PERIO2 - MT REVIEWER

86問 • 2年前

Kel Sy

通報

問題一覧

Deepening and conversion of normal gingival sulcus; important clinical feature of periodontal disease.

Periodontal Pocket

V-shaped shallow crevice around tooth bounded by tooth surface and epithelium lining of free marginal gingiva.

Gingival Sulcus

Probing depth of a normal gingival sulcus.

0.5 to 3mm

Histologic section of gingival sulcus.

1.8mm with variations from 0 to 6mm

Acts as physical barrier against plaque bacteria; stratified squamous non-keratinized in nature which develops by union of oral epithelium and reduced enamel epithelium.

Junctional Epithelium

Junctional epithelium is attached to the ________ by internal basal lamina and to ________ by external basal lamina.

Tooth and Connective Tissue

Junctional epithelium exhibits _______ permeability to cells,gingival fluid, and host-defense molecule to flow through.

Higher

Periodontal pocket is due to __________ of junctional epithelium, accompanied by attachment loss.

Apical Migration

What are the shared histopathological features of periodontal pockets?

Tissue changes in periodontal pocket, Mechanism of tissue destruction, Healing Mechanism

What are the difference of periodontal pockets?

Etiology, Natural History Progression, Response to therapy

Formed by gingival enlargement without destruction of the underlying periodontal tissue; deepened due to increased bulk of gingiva.

Gingival Pocket

Produces destruction of supporting periodontal tissues leading to loosening and tooth exfoliation.

Periodontal Pocket

What are the two sub-classification of periodontal pocket?

Suprabony/Supracrestal/Supraalveolar, Intrabony/Infrabony/Subcrestal/Intraalveolar

Sub-classification of periodontal pocket that is chronic and horizontal; occurs when bottom of the pocket is coronal to alveolar bone.

Suprabony

Sub-classification of periodontal pocket that is aggressive and vertical; occurs when bottom of pocket is apical to alveolar bone.

Intrabony

Can involve one, two or more tooth surfaces and can be of different depths and types.

Pocket

What are the clinical signs suggesting presence of periodontal pocket?

Bluish-red thickened marginal gingiva, Bluish-red vertical zone from gingival margin to alveolar mucosa, Tooth mobility, Gingival bleeding and suppuration, Diastema formation

Only reliable method of locating periodontal pockets and determining their extent is careful probing of gingival margin along each tooth surface.

True

On the basis of depth alone, it is easy to differentiate deep normal sulcus and shallow periodontal pockets.

False

Early concepts of a pocket assumed that after ______ bacterial attack, periodontal tissue destruction continued to be linked to bacterial action.

Initial

Host's immunoinflammatory response to the initial and persistent bacterial attack unleashed mechanism that leads to destruction of ______ and ______.

Bone and Collagen

The mechanism of pocket are related to various ________.

Cytokines

What are the cells that are involved in inflammatory process?

Polymorphonuclear Leukocytes, Monocytes

What are the mechanism for collagen loss?

Polymorphonuclear Leukocytes, Fibroblasts, Macrophage Secreted Collagenase, Cytokines, Prostaglandins, Matrix Metalloproteinases

Group of proteases involved in degradation of proteins in extracellular matrix.

Matrix Metalloproteinases

Inhibited for balance and maintenance of ECM remodelling tissue including periodontium.

Tissue Inhibitor of Metalloproteinases

Result of inflammation when PMNs invade coronal end of junctional epithelium in increasing number.

Pocket Formation

Tissue loses cohesiveness and detaches from tooth surface shift when relative volume of PMNs reaches approximately _____ or more.

60%

When filaments, rods, and coccoid organism with predominant gram-negative cell walls have been found in intracellular epithelium spaces.

Bacterial Invasion

What are present in gingival of aggressive periodontitis cases?

Porphyromonsas Gingivalis, Prevotella Intermedia

Found in tissue during bacterial invasion.

Aggregatibacter Actinomycetemcomitans

Bacteria may invade intracellular space and are also found in extracellular epithelial cells as well as basement lamina.

False

Some bacteria transverse the basement lamina and invade the sub-epithelial connective tissue.

True

After pocket is formed, several microscopic features are present.

True

Are present in cementum walls of periodontal pockets that induced morphologic changes and areas of collagen degeneration.

