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Refers to the tissues that invest and support the teeth, such as the gingiva and alveolar bone
periodontium
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the normal anatomic landmarks of alveolar bone (3)
- lamina dura
- alveolar crest
- periodontal ligament space
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appearance of healthy lamina dura
dense radiopaque line
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appearance of healthy periodontal ligament space
thin radiolucent line between the root of the tooth and lamina dura
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appearance of healthy alveolar crest
located 1.5-2 mm apical to the CEJs of adjacent teeth
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means "around a tooth"
Periodontal
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refers to a group of diseases that affects the tissues around the teeth
periodontal disease
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Range of periodontal disease
superficial inflammation of the gingiva to teh destruction of the supporting bone and periodontal ligament
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how should gingival tissues appear with perio?
- swollen
- red
- bleeding
- soft tissue pockets
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which exams are necessary to detect periodontal disease
clinical and radiographic
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clincal exams evaluate...
radiographs evaluate..
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clinical exam performed by?
dentist and dh
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a thorough clinical assessment must include
periodontal probing
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dental radiographs indicate what about periodontal disease? (3)
- pattern,
- distribution
- severity
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film of choice for the evalutaion of periodontal disease
periapical radiograph
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which technique is prefered for perio
paralleling
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why is paralleling prefered?
hight of crestal bone is accurately recorded in relation to the tooth
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which areas are particularly difficult to evalute for perio disease in a radiograph?
buccal and lingaul
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area between roots of multirooted teeth?
furcation area
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What does a radiograph allow you to view about bone loss?
amount of bone remaining, not amount lost
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Bone loss can be described in terms of (3)
- pattern
- distribution
- severity
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the pattern of bone loss viewed on a radiograph can be dexreibed as? (2)
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bone loss occures in a plane parallel to the CEJs of adjacent teeth
horizontal bone loss
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bone loss does not occur in a plane parallel to the CEJs of adjacent teeth
verical bone loss
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vertical bone loss is alos known as?
angular bone loss
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distribution of bone loss seen on a dental radiograph can be described as? (2)
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occures in isolated areas, with less than 30% of sites involved
localized
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bone loss occues evenly thoughout the dnetal arches with more than 30% of sites involved
generalized
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severity of bone loss can be viewed on a dental radiograph as (3)
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severity of bone loss is measured by the?
lincical attachment loss (CAL)
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measurement of CAL
CEJ to base of suclus or pocket
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what must be considered when determining the CAL (2)
- gingival overgrowth
- recession
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How many mm for slight, moderate, or severe
- slight:1-2 mm
- moderate:3-4 mm
- severe: 5mm or greater
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used to provide a framework to study clinical findings and treatment of disease
classfication of Periodontal disease
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Perio disease can be classified by the ADA as?
- Case Type I (gingivitis)
- case type II (mild or slight periodontitis)
- case type III (moderate periodontitis)
- case type IV (advanced or severe periodontitis)
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Describe ASA type I
Bone loss?
crestal lamina dura?
clinically: bleeding?
- no bone loss (alveolar crest is 1-2 mm apical to the CEJ)
- crestal lamina dura is present
- bleeding may or may not be present
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Describe ASA type II
Bone loss?
crestal lamina dura?
clinically: bleeding?
- bone loss. alveolar bone level approx 3-4 mm
- lamina dura unclear and fuzzy
- horizontal bone loss seen
- bleeding may occur on porbing
- pocket depths resulting from attachment loss may be present
- localized areas of recession
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Describe ASA type III
Bone loss?
crestal lamina dura?
clinically: bleeding?
- horizontal or vertical bone loss may be present
- may be localized or generalized
- alveolar bone level is about 4-6mm
- apical to the CEJs of adjacent teeth
- Clinically, pocketing and attachement loss is evident up to 6mm
- recession, furcation involvement areas and slight mobility may also be present
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Describe ASA type IV
Bone loss?
crestal lamina dura?
clinically: bleeding?
- may be horizontal or vertical
- alveolar bone level is 6 mm or greater from teh CEJ
- furcation involvement is readily viewed on poterior radiographs
- pocket depts adn attachement loss are grater than 6mm
- furcation involvment and mobility are more severe
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important in the management and treatment of perio disease
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dental radiographs play a major role in the detection of local irritants such as? (2)
- calculus
- defective restorations
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stonelike concretion that forms on the crowns ad roots of teeth due to the calcification of bacterial plaque
calculus
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act as potential food traps and lead to the accumulation of food debris and bacterial deposites
defective restorations
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radiographs allow the dental professional to identify restorations with (5)
- poor contour
- open or loose contacts
- uneven marginal ridges
- overhangs
- inadequate margins
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