Perio ch 6

  1. t/f no specific systemic diseas has been shwon to produce PD in the absence of local irritating factors?
  2. Social factors contributing to PD (4)
    • Stress
    • Alcohol
    • Drugs
    • Tobacco
  3. Evidence for genetic control of risk factors for some forms of PD include (3)
    • genetically transmitted traits
    • seperated twins w/ chronic onset
    • genetic studies of aggresive forms of periodontitis
  4. The IL-1 gene patient is about __x more likely to develope perio
  5. what percent of the poplulation has the gene for IL-1
  6. Several congenital diseases has manifestations of Perio (6)
    • Hereditary gingival fibromatosis
    • Cyclic neutropenia
    • Downs syndrome
    • Papillon-Lefevre syndrome
    • chediak-Higashi disease
    • Hypophosphatasia
  7. About what percent of the enhanced risk for severe PD can be accoundted for by heredity alone
  8. Greater incidence of PD: males or females
  9. Which race is at risk for PD
  10. How does age effect PD
    overtime, cumulation of biofilm
  11. Stress works in two ways:
    • people change their behavior
    • bodies increase the production of glucocorticosteriods (protect against stress) and cortisone (type of glucocorticosteriod with results in immunosuppression and reduced risistance to infection
  12. Diabetes results in Hyperglycemia and is classified into
    • type I
    • type II
  13. Which type is caused by a severe insulin deficiency resulting from a destruction of beta-cells of the pancreas
    Type I
  14. Which type is more common
    type 2
  15. In which type is insulin being secreted, but receptors are broken
    type 2
  16. Which type has insulin resistance?
    type 2
  17. types 1 and 2 are at risk for (2)
    • gingivitis
    • PD
  18. Hyperglycemia may suppress the immune response and lead to (2)
    • poor wound healing
    • recurrent infections (periodontal abscesses)
  19. exaggerated inflammatory respone to local irritation may be evident in these women (3)
    • pregnant
    • pubertal
    • postmenopausal
  20. in which trimesters do pregnant women have exaggerated gingival inflammatory changes (pregnancy gingivitis)
    second and third
  21. Gingival changes of inflammation and enlargement with increased tissue flow occur on this med
    oral contraceptives
  22. Can pubertal gingival inflammation and enlargement ocurr in males and females?
  23. Pubertal gingivitis more common in males or females
  24. Result of estrogen depletion causing bone to be more porous
  25. risk factors associated with osteoporosis include (5)
    • age
    • calcium intake
    • physical activity
    • body build
    • smoking status
  26. What type of meds may help improve total bone mineralization increase blood calcium, and stablalize supporting bone
  27. People with what are taking bisphosphonates? (3)
    • osteoporosis
    • pagent's disease
    • bone metastasis
  28. Normally there is n equilibrium between osteoblasts ans osteoclasts... what happens in patients taking bisphosphinates
    there are no more osteoclasts to resorb (eat) the old necrotic bone
  29. If necrotic bone stays what happens;
    can result in?
    • inhibit healing and affect blood sypply to an are
    • Osteonecrosis of the jaw (ONJ)
  30. ONJ shows up in patients taking
  31. bisphosphonate half life
    10 years
  32. two types of bisphosphonates
    • non-nitrogenous (first generation)
    • nitrogenous (second and third generation)
  33. which is more likely to cause ONJ
    nitrogenous (second and third generation)
  34. characterized by exposed, necrotic bone in teh maxillofacial region
    ONJ (osteonecrosis of the jaw)
  35. highest incedence of ONJ occurs after
  36. ONJ can occur after
    • extractions
    • implant placement
    • periodontal procedures
    • endodontic therapy
    • orthodontic therapy
    • spontaneously without any tx
  37. Risk factors for ONJ (6)
    • corticosteroid therapy
    • diabetes
    • smoking
    • alcohol use
    • poor oral hygiene
    • chemotherapeutic drugs
  38. Prior to tx with bisphosphonates what should be done (5)
    • oral exam
    • extractions
    • restorative
    • endodontic
    • periodontal therapies
  39. Risk for ONJ increased after the patient has been on bisphosphones for how many years
    3 years
  40. After three years of taking bisphosphonates, what test must be completed to determine if the patient can have invasive dental tx
    c-terminal cross-linked telopeide blood test (CTx)
  41. At what CTx level can you perform dental tx
    at what level cant you
    • 150pg/ml
    • 100pg/ml
  42. HIV patients are vulnerable to
    • aggressive necrotizing periodontal disease:
    • NUG (necrotizing ulcerative gingivitis)
    • NUP (necrotizing ulcerative periodontitis)
  43. Have nutritional deficiencies been shown to cause PD
  44. Which vit. plays a role in the fxns of fibroblasts, osteoblasts, ans odontoblasts
  45. Do tough or coarse foods provide functional stimulation to the gingiva? do they help to remove plaque below teh contact points or cerviacl bulge on teh teeth
    no, no
  46. how many times more likely are smokers to have PD
  47. why is tissue attachment prevented in smokers
    products of cigarettes remain on teeth and in the GCF providing a reservoir of irritants for the soft tissue
  48. Why does alcohol contribute to PD
    • poor oral hygiene
    • malnutrition
  49. gingival overgrowth is caused by which meds
    • phenytoin (seizure med)
    • nifedipin/diltiazem (cardiovasuclar problems and hypertension)
    • cyclosporine (intransplant patients)
    • calcium channel blockers
    • steroids
  50. gingival overgrowth has been reported in what percent of patients receiving phenytoin
    • 50%
    • 15%
    • 25%
  51. systemic diseases associated with PD
    • Diabetes
    • Cardiovascular diseases
    • Respiratory diseases
    • Alziehmers
  52. Relationships w/diabetes
    may be more susceptible to developing PD but does not cause PD
  53. relationship with cadio d
    inceased risk for atherosclerosis and thromboembolisms if have PD
  54. What is most common condition shared by PD patients? 50% risk
    Heart Conditions
  55. What percent increased riks for stroke if they also have perioD
  56. Inflammatory serum marker or a predictor of increased risk for cardioascular disease
    CRP c-reactive protein
  57. what percent of patients with coronary artery diseas suffered from moderated to sever peroi
  58. Women with PD may be __x more predisposed to deliver premature
  59. Elevated levels of what stimulate labor contratctions
  60. PD in pregnant women leads to
    • Preeclampsia (hypertension in pregnancy)
    • vaginal bleeding
  61. Risk of getting alzheimers Disease is higher if
    you have PD
Card Set
Perio ch 6