Endotoxins

What are the areas of collagen degeneration?

Relative Quiescence, Bacterial Accumulation, Emergence of Leukocytes, Leukocyte-Bacteria Interaction, Intense Epithelial Desquamation, Ulceration, Hemorrhage

An area that shows relatively flat gingival surface with minor depression.

Relative Quiescence

An area that has abundant debris and bacterial clumps.

Bacterial Accumulation

Designed for specific purposes such as removing calculus, planing, and curetting.

Periodontal Instruments

Check all parts of a periodontal instruments.

Blade, Shank, Handle

T or F. An instrument weight suggests that an optimal weight of a periodontal instrument is 15g or less.

True

T or F. Lightweight instruments place more stress on the muscle of the hand.

False

T or F. Optimal handle diameter for periodontal instruments and mirror is 10mm.

True

T or F. Small diameter handles are 5mm that requires more pinch force.

False

T or F. Large diameter handles are 10mm and padded handles requires the least pinch force.

True

A shank that is bent in one plane used primarily on anterior teeth.

Simple Shank Design

A shank that is bent in two planes used primarily around posterior crown and root.

Complex Shank Design

The instrument shank extends from below the __________ to __________ of the instrument handle.

Working End - Junction

Simple shank with short functional length.

For supragingival use on anterior teeth.

Simple shank with long functional length.

For subgingival use on anterior teeth.

Complex shank with short functional length.

For supragingival use on posterior teeth.

Complex shank with long functional length.

For subgingival use on posterior teeth.

T or F. The design and number are not usually seen on the handle but on its plastic.

False

T or F. A double-ended instrument will have two design numbers.

True

Use to measure the pocket depths to determine their configuration; inserted to pocket base with firm gentle pressure aligned with the long axis of the tooth.

Periodontal Probe

Used to remove calculus deposits from the crowns; has flat surface and two cutting edges inserted under ledges more than 1mm.

Sickle Scaler

Sickle scales is used with a ______ stroke.

Pull

An instrument of choice used to remove calculus deposits from the crowns and roots;

Curettes

Check the two basic type of curettes.

Universal, Area-Specific

When a dental professional alter his or her body position or equipment in a manner that is uncomfortable or painful just to get the job results in ________ stress.

Musculoskeletal

T or F. A mindset that is acceptable to assume an uncomfortable position just for 15minutes while performing periodontal instrumentation is destined to lead to MSD's.

True

T or F. Pain and injury result when body's natural spinal curves are in a seated position.

False

T or F. The inflammatory response to the bacterial biofilm insult has detrimental effects on the periodontal unit which result in the destruction of the periodontal ligament fibers and bone loss.

True

_______ is the ultimate and last consequence of the inflammatory process observed in periodontitis.

Bone Loss

T or F. The degree of bone loss necessarily correlates with the depth of periodontal pockets, severity of ulceration, presence or absence of exudate.

False

T or F. Pseudo means False.

True

T or F. Normal gingival pocket is 4mm.

False

Check all that affects the modification of the extension of inflammatory process into supporting structure.

Pathogenic Potential of Biofilm, Susceptibility/Resistance of the Host

Most common pattern; bone is reduced but remains perpendicular; acute.

Horizontal Bone Loss

Occurs in oblique direction leaving a hollowed-out; apical; has accompanying infrabony pockets.

Vertical or Angular Defects

Check the mechanism of bone destruction.

Bacterial Mediated, Host Mediated

Mechanism where products induce the differentiation of bone progenitor cells into osteoclasts and stimulate gingival cells to release mediators that has the same effect.

Bacterial Mediated

Mechanism released by inflammatory cells that are capable of inducing bone resorption.

Host Mediated

Check all the host factors released by inflammatory cells.

Prostaglandins, Interleukin-1a, Interleukin-B, Tumor Necrosis Factor Alpha

T or F. Trauma from occlusion may aggravate the bone destruction caused by inflammation when combined.

True

Changes caused by trauma from occlusion vary from _______ compression and tension of periodontal ligament and ______ osteoclasis of alveolar bone to necrosis.

Increase - Increase

I'm the absence of inflammation, the localized bone loss caused by trauma from occlusion is _______.

Reversible

Check all factors determining bone morphology in periodontal disease.

