Perio Ch. seven cont.

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Perio Ch. seven cont.
2011-11-28 23:37:44
Perio seven

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  1. Which type of periodontitis progresses rapidly with MASSIVE bone loss?
    Aggressive periodontitis
  2. Which type of periodontitis occurs in young individuals, and most young individuals with it do not have generalized destruction?
    Aggressive periodontitis
  3. Why is aggressive periodontitis difficult to diagnose based on bacterial and microflora identification?
    because the microflora of aggressive periodontitis is similar to that of chronic perio
  4. List 4 factors that can distinguish aggressive periodontitis from other forms
    • age of the patient at clinical detection
    • progression of bone loss
    • presence or absence of possible defects in the immune response or general health problems
    • perio destruction greater than would be expected given the local factors present
  5. List the 3 types of aggressive periodontitis.
    • early onset
    • Rapid progressive
    • Refractory
  6. What are 2 types of early onset periodontitis?
    • prepubertal periodontitis
    • Juvenile periodontitis:
    • Localized
    • Generalized
  7. Which type of aggressive perio is being described?
    rapid onset of tissue destruction
    association with defects in the immune system
    associated microbiota
    early age onset - under 30
    includes prepubertal and juvenile perio
    early onset perio
  8. Which type of aggressive perio has an age onset of younger than 30?
    early onset perio
  9. Which type of aggressive perio includes prepubertal and juvenile perio?
    early onset perio
  10. true or false. Prepubertal perio is a very rare condition that may be generalized or localized.
    both are true
  11. true or false. Prepubertal periodontitis only affects primary dentition.
    FALSE. it affects primary AND secondary dentition
  12. Which type of periodontitis includes severe gingival inflammation, rapid bone loss, and early tooth loss?
    prepubertal periodontitis
  13. Why are deciduous teeth often lost in prepubertal peridontitis?
    because of infection
  14. many patients with prepubertal periodontitis have _____ ______ cell defects.
    white blood cell
  15. true or false. Prepubertal periodontitis responds well to conventional treatment - scaling and root planing.
    FALSE. it does NOT
  16. true or false. Antibiotic therapy may help with prepubertal periodontitis; and adjunctive therapy tx usually slows but does not stop the progression of the disease.
    both are true
  17. It localized juvenile periodontitis; extreme bone loss is seen around which teeth most often?
    permanent 1st molars and incisors; but can be seen around other teeth
  18. Which type of perio is seen in individuals younger than 20?
    juvenile periodontitis
  19. true or false. Localized juvenile periodontitis is usually not diagnosed until the pt is older and defects are severe
  20. most patients with which type of aggressive perio have lost teeth or drifting teeth?
    localized juvenile periodontitis
  21. Which microorganism is found in high numbers in localized juvenile periodontitis?
    A. actinomycetemcomitans
  22. Which organism does not produce an extracellular matrix and can therefore be in large amounts in periodontal pockets?
    A. actinomycetemcomitans
  23. In which type of aggressive perio is plaque and calculus minimal around teeth with pockets, they have good oral hygiene, and large number of PMN's have a slow chemotatic response?
    Localized juvenile aggressive perio
  24. true or false. Localized aggressive juvenile perio is more common in caucasian males.
    FALSE. African American females
  25. What type of test can be done to confirm and identify bacteria in the oral cavity and perio pockets?
    DNA test
  26. Why is visible plaque usually low in patients with juvenile aggressive perio?
    because of the A. Actinomycetemcomitans predominated biofilm (that does not form a matrix)
  27. What are 3 factors in the treatment of juvenile aggressive periodontitis?
    • removal of A. Actinomycetemcomitans
    • mechanical debridement - scaling and root planing - pt taking some form of tetracycline
    • perio surgery to eliminate infection in deep bony defects
  28. true or false. Generalized Juvenile perio is more common than localized.
    FALSE. It is rarer
  29. Which teeth are the most severly involved in generalized juvenile aggresseiv perio?
    permanent 1st molars and incisors
  30. true or false. generalized aggressive perio is associated with a neutrophil chemotactic disorder similar to localized.
  31. What are 2 significant differences between localized and generalized juvenile perio?
    • Aggressive perio has siginificant inflammation present with heavy calc and plaque, and
    • it includes P. gingivalis, E. corrodens along with A. actinomycetemcomitans
  32. Which form of aggressive perio includes P. gingivalis, E. corrodens, and A. actinomycetemcomitans in large numbers?
    GENERALIZED juvenile periodontitis
  33. How should generalized juvenile perio be treated? (4)
    • improved home plaque control
    • scaling and root planing
    • antibiotic therapy
    • perio surgery to correct defects in bone architecture
  34. Which form of aggressive perio is being described?
    can be localized or generalized
    juvenile perio that has stopped or slowed
    based on appearance of sever bone loss around 1st molars and incisors
    postjuvenile form of aggressive perio
  35. Which type of aggressive perio is based on the appearance of severe bone loss around 1st molars and incisors?
    postjuvenile perio
  36. Which form of aggressive perio occurs in adults 20-30 yrs of age; involves most of the teeth but can be localized; has severe gingival inflammation and varying amounts of plaque and calc; loss of bone occurs over weeks and months; and the disease may have genetic component and altered neutrophil chemotaxis?
