1. when does an inflammatory response to dental biofilm occur?
    withinin 2 to 4 days of irritation
  2. 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
  3. t/f no clinical signs of an initial lesion can be seen.
    true-maybe some marginal inflammation
  4. how many days until it is considered an early lesion?
    7-14 days
  5. during the early lesion what happens to the epithelium?
    it proliferates: epithelial extensions and rete ridges are formed
  6. what is the clinical appearance of an early lesion?
    • early gingivitis
    • 4 mm pockets
  7. what happens to the junctional epithelium of an established lesion
    migrates and tries to wall out the inflammation
  8. t/f the pocket epithelium is less permeable with and established lesion.
    false-more permeable-areas of ulceration of the lining epithelium develop
  9. with the lesion progress _____ fibers are brokendown.
  10. what is the clinical appearance of an established lesion? (4)
    • inflammation
    • marginal redness
    • spongy marginal gingiva
    • bleeds on probing
  11. with an advanced lesion the bacteria from the ______ biofilm enter the sulcus and provide a source for _____ biofilm
    • supragingival
    • subgingival
  12. with an advanced lesion you start to see destruction of what?
    alveolar bone
  13. once the lesion is into the _____ _____ it spreads faster
    alveolar mucosa
  14. how does the inflammation enter the bone?
    small vessel channels in the alveolar crest
  15. how does inflammation spread with an advanced lesion
    through the bone marrow and out into the PDL
  16. what produces irritants with an advanced lesion
    biofilm microorganisms
  17. 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
  18. 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
  19. the cementum contains a thin layer of what during the progression of an advanced lesion? and why?
    endotoxins from the bacterial breakdown
  20. with the progession of an advanced lesion without treatment what will happen?
    the pocket will deepen
  21. what are five signs of periodontitis?
    • pocket formation
    • bone loss
    • mobility
    • recession
    • furcation involvement
  22. with an advanced lesion the bacteria can be _____ and then ____
    • active
    • inactive
  23. healthy gums don't ____
  24. what are 4 characteristics of type 1 perio
    • early gingivitis
    • tissue changes-red
    • bleeding on probing
    • 1-3 mm pockets
  25. what perio type has 1-3 mm pockets
    type 1
  26. with type 1 the pockets are ____-____ mm
  27. what is a factor other than pocket depth that helps to determine the perio class?
  28. t/f type I perio class is early periodontitis
    false-early gingivitis
  29. type II perio class is early ______
  30. what are the type II pocket measurements
    1-5 mm
  31. type II has slight _____ loss and slight ______ loss
    • bone
    • attachement
  32. type III is classified as ______ periodontitis
  33. type III has noticeable ______ ______
    bone loss
  34. type III can have possible ______ involvement?
    furcation (class I or II)
  35. what are the pocket measurements for type III
    4-6 mm
  36. what perio class has 1-5 mm pockets
    type II
  37. what perio class has pockets 4-6 mm
    type III
  38. what perio class has pockets >7mm
    type IV
  39. what are the pocket measurements for type IV
  40. type III has beginning tooth ____
  41. type IV is classified as _____ periodontitis
  42. type IV has severe ____ ____, increased tooth _____ and _____ involvement.
    • bone loss
    • mobility
    • furcation
  43. t/f type two can have a lot or a little calculus
  44. what is defined as a pocket formed by gingival enlargement without apical migration of the junctional epithelium
    gingival pocket
  45. t/f a gingival pocket must have apical migration of the junctional epithelium
    false! it is formed by gingival enlargement WITHOUT apical migration of the junctional epithelium. dur dur
  46. does a gingival pocket involve attachement loss?
    no-deeper perio structures not involved
  47. where is the base of the sulcus with a gingival pocket
    3mmm above alveolar bone
  48. a gingival pocket is considered ______ (outside the bone)
  49. 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
  50. unlike a gingival pocket with a perio pocket the _____ ____ is involved
    attachement apparatus
  51. what is the attachment with a perio pocket?
  52. a perio pocket can be _____ or _____
    suprabony or intrabony
  53. what is it called when a pocket base is below alveolar bone
  54. when calculus deposits are present what does the pocket wall do?
    follows contour of calculus
  55. in health what does the pocket wall follow
    contour of the tooth
  56. the deeper the pocket the ____ it can be cleaned by toothbrusing
  57. what does a deeper pocket mean for biofilm
    more opportunity for biofilm to collect and too deep for toothbrush to reach
  58. what are five substances found in a pocket?
    • microorganisms
    • fluid
    • epithelial cells
    • leukocytes
    • purulent exudate
  59. what are some microorganisms and their products found in the pocket
    enzymes, endotoxins and metabolic products
  60. what are the numbers of leukocytes during inflammation of the tissue
  61. what is purulent exudate made up of?
    living and broken down leukocytes, living and dead microorganisms and serum
  62. _____ help with the formation of a pocket
  63. PDL fibers _____ with a pocket and the JE _____ _____
    • detach
    • migrates apically
  64. when a pocket deepens the ____ becomes exposed to the open pocket and oral fluids
  65. 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
  66. periodontal disease is formed by ____ and ____ not calculus
    plaque and biofilm
  67. how are supragingival tooth surface irregularities detected?
    drying the surface and observing (explorer used as needed)
  68. how are subgingival tooth irregularities detected?
    tactile and auditory sensitivity transmitted by a probe and explorer
  69. what are causes of surface roughness on the enamel surface (supragingivally) (5)
    • cracks and grooves
    • demineralization
    • calculus
    • erosion and abrasion
    • hypoplasia
  70. what % does the cementum overlap the enamel?
  71. what % does the cementum and enamel meet?
  72. what % does the cementum and enamel have a gap exposing dentin?
  73. what are some causes of surface roughness with the CEJ?
    • cementum and enamel overlap
    • cementum and enamel meet
    • cementum and enamel gap
  74. what are 6 causes of surface roughness on the root?
    • diseased cementum
    • root caries
    • abrasion
    • calculus
    • overhanging restorations
    • grooves from previous instrumentation
Card Set
periodontal disease development