Examine & Assess Test
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| List each of these common oral pathologies and conditions. | A= Aphthous Ulcer B= Geographic tongue C= Linea Alba D= Fistula / draining sinus E= Hyperkeratosis F= Hairy tongue G= mandibular tori H= Amalgam tattoo I= Denture stomatitis J= Necrotising ulcerative gingivitis K= Pregnancy epulis |
| What are 3 other things recommended by the Australian dietary guidlines for a heallthy diet? | - Only consume small amounts of oil - Drink lots of water - Consume sugary foods and drinks in moderation |
| List each of these clinical changes to the gingiva. | A = Recession B = Cleft Recession C = Festooned Gingiva D = Rolled margin and Bulbous Interdental Papilla E = Gingival Hyperplasia |
| What are some other things that might cause bleeding in the mouth? | Calculus and biofilm Hyperplasia Local factors e.g. orthodontics, restorations with poor margins, partial dentures, rotating teeth may increase the risk of inflammation |
| What are some other things that might cause bleeding in the mouth? | Calculus and biofilm Hyperplasia Local factors e.g. orthodontics, restorations with poor margins, partial dentures, rotating teeth may increase the risk of inflammation |
| What is this lesion and describe it? | Papule – A small mass without the dimension of depth that is less than 1cm in diameter. a. When described as pedunculated, a papule is on a stalk. b. When described as sessile, a papule is attached at its base and does not have a stalk. |
| What is a systemic factor? List some. | A factor that is increasing the risk of periodontal disease from their physical or general health (happening within the whole body, like other conditions, (E.g., heart disease, diabetes), is it that their immune response to the oral diseases is weakened because of their underlying general health issues. • Diabetes • Stress • Hormonal fluctuations (puberty, pregnancy, menopause) • Metabolic syndrome (high blood pressure, excess body fat, abnormal cholesterol) • HIV/AIDS • Neutropenia • Down syndrome • Leukemia |
| What is a ... Contributing Factor? Systemic Factor? Etiologic Factor? Local Factor? Predisposing factor? Risk Factor? | Contributing Factor – A factor that lends assistance to, supplements or adds to a condition or disease. Systemic Factor – A factor that results from or is influenced by a general, physical, or mental condition or disease. Etiologic Factor – A factor that is the actual cause of a condition or disease. Local Factor – A factor in the immediate environment of the oral cavity or specifically in the environment of the teeth or periodontium. Predisposing Factor – A factor that renders a person susceptible to a condition or disease. Risk Factor – An exposure that increases the probability that a disease or condition will occur. |
| List some cultural issues which may affect dental examinations and patient management? | Medical history and family history. Medications. Financial situations. Family situations. Socio economic status Motivations. Compliance to OHI. Social history. Risk factors. smoking, age, pregancy, diet Cultural safety. Literacy. Patient’s wants, needs, and expectations. Availability. Living remote/rural. Patient's dental awareness/education and home care. Chief complaint/concern. |
| Why do we use staging and grading for periodontitis? 1. Staging 2. Grading | 1. To describe the Severity/extent/distribution of the disease 2. Progression/responsiveness to treatment/potential impact of systemic health |
| How many stages of periodontitis are there? Name them. | Stage 1 – Initial Periodontitis (No tooth loss) Stage 2 – Moderate Periodontitis (No tooth loss) Stage 3 – Severe Periodontitis (Tooth loss with potential for additional tooth loss) Stage 4 – Severe Periodontitis (Tooth loss with potential for additional tooth loss) |
| Name the grades of periodontitis. | Grade A – Slow rate Grade B – Moderate rate Grade C – Rapid rate |
| The periodontium is made up of which 4 tissues? | 1. Gingiva = tissues which cover the crevicular portion of the teeth and the alveolar process of the jaw 2. Periodontal ligament = fibres which surround the root of the tooth 3. Cementum = thin layer of mineralised tissue which covers the root of the tooth 4. Alveolar bone = bone that supports the root of the tooth |
| What is OE, SE and JE? | Oral epithelium = outer layer that covers the free and attached gingiva Sulcular epithelium = lines the sulcus but doesn’t meet the tooth surface Junctional epithelium = at the base of the sulcus and join the gingiva to the tooth surface |