    rapid progressive perio
  37. What age does rapid progressive perio usually occur?
    20-30 yrs
  38. Which type of aggressive perio may have a genetic component and altered neutrophil chemotaxis?
    rapid progressive perio
  39. The following bacteria are related to which form of aggressive perio?
    P. gingivalis
    P. intermedia
    E. corrodens
    Cr. Rectus
    Rapid progressive perio
  40. Treatment for Rapid progressive perio includes eliminating ______ factors; surgery; good ______ care; ______ or __________ and other drugs can be used
    • local
    • home
    • tetracycline
    • metronidazole
  41. Which form of aggressive perio is being described?
    unresponsive to appropriate tx; may occur in single or multiple sites; no single bacterial agent identified may be from several species working together; most patients undergo repeated therapies to control the disease progression.
    refractory perio
  42. To determine if the form of aggressive perio is refractory or chronic, you must first rule out what?
    poorly treated disease
  43. List 6 systemic diseases that can cause perio.
    • Down Syndrome
    • IDDM (Insulin dependant Diabetes mellitus)
    • AIDS
    • papillon-Lefevre syndrome
    • Leukemia
    • Hypophosphatasia
  44. What is hypophosphotasia?
    altered tooth development
  45. Which genetic disorder is characterised by a low level of neutrophils in the blood making the body vulnerable to bacteria and fungal infections, and is therefore associated with perio?
    familial cyclic neutropenia
  46. Which genetic disorder is characterised by a lack of molecules which help neutrophils get from the blood stream to the infected area, making it so infection can spread further; and is associated with perio?
    Leukocyte adhesion defiency syndrome
  47. Which genetic disorder is characterised as a disease that affects humans and animals (such as whales and tigers) that has Leukocytes defective in chemotaxis and intracellular killing, and platetelet storage defect, and is associated with perio?
    Chadiak-Higashi syndrome
  48. Which genetic disorder is characterised by things like obesity, mental retardation, and craniofacial dysmorphism, and is associated with perio?
    Cohen syndrome
  49. Which genetic disorder is characterised by an increase in immune cells called histiocytes (macrophages); that is associated with perio?
    histiocytosis syndrome
  50. Which genetic disorder is characterised by an inborn error of metabolism, or glycogen breakdown, and is associated with perio?
    glycogen storage diseases
  51. Which genetic disorder is characterised by children born with a lack of neutrophils, is also known as severe congenital neutropenia, and is associated with perio?
    Infantile genetic agranulocytosis
  52. Which genetic disorder is characterised by a defect in the synthesis of collagen, and is associated with perio?
    Ehlers-Danlos syndrome
  53. When is NUG considered NUP?
    when it involves the attachment apparatus, bone, and connective tissue
  54. Which form of aggressive perio is being described?
    intensely red and inflammed; extensive necrosis of the soft tissues that form white pseudomembranous surface; severe loss fo connective tissue; fetid odor
  55. Why are there no pockets present with NUP?
    because gingival tissue has eroded away
  56. Which form of aggressive perio is associated with:
    transplant patients
    nutritional deficiencies
    extreme stress
  57. Which form of aggressive perio is associated with each of the following bacteria:
    spirochetes (esp. trepenoma denticola)
    prevotella intermedia
    porphyromanos gingivalis
  58. What is the drug of choice in the tx of nup?
  59. What is an acute, localized purulent infection that can be gingival, periodontal, pericoronal, or perioapical?
    abcess of the periodontium
  60. List 4 different types of abscesses of the periodontium.
    • gingival
    • periodontal
    • pericoronal
    • periapical
  61. What is the point of origin for a gingival abscess?
    injury to or infection of the surface gingival tissue
  62. Which form of abcess is a result of injury to or infectino of the surface gingival tissue?
    gingival abscess
  63. What is the point of origin for a periodontal abscess? (aka lateral periodontal abscess)
    • if an infection is spread deep in the periodontal pockets, and drainage is blocked
    • **may develop after debridement**
  64. Which form of abcess occurs if infection spreads deep into periodontal pockets and drainage is blocked.
    periodontal abcess (lateral periodontal abscess)
  65. Which form of abscess may develop after periodontal debridement?
    periodontal abscess (lateral periodontal abscess)
  66. What is the point of origin for a pericoronal abscess?
    inflammed dental follicular tissue overlying the crown of a partially erupted tooth
  67. Which form of abscess develops in inflammed dental follicular tissue overlying the crown of a partially erupted tooth?
    pericoronal abscess
  68. What is the point of origin for a periapical abscess?
    results from a pulp infection
  69. Which form of abscess results from pulp infections, and is usually secondary to deep decay?
    periapical abscess
  70. What occur with chronic periodontitis, usually cases that have not been treated, and also occur because the perio pocket becomes occluded, allowing the infection to become localized and pus to accumulate?
    periodontal abscess
  71. Which form of abscess is associated with rapid bone loss; thought to occur more often after periodontal scaling and root planing, and if left untreated will seek a route to drain and become worse (chronic) constantly inflamed and will result in continued bone loss?
    acute perio abscess
  72. Which form of abscesses are asymptomatic and the patient is unaware of any drainage pus; they typically occur in deepened pockets, and gingival abscesses are typically from a foreign object.
