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Periodontolgy
Vet Dentistry
| Question | Answer |
|---|---|
| What is the definition of periodontal disease? | Inflammation of the gingiva or periodontium, their active recessive alteration, or their alteration state with or without active disease |
| What is the definition of periodontitis? | an active disease state of the periodontium |
| What is the role of the interdental papilla? | to prevent food and debris from being impacted between teeth |
| What is a col? | A valley between the facial and lingual interdental papillae, covered with a thin layer of nonkeratinized epithelium |
| What are the 3 most common sites for col involvement in dogs? | Maxillary 08/09, mandibular 09/10, incisors |
| In addition to the col, what other area of masticotry gingiva is nonkeratinized? | epithelium lining the sulcus |
| What causes gingival stippling? | the insertion of rete pegs into underlying connective tissue |
| What are the 2 main types of collagen fibers in cementum? | 1: Sharpey's fibers (insert at 90 degrees to surface) 2: collagen fibers that originate within and run parallel to the surface of cementum |
| What is another term for alveolar bone? | cribriform plate |
| What is the radiographic presence of the cribriform plate called? | lamina dura |
| What is it called when PDL collagen fibers interdigitate? What type of teeth exhibit this? | Intermediate plexus hypsodont teeth |
| What is the cellular arrangement of junctional epithelium? | only a few cell layers thick at apical extent 15-30 cell layers thick at coronal extent |
| What is the average cell turnover rate of junctional epithelium? | 4-6 days |
| What is the average cell turnover rate of other oral epithelium? | 6-12 days |
| Where can the actual epithelial attachment to the tooth surface occur? | enamel, cementum, or dentin with an internal basal lamina of the hard tissue |
| What type of attachment adheres the basal cell layer to the Internal basal lamina? | hemidesmosomes |
| Where does the apical boundary of the junctional epithelium end in healthy periodontal tissues? | CEJ |
| From where are the constituents of plaque derived? | Ingested food Salivary glycoproteins Bacterial byproducts |
| What are the inorganic components of plaque? | Calcium, phosphorus, magnesium, sodium, potassium |
| Where can FACULTATIVE anaerobic bacteria live | with or without oxygen |
| What bacterial products/components can invade tissue on their own and cause direct tissue destruction/injury in the absence of a host response? | cytotoxins endotoxins |
| What are 3 examples of cytotoxins? | ammonia hydrogen sulfide organic acids |
| What are the 2 major factors that influence whether or not gingivitis will progress into periodontitis | virulence of bacterial flora host immune response |
| Is periodontal disease a linearly continuous process? | No, it is a cyclic process of recurring intervals of active destruction and inactive dormancy |
| What are two detrimental effects of calculus? | aids in further plaque and bacterial adherence near the gingival margin provides a local passive irritant effect |
| What cat breeds are predisposed to perio dz? | Somali, abyssinian |
| What dog breeds are predisposed to perio dz? | Mini schnauzers, grayhounds Small dogs w/crowded teeth & malocclusions |
| What nutritional deficiencies have been shown to result in weak periodontal ligament that is easily damaged? | Vitamin C, selenium |
| What contributes to physiologic mobility? | width of the PDL and elasticity of the supporting alveolar bone |
| How should fluoride products be removed after the prescribed time period of contact with the teeth? | Wiped or blown off w/air Rinsing with water inactivates fluoride |
| What is GINGIVOPLASTY? | perio sx to correct gingival deformities of contour not associated with pocketing |
| What is GINGIVECTOMY? | excision of excess gingival tissues to create a new gingival margin level and to adjust contour |
| When is reverse bevel gingivectomy indicated? | to reduce pocket depth in areas where limited attached gingiva is available and infrabony pockets are present |
| What other procedure is the reverse bevel incision indicated for? | creating releasing flaps |
| What is OSTEOPLASTY? | shaping of bone to restore physiologic contour without removing the walls of a pocket |
| What is OSTECTOMY? | removal of osseous defects and infrabony pockets by the removal of bony pocket walls |
| When are sliding/pedicle flaps used? | to cover root surfaces denuded of gingiva that have adjacent areas with adequate gingiva for movement |
| What is the benefit of using a partial thickness flap for a pedicle graft? | permits more rapid healing at the donor site |
| How much wider than the defect to be covered should a donor flap be made? | 1.5 times as wide |
| What are appropriate locations for vertical releasing incisions? | proximfacial or proximolingual line angle interradicular |
| What are NOT appropriate locations for vertical releasing incisions? | radicular midfacial interproximal |
| What is the minimum needed width of attached gingiva that must remain or be spared in considering gingival incisions? | 2mm |
| What is a common site with sufficient attached gingiva to use as a donor site for a free gingival graft? | upper or lower canines |
| What degree of donor tissue shrinkage during healing may be anticipated for a free gingival graft | 20% |
| What is the average time frame for uncomplicated healing of a free gingival graft? | 1 month |
| What tissue types are regenerated with Guided Tissue Regeneration? | bone cementum PDL |
| What are the 4 tissue types competing to be the first to repopulate a root surface? | Gingival epithelium gingival connective tissue alveolar bone PDL |
| What is the typical consequence of gingival connective tissue being the first to repopulate a root surface? | root resorption |
| What is the consequence if gingival epithelium is the first to repopulate a root surface? | formation of a long, weak junctional epithelium that is easily broken down to re-establish dz |
| What is the consequence if bone cells are the first to repopulate a root surface? | EITHER resorption or ankylosis |
| What is the ideal tissue to repopulate the root surface? | PDL, it is able to redevelop cementum and a healthy attachment may be generated |
| What does an OSSEOCONDUCTIVE product do? | Aid in the regeneration of new bone in an osseous site (all bone graft products have this quality) |
| What does an OSSEOINDUCTIVE product do? | will aid in the generation of bone in any site, regardless of the surrounding tissue (only demo'd by autogenous bone and BMP) |
| Where should the membrane barrier be placed for GTR? | between the instrumented root surface and the gingival flap to deter gingival cells from being the first to colonize the root surface |
| How long should GTR barriers be in place for optimal effect? | 28-42 days |
| List 4 sites where GTR would be appropriate | 1: class II furcation exposure 2: 2 or 3 walled vertical interproximal defects 3: 3 walled palatal defects of single root teeth 4: circumferential intrabony osseous defects |
| What patients are good candidates for GTR? | Those whose periodontal dz is under control and whose maintenance of plaque control is good |
| Why is tetracycline often chosen for dental tx? | effective against many oral pathogens gingival crevicular fluid concentration up to 10X serum levels matrix metalloproteinase inhibition stimulate fibroblast activity approximate the demineralizeing effect for which citric acid conditioning is used |
| What potent antimicrobial has dose dependent inhibition and toxicity to periodontal cells? | chlorhexidine |
| How long are non-absorbable GTR membranes left in place? | 1-9 months |
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lamarron
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