| What are the Pathological/Histological Changes To The Periodontium From Disease during Bacterial Accumulation (initial lesion) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features | 1. Bacteria colonise along the gingival margin - JE cells release cytokines, PGE, MMPs, TNF these calls stimulate an immune/inflammatory response which brings PMNs to the site of infection - PMS pass into the gingival connective tissue and they release cytokines, cytokine destroy health gingival connective tissue to allow PMNs to quickly reach the infected tissue to destroy harmful bacteria - PMN migration to the gingival sulcus to fight bacterial infection (phagocytize bacteria) - If bacteria are destroyed tissues can be repaired and the infection can be stopped and progression to gingivitis will not occur 2. Increased vascular dilation Increase of gingival crevicular fluid |
| What are the clinical Features Of Gingival And Periodontal Health? Describe: 1. Tissue colour 2. Tissue contour (shape and size) 3. Tissue Consistency 4. The surface texture of tissue 5. Position of the gingival margin 6. Bleeding 7. Sulcus 8. Attachement 9. Radiological bone levels 10. Edema 11. Erythema 12. Patient symptoms | 1. Uniform pink, Pigmentation may be present 2. Marginal gingiva: Meets the tooth in a tapered or slightly rounded edge, Interdental papillae: Pointed papilla fills the space between the teeth (Knifed edged) 3. Firm, Resilient under compression 4. Smooth and/or stippled 5. Slightly coronal to the CEJ 6. No bleeding upon probing 7. Probing depths range from 1-3mm 8. No attachment loss 9. No bone loss 10. No edema 11. No Erythema 12. No patient symptoms |
| What are the clinical Features Of Gingival Inflammation? Describe: 1. Tissue colour 2. Tissue contour (shape and size) 3. Tissue Consistency 4. The surface texture of tissue 5. Position of the gingival margin 6. Bleeding 7. Sulcus 8. Attachement 9. Radiological bone levels 10. Edema 11. Erythema 12. Patient symptoms | 1.Acute: Bright red Chronic: Bluish red to purplish red 2.Marginal Gingiva: Meets tooth in a rolled, thickened edge. Interdental papillae: Bulbous, blunted, cratered 3.Spongy, ficid Indents easily when pressed lightly Compressed air deflects the tissue 4.Tissues appear “shiny” Stretched appearance 5.Coronal to the CEJ (due to swelling) 6.Bleeding upon probing 7. Probing depths range from 1-4mm 8. No attachment loss 9. No RBL 10. Edema present 11. Erythema present 12. Symptoms of pain, tenderness and to eating |
| What is the Extent And Distribution Of Inflammation? and how would you describe it if you saw it in the mouth? | Extent = Localised: Inflammation confined to the tissue of a single tooth or a group of teeth Generalised: Inflammation of the gingival tissue of all or most of the mouth Distribution = Papillary: Inflammation of the interdental papilla only Marginal: Inflammation of the gingival margin and papilla Diffuse: Inflammation of the gingival margin, papilla, and attached gingiva Descriptive terms may be combined to create verbal picture of the inflammation, such as: “Localised marginal inflammation in the mandibular anterior sextant” “Generalised marginal inflammation” |
| 1. What are the Signs And Symptoms Of Chronic And Acute Inflammation? 2. When can it clincally be seen? | 1. Acute = Lasts for a short period of time Bleeding on probing Bright red – increased blood in the area Swelling/fluid in the gingival connective tissue May be tender or painful – pressure in tissues Heat - vasodilation Loss of function – the result of swelling and pain Chronic = Lasts for months or years Bleeding on probing Dark red or purple in colour Enlarged and/or fibrotic gingival tissues due to excess collagen fibres Painless 2. Can be clinically seen 4-14 days after the biofilm accumulates in the gingival sulcus |
| What is the Pathological/Histological appearance of a Healthy periodontium? 1. Junctional epithelium 2. Connective Tissue Attachment 3. Periodontal Ligament Fibers 4. Alveolar Bone | 1. JE coronal (above) to CEJ, Tight intercellular junctions (to the enamel) 2. Intact supragingival fibre bundle 3. Intact 4. Intact (crest of alveolar bone is located 2-3mm below the base of the JE) |
