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when does an inflammatory response to dental biofilm occur?
withinin 2 to 4 days of irritation
what is the natural body response to infectious agent with an initial lesion?
migration and infiltration of white blood cells into the junctional epithelium and gingival sulcus
t/f no clinical signs of an initial lesion can be seen.
True
False
true-maybe some marginal inflammation
how many days until it is considered an early lesion?
7-14 days
during the early lesion what happens to the epithelium?
it proliferates: epithelial extensions and rete ridges are formed
what is the clinical appearance of an early lesion?
early gingivitis
4 mm pockets
what happens to the junctional epithelium of an established lesion
migrates and tries to wall out the inflammation
t/f the pocket epithelium is less permeable with and established lesion.
True
False
false-more permeable-areas of ulceration of the lining epithelium develop
with the lesion progress _____ fibers are brokendown.
collagen
what is the clinical appearance of an established lesion? (4)
inflammation
marginal redness
spongy marginal gingiva
bleeds on probing
with an advanced lesion the bacteria from the ______ biofilm enter the sulcus and provide a source for _____ biofilm
supragingival
subgingival
with an advanced lesion you start to see destruction of what?
alveolar bone
once the lesion is into the _____ _____ it spreads faster
alveolar mucosa
how does the inflammation enter the bone?
small vessel channels in the alveolar crest
how does inflammation spread with an advanced lesion
through the bone marrow and out into the PDL
what produces irritants with an advanced lesion
biofilm microorganisms
with the progression of an advanced lesion what happens to the CT fibers below the JE?
they are destroyed and the epithelium migrates along the root surface
with the progression of an advanced lesion the cementum is exposed where what fibers used to be attached, why?
sharpey's fibers
altered by inflammatory products of bacteria and sulcus fluid
the cementum contains a thin layer of what during the progression of an advanced lesion? and why?
endotoxins from the bacterial breakdown
with the progession of an advanced lesion without treatment what will happen?
the pocket will deepen
what are five signs of periodontitis?
pocket formation
bone loss
mobility
recession
furcation involvement
with an advanced lesion the bacteria can be _____ and then ____
active
inactive
healthy gums don't ____
bleed
what are 4 characteristics of type 1 perio
early gingivitis
tissue changes-red
bleeding on probing
1-3 mm pockets
what perio type has 1-3 mm pockets
type 1
with type 1 the pockets are ____-____ mm
1-3
what is a factor other than pocket depth that helps to determine the perio class?
calculus
t/f type I perio class is early periodontitis
True
False
false-early gingivitis
type II perio class is early ______
periodontitis
what are the type II pocket measurements
1-5 mm
type II has slight _____ loss and slight ______ loss
bone
attachement
type III is classified as ______ periodontitis
moderate
type III has noticeable ______ ______
bone loss
type III can have possible ______ involvement?
furcation (class I or II)
what are the pocket measurements for type III
4-6 mm
what perio class has 1-5 mm pockets
type II
what perio class has pockets 4-6 mm
type III
what perio class has pockets >7mm
type IV
what are the pocket measurements for type IV
>7mm
type III has beginning tooth ____
mobility
type IV is classified as _____ periodontitis
advanced
type IV has severe ____ ____, increased tooth _____ and _____ involvement.
bone loss
mobility
furcation
t/f type two can have a lot or a little calculus
True
False
true
what is defined as a pocket formed by gingival enlargement without apical migration of the junctional epithelium
gingival pocket
t/f a gingival pocket must have apical migration of the junctional epithelium
True
False
false! it is formed by gingival enlargement WITHOUT apical migration of the junctional epithelium. dur dur
does a gingival pocket involve attachement loss?
no-deeper perio structures not involved
where is the base of the sulcus with a gingival pocket
3mmm above alveolar bone
a gingival pocket is considered ______ (outside the bone)
suprabony
what is defined as a pocket formed as a result of disease that causes the junctional epithelium to migrate apically along the cementum
periodontal pocket
unlike a gingival pocket with a perio pocket the _____ ____ is involved
attachement apparatus
what is the attachment with a perio pocket?
cementum
a perio pocket can be _____ or _____
suprabony or intrabony
what is it called when a pocket base is below alveolar bone
intrabony
when calculus deposits are present what does the pocket wall do?
follows contour of calculus
in health what does the pocket wall follow
contour of the tooth
the deeper the pocket the ____ it can be cleaned by toothbrusing
less
what does a deeper pocket mean for biofilm
more opportunity for biofilm to collect and too deep for toothbrush to reach
what are five substances found in a pocket?
microorganisms
fluid
epithelial cells
leukocytes
purulent exudate
what are some microorganisms and their products found in the pocket
enzymes, endotoxins and metabolic products
what are the numbers of leukocytes during inflammation of the tissue
increased
what is purulent exudate made up of?
living and broken down leukocytes, living and dead microorganisms and serum
_____ help with the formation of a pocket
irritants
PDL fibers _____ with a pocket and the JE _____ _____
detach
migrates apically
when a pocket deepens the ____ becomes exposed to the open pocket and oral fluids
cementum
what surface changes can occur as a result of the exchange of minerals with oral fluids and exposure to biofilm bacteria? (4)
hypermineralization
demineralization
calculus formation
dental bioflim and debris collection
periodontal disease is formed by ____ and ____ not calculus
plaque and biofilm
how are supragingival tooth surface irregularities detected?
drying the surface and observing (explorer used as needed)
how are subgingival tooth irregularities detected?
tactile and auditory sensitivity transmitted by a probe and explorer
what are causes of surface roughness on the enamel surface (supragingivally) (5)
cracks and grooves
demineralization
calculus
erosion and abrasion
hypoplasia
what % does the cementum overlap the enamel?
60-65%
what % does the cementum and enamel meet?
30%
what % does the cementum and enamel have a gap exposing dentin?
5-10%
what are some causes of surface roughness with the CEJ?
cementum and enamel overlap
cementum and enamel meet
cementum and enamel gap
what are 6 causes of surface roughness on the root?
diseased cementum
root caries
abrasion
calculus
overhanging restorations
grooves from previous instrumentation
Author
sweetpea281
ID
51279
Card Set
Theory
Description
periodontal disease development
Updated
2010-12-01T02:44:32Z
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