1. what is defined as the tissues that invest and support the teeth
  2. what are two types of tissues that invest and support the teeth?
    gingiva and alveolar bone
  3. what are the three parts of alveolar bone?
    • lamina dura
    • alveolar crest
    • periodontal ligament space
  4. what does the lamina dura appear as when healthy?
    dense radiopaque line
  5. when healthy where is the alveolar crest located?
    approx 1.5 to 2.0 mm apical to the cementoenamel junction CEJ
  6. what does the alveolar crest look like in the anterior area?
    pointed and sharp
  7. what does the alveolar crest appear like for the posterior area?
    flat smooth and parallel to a line between adjacent CEJs. Slightly less radiopaque compared to anteriors
  8. how does the periodontal ligament space appear?
    thin radiolucent line between root of tooth and lamina dura
  9. when the periodontal ligament space is healthy how does it appear?
    continuous around the root structure and is uniform in thickness
  10. what means around a tooth?
  11. what refers to a group of diseases that affect the tissues around the teeth?
    periodontal disease
  12. what does the tissue look like with periodontal disease?
    • inflammation of gingiva
    • loses stippling, pink and firm appearance
    • swollen, red, bleeding with pocketing
  13. periodontal disease involves destruction of the ______ ______ and ______ ______
    • supporting bone
    • periodontal ligament
  14. with periodontal disease the alveolar crest is no longer located where?
    1.5 to 2.0 mm apical to CEJ
  15. with periodontal disease the alveolar bone no longer appears _____
  16. how does the alveolar bone appear with periodontal disease?
    indistinct and bone loss is seen
  17. how is periodontal disease detected?
    clinically and radiographically both necessary
  18. _____ examination provides info about soft tissue
  19. _____ examination provides info about the bone?
  20. what type of info does a clinical examination provide?
    about soft tissue
  21. what type of info does radiographic examination provide?
    about the bone
  22. who can perform the clinical examination?
    DDS or RDH
  23. what are you evaluating the soft tissues for in a clinical examination?
    inflammation-redness, bleeding, swelling, pus
  24. what must be included in you clinical examination?
    periodontal probing
  25. what do the periodontal probing measurements help you do?
    classify the perio
  26. what are you looking for in a radiographic examination for periodontal disease?
    amount of bone present
  27. what do radiographs provide for periodontal disease?
  28. what type of film is used to look at periodontal disease?
  29. what technic is used for periodontal disease radiographs?
  30. what types of radiographs are not used for periodontal disease examinations?
    • horizontal BWX
    • Pano
    • Bisecting
  31. what type of periodontal disease is easier to treat, vertical or horizontal?
  32. what is limited to see on a radiograph?
    furcation area
  33. how is bone loss estimated?
    difference between the physiologic level and the height of the remaining bone
  34. how is bone loss described?
    in terms of pattern, distribution and severity of loss
  35. what type of bone loss occurs in a plane parallel to the CEJ's of adjacent teeth?
    horizontal bone loss
  36. what type of bone loss does not occur in a plane parallel to the CEJ's of adjacent teeth?
    vertical bone loss (angular)
  37. what type of distribution occurs in isolated areas with less than 30% of the sites involved?
    localized bone loss
  38. what type of bone loss accounts for less than 30% of sites involved?
  39. what type of distribution occurs evenly throughout the dental arches with more than 30% of the sites involved?
    generalized bone loss
  40. what type of bone loss accounts for more than 30% of sites involved
    generalized bone loss
  41. how is bone loss severity classified?
    • slight
    • moderate
    • severe
  42. how is bone loss measured?
    by the clinical attachment loss (CAL) from the CEJ to bas of sulcus or pocket (probe)
  43. slight bone loss is how many mm?
  44. moderate bone loss is how many mm
  45. severe bone loss is how many mm?
    5mm or greater
  46. what are the four ADA classifications of periodontal disease?
    • 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
  47. Describe ADA case type I
    • Gingivitis
    • no bone loss
    • no radiographic changes seen
    • only gingival tissues are affected by the inflammatory process
  48. describe ADA case type II
    • mild or slight periodontitis
    • mild crestal changes
    • lamina dura becomes unclear and fuzzy also no longer appears to be a continuous radiopaque line
    • horizontal bone loss
    • alveolar bone level appox 3-4 mm
    • bleeding may occur on probing pocketing and recession may be present clinically
  49. which ADA case has alveolar bone level approx 3-4 mm apical to CEJ
    type II
  50. what ADA case does the lamina dura become unclear and fuzzy, also no longer appears to be a continuous radiopaque line
    type II
  51. what case type has horizontal or vertical bone loss that is localized or generalized
    type III
  52. what ADA case type is moderate periodontitis?
    type III
  53. what ADA case type has alveolar bone level at approx 4-6 mm apical to CEJ
    type III
  54. which ADA case type may have furcation involvement?
    type III
  55. clinically what ADA case type has pocketing, attachment loss up to 6 mm, recession, furcation areas, and slight mobility possible?
    type III
  56. what is the alveolar bone level for ADA case type IV?
    6 mm or greater from the CEJ
  57. which ADA case type has furcation involvement and is readily viewed on posterior radiographs?
    type IV
  58. what does ADA case type IV look like clinically?
    pocket depths and attachment loss is greater than 6mm, furcation involvement and mobility are more severe
  59. what are some predisposing risk factors of periodontal disease?
    medications, tobacco use, diabetes
  60. _______, _______ and ______ of local irritants are important
    • identifications
    • detection
    • elimination
  61. what are some local irritants that must be eliminated?
    • calculus
    • defective restorations
  62. what is a stone like concretion that forms on crowns and roots of teeth due to calcifications of bacterial plaque?
  63. what are three characteristics of calculus?
    • radiopaque
    • pointed or irregular projections
    • extends from proximal root surfaces
  64. what are three forms calculus can take?
    • ring like
    • nodular
    • smooth
  65. calculus is a _____ or _____ projection
    sharp or pointed
  66. defective restorations act as potential _____ _____ and contribute to _______ _______
    • food traps
    • periodontal disease
  67. what do radiographs help to identify with restorations?
    open or loose contacts, uneven marginal ridges, overhangs and inadequate margins
Card Set
interpretation of periodontal disease