| What are the Pathological/Histological Changes To The Periodontium From Disease during Bacterial Accumulation (INITIAL LESION) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features/Time | 1. - Bacteria build up along the gingival margin. - Migration, infiltration and production of white blood cells/chemical defenders (leukoocytes, neutrophils-PMNs, cytokines, PGE2, MMPs, TNFs) in the JE and gingival sulcus/connective tissue to fight infection/inflammation by destroying some connective tissue to get to the bacteria and destroy that too (through phagocytosis). - If bacteria are destroyed tissues can be repaired and the infection can be stopped and progression to gingivitis will not occur. 2. - Vascular dilation (blood vessels widen) - Increase of gingival crevicular/sulcus fluid. 3. - Gingiva looks clinically healthy- no clinical evidence of change - Develops 2-4 days after plaque biofilm accumulation |
| What are the Pathological/Histological Changes To The Periodontium From Disease during Early Gingivitis (EARLY LESION) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features/Time | 1. - Bacteria accumulates and subgingival plaque biofilm maturation occurs. - Migration, infiltration and production of white blood cells/chemical defenders (leukocytes, neutrophils-PMNs, macrophages, cytokines, PGE2, MMPs, lymphocytes, T-Cells, antibodies and some plasma cells) into the connective tissue. Response causes cytokines and PMNs to destroy connective tissue. - Gingivitis is reversible when biofilm is controlled and inflammation is reduced, if not progression to established gingivitis occurs. 2. - Increased vascular dilation and permeability - Infiltration of fluid - Collagen loss in sulcular epithelium and epithelial ridges form 3. - Edema/swelling and redness of marginal gingiva- gingival enlargement (signs of gingivitis) - Develops 4-7 days following plaque biofilm accumulation- biofilm is older and thicker (can vary e.g. 7-14 days) |
| What are the Pathological/Histological Changes To The Periodontium From Disease during Established Gingivitis (ESTABLISHED LESION) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features/Time | 1. - Plaque biofilm increases and extends sub gingivally into the junctional epithelium. - Increased migration, infiltration and production of white blood cells/chemical defenders (leukocytes, neutrophils- PMNs, macrophages, cytokines, PGE2, MMPs, lymphocytes, T-Cells, B-Cells, fibroblasts and leukocytes/plasma cells-produce antibodies) into connective tissue and sulcus. Plasma cells are in areas of chronic inflammation. Their processes destroy connective tissue. - Established gingivitis is reversible when professionally treated, if not advanced lesion/periodontitis occurs. 2. - Junctional epithelium loosens its attachment and forms a pocket epithelium - Proliferation of JE and sulcus to “wall out” inflammation - Continued collagen loss - Deeper extension of epithelial ridges - Increased crevicular fluid 3. - All clinical features of gingivitis are evident and more pronounced than earlier stages (inflammation, red/blue gingiva, bleeding, spongy, exudate) - Observed 21 days after plaque biofilm accumulation |
| What are the Pathological/Histological Changes To The Periodontium From Disease during Periodontitis (ADVANCED LESION) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features | 1. - Bacteria from supragingival plaque biofilm continue to enter the sulcus and provide the source for subgingival plaque biofilm build up both apically and laterally on root surfaces. Chronic inflammation from intense bacterial infection is evident. - Intensified migration, infiltration and production of white blood cells/chemical defenders (leukocytes, neutrophils- PMNs, macrophages, cytokines, PGE2, MMPs, lymphocytes, T-Cells, B-Cells and leukocytes/plasma cells-produce antibodies, fibroblasts- favor the destruction, osteoclasts-resorb crest of alveolar bone) lead to destruction of connective tissue, periodontal ligament fibres, collagen fibres and alveolar bone. Diseased cementum contains a thin layer of endotoxins from the bacterial breakdown. - Chronic inflammation causes irreversible damage to the periodontium and tissues causing the condition periodontitis. 2. -Sulcus fluid present - Exposed cementum - Destruction gingival connective tissue - Destruction of connective tissue fibers cause apical migration of junctional epithelium (development of perio pockets) - Destruction of periodontal ligament fibers - Destruction of alveolar bone 3. Periodontal pocket formation, bleeding on probing, destruction of ligaments(seen on x-rays), alveolar bone loss (seen on x-rays), furcation involvement and tooth mobility |