Thickness, width, and crystal angulation of the interdental septa., Thickness of the facial and lingual alveolar plates., Presence of fenestration and dehiscences., Alignment of the teeth., Root and root trunk anatomy., Root position within alveolar process., Proximity with another tooth surface.

Defects that cannot form in thin facial or lingual alveolar plates which has little or no cancellous bone between outer and inner cortical layer.

Angular Osseous

Refers to the invasion of the bifurcation and trifurcation of multirooted teeth by periodontitis.

Furcation Involvement

Extension of the inflammation into the bone promotes _______ and _______ in bone height and leads to furcation being unveiled.

Resorption - Reduction

Used to determine the extent of furcation involvement.

Nabers Probe

Early stage; suprabony pocket primarily affects soft tissues; unseen radiographic changes.

Grade I

Cul-de-sac furcation with a definite horizontal component particularly with max. molar; radiographic overlap of root.

Grade II

Opening may be filled with soft tissue but is not visible; properly exposed.

Grade III

Interdental bone is destroyed; visible tunnel or opening.

Grade IV

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問題一覧

Deepening and conversion of normal gingival sulcus; important clinical feature of periodontal disease.

Periodontal Pocket

V-shaped shallow crevice around tooth bounded by tooth surface and epithelium lining of free marginal gingiva.

Gingival Sulcus

Probing depth of a normal gingival sulcus.

0.5 to 3mm

Histologic section of gingival sulcus.

1.8mm with variations from 0 to 6mm

Acts as physical barrier against plaque bacteria; stratified squamous non-keratinized in nature which develops by union of oral epithelium and reduced enamel epithelium.

Junctional Epithelium

Junctional epithelium is attached to the ________ by internal basal lamina and to ________ by external basal lamina.

Tooth and Connective Tissue

Junctional epithelium exhibits _______ permeability to cells,gingival fluid, and host-defense molecule to flow through.

Higher

Periodontal pocket is due to __________ of junctional epithelium, accompanied by attachment loss.

Apical Migration

What are the shared histopathological features of periodontal pockets?

Tissue changes in periodontal pocket, Mechanism of tissue destruction, Healing Mechanism

What are the difference of periodontal pockets?

Etiology, Natural History Progression, Response to therapy

Formed by gingival enlargement without destruction of the underlying periodontal tissue; deepened due to increased bulk of gingiva.

Gingival Pocket

Produces destruction of supporting periodontal tissues leading to loosening and tooth exfoliation.

Periodontal Pocket

What are the two sub-classification of periodontal pocket?

Suprabony/Supracrestal/Supraalveolar, Intrabony/Infrabony/Subcrestal/Intraalveolar

Sub-classification of periodontal pocket that is chronic and horizontal; occurs when bottom of the pocket is coronal to alveolar bone.

Suprabony

Sub-classification of periodontal pocket that is aggressive and vertical; occurs when bottom of pocket is apical to alveolar bone.

Intrabony

Can involve one, two or more tooth surfaces and can be of different depths and types.

Pocket

What are the clinical signs suggesting presence of periodontal pocket?

Bluish-red thickened marginal gingiva, Bluish-red vertical zone from gingival margin to alveolar mucosa, Tooth mobility, Gingival bleeding and suppuration, Diastema formation

Only reliable method of locating periodontal pockets and determining their extent is careful probing of gingival margin along each tooth surface.

True

On the basis of depth alone, it is easy to differentiate deep normal sulcus and shallow periodontal pockets.

False

Early concepts of a pocket assumed that after ______ bacterial attack, periodontal tissue destruction continued to be linked to bacterial action.

Initial

Host's immunoinflammatory response to the initial and persistent bacterial attack unleashed mechanism that leads to destruction of ______ and ______.

Bone and Collagen

The mechanism of pocket are related to various ________.

Cytokines

What are the cells that are involved in inflammatory process?

Polymorphonuclear Leukocytes, Monocytes

What are the mechanism for collagen loss?

Polymorphonuclear Leukocytes, Fibroblasts, Macrophage Secreted Collagenase, Cytokines, Prostaglandins, Matrix Metalloproteinases

Group of proteases involved in degradation of proteins in extracellular matrix.

Matrix Metalloproteinases

Inhibited for balance and maintenance of ECM remodelling tissue including periodontium.