    Chronic perio abscess
  73. Periocoronal abscesses occur around partially erupted teeth; usually _______ molars
  74. Pericoronal abscesses occur around the flap of tissue that is partially covering the tooth called a/an ____________; called a pericoronal abscess or ___________.
    • operculum
    • pericoronitis
  75. true or false. Pericoronal abscesses are extrememly painful, and can spread to the submandibular tissues.
  76. when must systemic antibiotics be used in the treatment of a perio abscess?
    if there is eveidence of fascial cellulitis or if the pt has a fever
  77. Definitive treatment of a pericoronal abscess is removal of the ____________; or __________ of the partially erupted molar
    • operculum
    • extraction
  78. Periodontitis associated with endodontic lesions occur as a single isolated deep pocket or present in the furcation of a specific tooth; and are sensitive to what?
  79. Periodontitis could infect the pulp through the ______ or ______ canals; or an endo lesion can drain through the ____ infecting the surrounding tissues.
    • apex
    • lateral canals
    • PDL
  80. true or false. We should not perform scaling and root planing until after the endo lesion has healed.
  81. ______________ can be a developmental condition if it is caused by an underlying osseous defect or be an acquired defect. Cemental spur or lateral developmental groove are examples that can cause this.
  82. What is it when the gingival margin is coronal to the CEJ and has no attachment loss? It is often seen on the distals of second and third molars
  83. _____ contains a large number of cytotoxic and vasoactive components.
  84. Nicotine ingestion causes ______________.
  85. Tobacco use causes diminished ___________ function.
  86. ________ periodontitis is often seen with tobacco use. (it masks inflammatory response and prolongs healing)
  87. Tobacco use impairs _____ function and reduces the capacity of the perio tissue to heal
  88. true or false. specific gene markers may be associated with increased periodontal disease. There is a commercially available genetic test for interleukin genes which have been implicated in chronic perio disease.
    both true
  89. What are 2 reasons systemic antibiotics would be used for periodontal disease.
    • mechanical therapy has not been successful
    • when specific microorganisms have been identified
  90. generally chronic perio that responds to mechanicl therapy does or does not? benefit from antibiotic treament?
    does not
  91. Which antibiotic is concentrated in the gingival fluid?
  92. A. actinomycetemcomitans is usually susceptible to which antibiotic?
  93. Which antibiotic is usually prescribed in the form of minocycline which has a long serum half-life or doxycycline which tend to have a lower incidence of gastrointestinal side effects?
  94. Tetracycline inhibit _______ activity
  95. Which antibiotic used in perio is being described?
    inhibits several perio pathogens including spirochetes, porphyromonas species, and prevotella species, kills anaerobic bacteria good for use with rapidly progressing perio, and is not effective againse treating A. actinomycetemcomitans?
  96. Which antibiotic used in perio is being described?
    less effective againset perio pathogens; resistance occurs when bacteria produce enzymes that break down the antibiotic; these enzymes are produced by other bacteria in the pocket
  97. Combinations such as penicillin and potassium clavulanate have been used for the tx of which form of perio?
  98. List 5 sidef effects of antibiotics
    • stomach upset
    • diarrhea
    • abdominal pain
    • dizziness
    • muscle weakness
  99. What is the most important side effect of tetracycline?
    it interferes with the effectiveness of birth control pills
  100. true or false. If possible, before prescribing antibiotics, know what organisms are associated with the disease and whether they are suseptible to the specific antibiotic being used.
  101. What was the first locally delivered antibiotic?
    the controlled release of tetracycline fiber
  102. Which locally administered antibiotic is used in the form of a biodegradable polymer gel that is liquid when mixed, applied with a syringe, and becomes a simisolid gel as it heats to body temp?
    doxycycline hyclate (atridox)
  103. Which form of locally delivered antibiotics is large in size, a 5mmby4mm and can only be used in deeper pockets, and is safer than an antibiotic.
    chlorhexidine biodegradable chip
  104. Which form of locally delivered antibiotic is contained in tiny blobule in a ointment that is inserted into the pocket with a custom design syringe?
    minocycline (arestin)
  105. How long can arestin have therapeutic affects?
    21 days
  106. What is another name for doxycycline hyclate