| What Class is this? and describe the molar and canine relations. | Class I- Neutroocclusion Molar Relation - The MB cusp of the maxillary 1st molar occludes with the buccal groove of the mandibular 1st molar. Canine Relation - The maxillary canine occludes between the mandibular canine and the mandibular first premolar. |
| What class is this? and describe the molar and canine relations. | Class III-Mesiocclusion Molar Relation - The buccal groove of the mandibular 1st molar is mesial to the mesiobuccal cusp of the maxillary 1st molar by at least the width of a premolar. Canine Relation - The distal surface of the mandibular canine is mesial to the mesial surface of the maxillary canine by at least the width of a premolar. |
| What class is this? and describe the molar and canine relations. | Class II (distocclusion) Division 1 - All maxillary incisors are protruded. Molar Relation - Buccal groove of the mandibular 1st molar is distal to the mesio-buccal cusp of the maxillary 1st molar by at least the width of a premolar. Canine Relation - The distal surface of the mandibular canine is distal to the mesial surface of the maxillary canine by at least the width of a premolar. |
| What class is this? and describe the molar and canine relations. | Class II (distoocclusion)Division 2 - One or more maxillary incisors are retruded. Molar Relation - Buccal groove of the mandibular 1st molar is distal to the mesio-buccal cusp of the maxillary 1st molar by at least the width of a premolar. Canine Relation - The distal surface of the mandibular canine is distal to the mesial surface of the maxillary canine by at least the width of a premolar. |
| What is it meant by Malposition of individual teeth? | Are any teeth rotated, lingually or buccally positioned, over-erupted, depressed? |
| List 7 malrelations of groups of teeth | Crossbites = Teeth positioned facially or lingually to their normal position Open bites = lack of occlusion or incisal contact between certain maxillary and mandibular teeth Overjet = Horizontal distance between incisal teeth measured in mm (usually Class II) Under jets = Horizontal distance between incisal teeth measured in mm (usually Class III) Overbite = Recorded as a % Edge to Edge = incisal surfaces of maxillary teeth occlude with incisal mandibular teeth (don’t overlap) End to End bites = molars and premolars occlude cusp to cusp |
| Name four main varients of normal you would look for when examining the oral cavity and facial region? | 1. Alterations from the norm 2. Asymmetry (soft tissue shape and consistency) 3. Malocclusions 4. Presence of diseases or lesions |
| What is a local factor? List some. | A factor that is increasing the risk of periodontal disease that is in the immediate environment of the oral cavity. -Tooth and root morphology -Calculus -Occlusion -Smoking -Pellicle -Clenching/bruxism -Tongue thrust |
| What are the 3 categories of periodontal health? Describe each of them including any Clincal Attachment Loss and Radiographic Bone Loss. | 1. Periodontal health on an intact periodontium: No clinical signs of gingival inflammation and no previous loss of periodontal tissue and no alveolar bone loss. No CAL or RBL. 2. Periodontal health on a reduced periodontium in a non-periodontitis patient: Clinical signs of periodontal health on a periodontium with a pre-existing loss of connective tissue and/or loss of alveolar bone which is attributed to non-periodontitis reasons. (e.g., Gingival recession from toothbrushing). CAL present and Possibility of RBL. 3. Periodontal health on a reduced periodontium in a successfully treated stable periodontitis patient: Clinical signs of periodontal health on a periodontium with pre-existing loss of connective tissue an alveolar bone which is attributed to periodontitis but has been successfully treated and is currently stable. CAL and RBL present. |
| List the grades of mobility and describe them. | Grade 1 - tooth can be moved 1mm in BL direction Grade 2 tooth can be moved 2mm in BL direction Grade 3 tooth can be moved 3mm in BL direction & can depress tooth into socket in an apical occlusal direction |
| List the levels of attrition and describe them. | Level 1 – No need to be charted as only in enamel surface Level 2 - Wear has gone through to the dentine Level 3 - Outline of pulp is visible |
| List the classes of furcation and describe them. | Class 1= where probe can extend 1mm into furcation Class 2= where probe can extend 2mm or more into the furcation but not through Class 3= where the probe can extend through one side (lingual/palatal) of the tooth to the other (buccal) |
