periodontal disease NOT appear: (3)
stippled, pink, firm
periodontal disease in gingival tissues appear: (4)
red, swollen, bleeding, and pocket of soft tissue
The CEJ's on a radiograph with periodontal disease no longer appear:
radiopaque
periodontal disease may result in severe _________ of bone and loss of _______
destruction
teeth
a clinical exam must be performed by who?
the dentist and dental hygienist
what should be included in a clinical exam? (2)
evaluation of soft tissues (gingiva)
signs of inflammation
what must be included in a thorough clinical assessment?
probing
what is the film of choice for evaluating periodontal disease?
periapical with the paralleling technique
the vertical bite-wing radiograph can be used to examine bone levels and is best used as a ___________ or _________-___ film
posttreatment
follow-up
why might the furcation area not be seen on a radiograph?
because of the superimposition of the buccal and lingual bone
T/F a radiograph allows the dental professional to view the amount of bone lost rather that the amount remaining
false! view the amount remaining rather than the amount lost
the difference between the physiologic bone level and the height of remaining bone =
bone loss
_____ ______ can be describe in terms of pattern, distribution, and severity of loss
bone loss
the pattern of bone loss can be described as ________ or _________
vertical or horizontal
with ________ bone loss, the bone loss occurs in a plane parallel to the CEJ's of adjacent teeth
horizontal
with ________ bone loss (angular bone loss) the bone loss does not occur in a plane parallel to the CEJs of adjacent teeth
vertical
distribution of bone loss can be: (2)
generalized
localized
which bone loss occurs in isolated areas with less than 30% of sites involved?
localized bone loss
which bone loss occurs evenly throughout the dental arches, with more than 30% of the sites involved?
generalized
the severity of bone loss is described as: (3)
slight
moderate
severe
the measurement of the distance in millimeters from the CEJ to the base of the sulcus or periodontal pocket is:
CAL clinical attachment loss
bone loss: 1-2mm:
slight
bone loss: 3 to 4 mm
moderate
bone loss: 5mm or greater
severe
ADA Case Type I:
gingivitis
ADA Case Type II
mild or slight periodontitis
ADA Case Type III
moderate periodontitis
ADA Case Type IV
advanced or severe periodontitis
is there radiographic change seen on a radiograph in the bone for a type I disease?
no
what case type are mild crestal changes?
case type II mild or slight periodontitis
the lamina dura becomes unclear and fuzzy and no longer appears to be a continuous radiopaque line. Horizontal bone loss is seen more often in this type of disease
type II mild or slight periodontitis
3-4mm apical to CEJ, clinically BOP may occur, pocket depths from attachment loss may be present and areas of recession may be seen in this type:
type II mild or slight periodontitis
which type might horizontal or vertical bone loss be present, localized or generalized?
type III moderate periodontitis
alveolar bone level 4-6 mm apical to the CEJs of adjacent teeth. furcation involvement or the extension of perio between the roots of the multirooted teeth may be seen with this disease type:
type III moderate periodontitis
recession, furcation involvement areas, and slight mobility = type:
type III moderate periodontitis
the pattern of bone loss may be horizontal or vertical and the alveolar bone level is 6mm or greater from the CEJ.
type IV advanced or severe periodontitis
the effect of certain _________, tobacco use, and someone with ________ are predisposing risk factors for perio
medications
diabetes
a stonelike concretion that forms on the crowns and roots of teeth due to calcification of bacterial plaque
calculus
calculus on a radiograph appears as a pointed or irregular radiopaque projection extending from the _____ _____ surfaces
proximal root
may appear as a ringlike radiopacity encircling the cervical portion of the tooth, nodular projection, or smooth radiopacity on a root surface:
calculus
_______ ________ act as potential food traps and lead to the accumulation of food debris and bacterial deposits
defective restorations
T/F open or loose contacts of restorations, uneven marginal ridges, overhangs, and inadequate margins contribute to periodontal disease