| List some basic hard tissue pathologys. | Abrasion Erosion Attrition Decalcification Caries Calculus Overhangs Restorations (FS, amalgam, comopsite, crowns) |
| 1. How many sites do we probe when measuring pocket depth? 2. When do we chart them? 3. List them. | 1. 6 Sites 2. >4mm 3. Distobuccal Buccal Mesiobuccal Distolingual Lingual Mesiolingual |
| 1. How many sites do we chart when recording bleeding on probing? 2. List them. 3. How do you describe the bleeding in your patient notes? | 1. 4 sites 2. Distal Buccal / facial / Labial Mesial Lingual /palatal 3. Light Moderate Heavy |
| 1. How many sites do we chart for recession? 2. When do we chart them? 3. How is it measured? | 1. 6 sites 2. When the gingival margin is apical to the CEJ 3. In mm (All loss should be recorded) |
| A. What are the 5 main things required to be gathered from a patient before treatment? B. From this gathered information, what do we need to consider? | A. Personal details - Full name, DOB, Address, Phone number Chief complaint - Why have they come in? Medical history- Health conditions, medications, hospitalisation, GP or specialist name and location of practice Dental history - Old practice? ortho? Fills? Exo's? gum disease? Social history - Different questions for different age groups use causal conversation, builds over time. B. Risk factors - More prone to dental diseases or poor oral health- diet, meds, social, smoking, alcohol, systemic conditions |
| What is recorded on a TAFE HE1 for Intra and Extra Oral Examination? | Extra Oral: Head, Neck, Lips, TMJ Intra Oral: Buccal and Vestibular Mucosa, Palate, Floor of Mouth, Orophyrygeal, peripheral attachemnts/frena, Tongue, Salivary Glands, Trouble Teeth, Salvia, Other |
| What are the 4 types of palpitation and describe them? | 1. Bilateral palpitation: is when two hands are used 2. Palpation: is when two fingers and hands are used to move or press tissues consistency 3. Digital palpitation: is the use of 1 finger 4. Bimanual palpation: is the use of the fingers and the thumb from two hands |
| What are the 16 things that you examine during an intra and extra oral examination and describe things that you look at and record? | 1. Overall appearance of patient (posture, size, breathing) 2. Face (injuries, shape) 3. Skin (colour, texture, scars, growths) 4. Eyes (size of pupils, colour, protruding) 5. Nodes-Palpate (size and pain to: Pre – and posticular, Occipital, Submental and Submandibular, Cervical chain, Supraclavicular) 6. Glands-Palpate (size or pain to: Parotid, Submental, Submandibular) 7. Tempomandibular joint- Palpate (limitations or deviations, pain, clicking or noise) 8. Lips-Observe and Palpate (colour, texture, size, lesions, cracks, ulcers, cold sores) 9. Breath odor (severity in relation to OH) 10. Labial and buccal mucosa (colour, size, texture, contour, lesions to: vestibule, mucobuccal folds, frena, stenstons duct, cheeks) 11. Tongue (colour, size, texture, shape, fissures, coatings, lesions to: vestibule, dorsal, lateral borders, base of tongue, deviation on extension) 12. Floor of mouth (veins, thickness, lesions, frena limitations to: ventral surface, ducts, muscoa, frena) 13. Saliva (quantity, quality, dry mouth/lips?) 14. Hard palate (height, contour, colour, rugae, tori, growths, ulcers) 15. Soft palate (colour, size, shape, growths, ulcers) 16. Tonsillar region, throat (size, shape, colour, lesions) |
| Descriptive lesion terminology includes describing 3 things: 1.History 2.Location/Extent 3.Physical Characteristics. Explain how you would describe/record these 3 things in your notes. | 1. History: Duration Reoccurring Symptoms Changes 2. Location and Extent: Localised = limited to a small area Generalised = involves most of an area or segment Single lesion = one lesion of a particular type with a distinct margin Multiple lesions = more than one lesion of a particular type can be separate or merging 3. Physical Characteristics: Size and shape = record length, width, and height (elevated, flat, or depressed lesions) Colour Surface texture = smooth or irregular Consistency = soft, spongy, hard |
| What is Atrophy? | Atrophy - A normally developed tissue that has decreased in size. |
| What is Hyperplasia? | Hyperplasia – An increase in the size of a tissue that is caused by an increase in the NUMBER of constituent cells. |
| What is Hypertrophy? | Hypertrophy – An increase in the size of a tissue that is caused by an increase in the SIZE of constituent cells. |
| What lesion is this and describe it? | Bulla – A circumscribed, fluid containing, elevated lesion of the skin that is greater than 1cm in diameter. Bulla: Fluid filled sac or lesion like a blister |
| What is this lesion and describe it? | Macule – A spot or stain on the skin or mucous membrane that is neither raised nor depressed. (E.g., café au lait spots, hyperaemia, erythema, petechiae, ecchymoses, purpura, and oral melanotic macules.) |
| What is this lesion and describe it? | Nodule - A circumscribed, usually solid lesion having the dimension of depth. Nodules are less than 1cm in diameter. Nodule: growth of abnormal tissue, lump under skin 1cm or greater |
| What is the periodontal probe used for? | Measure the depth of the gingival sulcus (pockets). Measure width of attached gingiva Measure clinical attachment loss and furcation's Measure extent of recession the gingival margin Measure size of intra oral lesions Assess bleeding on probing Measure overjet malocclusion and diastema |
| What is the explorer used for? | The Explorer is used to detect: Caries Overhangs Decalcification, erosion and abrasion etc Plaque and calculus Restorations Furcations |
| What are the 5 main food groups recommended by the Australian Dietary Guidelines for a balanced diet? | Grains Vegtables Fruit Dairy Lean meats, fish and poultry, eggs, nuts (proteins) Sweets(liquid, hard or soft), oils and fats should be limited |
| How do you calculate someone's plaque score? | Number of surfaces with retained stain/Number of teeth present x 100/4 |
| How do you calculate the bleeding %? | Number of bleeding sites/Number of sites probed x 100 = % |
| Explain the GC Tri Plaque ID Gel colours and what they indicate | GC Tri Plaque ID Gel stains: new plaque = pink/red, mature plaque (older than 48hrs) blue/purple high-risk/acidic plaque = light blue (Any time that the acidity is below 4.5 is when high risk occurs - light blue.) |
| What is Materia Alba? | A loosely attached white/grey/yellowish (colour depends on OH) material in the oral cavity, which can be composed of cells of tissues and food debris (desquamated epithelial cells, leukocytes, salivary proteins and lipids, and microorganisms) |
| What is calculus? | Dental calculus is hard calcified deposits on the teeth. This is formed when the soft deposits calcify with the minerals from our saliva. |
| 1. What is the acquired pellicle? 2. When does acquired pellicle start to form? | 1. Thin acellular tenacious protein film that form over teeth. It forms as soon as salivary proteins (glycoproteins) come in contact with the tooth and they adheres to the tooth surface. It acts like "double sided sticky tape"- as well as adhering to the tooth’s surface on the inside, unfortunately it also allows bacteria to adhere on the outside of it. 2. Form within minutes after brushing teeth and is fully formed within 30-90 minutes. Can't rinse it away must be manually removed |
| 1. What is dental biofilm? 2. What is dental biofilm a risk factor for? | -Dental biofilm is a dense, soft, slimy, structured community of microorganisms (bacteria colonies). Biofilm formation begins with bacteria entering the moist and warm oral cavity and slowly forming a layer/film over the teeth. -Biofilm is a risk factor for gingivitis, periapical periodontitis, periodontitis, and peri-implantitis as it causes inflammation, infection and destruction of periodontal structures. The bacteria in biofilm produces acid which de-mineralises tooth surface and increases the risk of caries. |
| What is this lesion and describe it ? | Ulcer = Loss of surface tissue caused by a sloughing of necrotic inflammatory tissue: the defect extends into the underlying lamina propria. Appears red around the outside and white in the middle.(E.g., Aphthous Ulcer – Usually appears on the mucous membranes of the mouth. Is painful and typically heals spontaneously within 7-10 days.) Ulcer: an open wound that develops on skin as a result of injury, poor circulation or pressure Aphthous Ulcer: small, shallow lesions that develop on soft tissue, whitish yellow, red border |
| What is this lesion and describe it? | Pustule = A elevated, well-circumscribed, pus containing lesion. Usually less than 1cm in diameter. |
| What is this lesion and describe it? | Plaque – A white area with flat surface and raised edges can usually be wiped away. Eg. Oral thrush. |
| What are some things other than gingivitisis and periodontitis that might cause bleeding in the mouth? | Calculus and biofilm Hyperplasia Local factors e.g. orthodontics, restorations with poor margins, partial dentures, rotating teeth may increase the risk of inflammation |
| Name the Anatomy from A-T? | A= gingival margin, B= free gingiva, C= free gingival groove, D= attached gingiva,E= mucogoingival junction, F= alveolar mucosa, G= alveolar bone, H= cementum, I= cementoenamel junction, J= junctional epithelium, K= gingival sulcus, L= Enamel, M= gingival sulcus, N= oral epithelium, O= sulcular epithelium, P= connective tissue, Q= junctional epithelium, R= gingival fibres, S= mucogingival junction,T= periodontal ligament |
| Name the anatomy from A-G? | A= periodontal ligament, B= cementum, C= alveolar process, D= alveolar crest fibers, E= horizontal fibers, F= oblique fibers, G= apical fibers |
| What are the 3 possible arrangements of the CEJ? | See picture answer Three possible arrangements of enamel and cementum (commonly abbreviated to OMG): Overlap- Cememntum overlaps the enamel for a short distance Meet- Cememntum meets the enamel Gap- There is a small gap between the cementum and enamel, exposing the dentine in this area (patient may have dentinal sensitivity/pain) |
| Name anatomy A-I ? | A= junctional epithelium, B= sulcular epithelium, C= oral epithelium, D= dentine, E= enamel, F=CEJ, G= bone, H= cementum, I= connective tissue |
| What are the 3 things acquired pellicle can do? | 1. provides a barrier against acids 2. provides lubrication- moistens environment and aid in speech and mastication 3. aids in adherence of microorganisms and attachment of calculus to teeth |
| Distribution talks about localised and generalised..... what percentage is classed as localised and what percentage is classed as generalised? | Localised= lower than 30% generalised= higher than 30% |
| What are we looking at when we examine gingival and periodontal tissues? | - Changes to the gingival tissues (colour, size, shape, consistency, surface texture and also position of gingival margin) - Looking at mucogingival involvement (adequate width of attached gingiva) - Presence of bleeding on probing - Presence of exudate - Probing depths - Pocket formation - Attachment levels - Furcation involvement - Dental biofilm and calculus present - Tooth mobility - Radiographic evidence |
| Give a brief definition of gingivitis? | Gingivitis is a bacterial infection that is confined to the gingiva, characterised by changes in the colour, contour and consistency of the gingiva (red, swollen, bleeding). The tissue damage that occurs in gingivitis results in reversible damage to the tissues of the periodontium. |
| Give a brief definition of periodontitis ? | Periodontitis is a bacterial infection that affects all parts of the periodontium including the gingiva, periodontal ligament, bone and cementum. Periodontitis results in some extent of permeant tissue destruction characterised by changes in colour, contour and consistency (pink or purplish, swollen or fibrotic, bleeding). Periodontitis involves IRREVERSIBLE loss of attachment and bone. |
| Name 4 characteristics of the periodontium in gingivitis? | 1. Junctional epithelium is at the CEJ- meaning there is no apical migration of the junctional epithelium. 2. Supragingival fibre destruction present 3. Alveolar bone intact (meaning no bone loss) 4. Periodontal ligament intact |
| Name 4 characteristic of the periodontium in periodontitis? | 1. Junctional epithelium is still at the CEJ 2. Supragingival fibre destruction present 3. Alveolar bone destruction (reabsorption) 4. Periodontal ligament destruction |
| Immune system sends more immune cells to fight bacteria and release more toxic chemicals that destroys healthy connective tissue: Macrophages produce.......1,2,3? Cytokines recuit more 4,5? PGE2 and MMPs initiate..... what? Gingival fibroblasts are stimulated to produce more 6,7? | 1= Cytokines 2=PGE2 3=MMPs 4= Macrophages 5= Lymphocytes what? = collagen destruction 6= PGE2 7= MMPs |
| What stages are A-H? | A= initial lesion,B= early lesion, C= initial lesion, D= early lesion, E= initial lesion, F= early lesion, G= early lesion, H= initial lesion |
| What stages are A-J? | A= advanced lesion, B= established lesion, C= advanced lesion, D= established lesion, E= established lesion,F= advanced lesion, G=advanced lesion, H= advanced lesion, I= advanced lesion, J= established lesion |
| Label | Did you get it right? |
| Describe 4 histological things about the periodontium in health... | 1. JE is slightly coronal to the CEJ and has a tight connection to enamel 2. Connective tissue attachment of the supra gingival fibre bundles are intact 3. Periodontal ligament fibers are intact 4. Alveolar bone is intact, crest is 2-3mm below the JE |