Tissue Inhibitor of Metalloproteinases

Result of inflammation when PMNs invade coronal end of junctional epithelium in increasing number.

Pocket Formation

Tissue loses cohesiveness and detaches from tooth surface shift when relative volume of PMNs reaches approximately _____ or more.

60%

When filaments, rods, and coccoid organism with predominant gram-negative cell walls have been found in intracellular epithelium spaces.

Bacterial Invasion

What are present in gingival of aggressive periodontitis cases?

Porphyromonsas Gingivalis, Prevotella Intermedia

Found in tissue during bacterial invasion.

Aggregatibacter Actinomycetemcomitans

Bacteria may invade intracellular space and are also found in extracellular epithelial cells as well as basement lamina.

False

Some bacteria transverse the basement lamina and invade the sub-epithelial connective tissue.

True

After pocket is formed, several microscopic features are present.

True

Are present in cementum walls of periodontal pockets that induced morphologic changes and areas of collagen degeneration.

Endotoxins

What are the areas of collagen degeneration?

Relative Quiescence, Bacterial Accumulation, Emergence of Leukocytes, Leukocyte-Bacteria Interaction, Intense Epithelial Desquamation, Ulceration, Hemorrhage

An area that shows relatively flat gingival surface with minor depression.

Relative Quiescence

An area that has abundant debris and bacterial clumps.

Bacterial Accumulation

Designed for specific purposes such as removing calculus, planing, and curetting.

Periodontal Instruments

Check all parts of a periodontal instruments.

Blade, Shank, Handle

T or F. An instrument weight suggests that an optimal weight of a periodontal instrument is 15g or less.

True

T or F. Lightweight instruments place more stress on the muscle of the hand.

False

T or F. Optimal handle diameter for periodontal instruments and mirror is 10mm.

True

T or F. Small diameter handles are 5mm that requires more pinch force.

False

T or F. Large diameter handles are 10mm and padded handles requires the least pinch force.

True

A shank that is bent in one plane used primarily on anterior teeth.

Simple Shank Design

A shank that is bent in two planes used primarily around posterior crown and root.

Complex Shank Design

The instrument shank extends from below the __________ to __________ of the instrument handle.

Working End - Junction

Simple shank with short functional length.

For supragingival use on anterior teeth.

Simple shank with long functional length.

For subgingival use on anterior teeth.

Complex shank with short functional length.

For supragingival use on posterior teeth.

Complex shank with long functional length.

For subgingival use on posterior teeth.

T or F. The design and number are not usually seen on the handle but on its plastic.

False

T or F. A double-ended instrument will have two design numbers.

True

Use to measure the pocket depths to determine their configuration; inserted to pocket base with firm gentle pressure aligned with the long axis of the tooth.

Periodontal Probe

Used to remove calculus deposits from the crowns; has flat surface and two cutting edges inserted under ledges more than 1mm.

Sickle Scaler

Sickle scales is used with a ______ stroke.

Pull

An instrument of choice used to remove calculus deposits from the crowns and roots;

Curettes

Check the two basic type of curettes.

Universal, Area-Specific

When a dental professional alter his or her body position or equipment in a manner that is uncomfortable or painful just to get the job results in ________ stress.

Musculoskeletal

T or F. A mindset that is acceptable to assume an uncomfortable position just for 15minutes while performing periodontal instrumentation is destined to lead to MSD's.

True

T or F. Pain and injury result when body's natural spinal curves are in a seated position.

False

T or F. The inflammatory response to the bacterial biofilm insult has detrimental effects on the periodontal unit which result in the destruction of the periodontal ligament fibers and bone loss.

True

_______ is the ultimate and last consequence of the inflammatory process observed in periodontitis.

Bone Loss

T or F. The degree of bone loss necessarily correlates with the depth of periodontal pockets, severity of ulceration, presence or absence of exudate.

False

T or F. Pseudo means False.

True

T or F. Normal gingival pocket is 4mm.

False

Check all that affects the modification of the extension of inflammatory process into supporting structure.

Pathogenic Potential of Biofilm, Susceptibility/Resistance of the Host

Most common pattern; bone is reduced but remains perpendicular; acute.

Horizontal Bone Loss

Occurs in oblique direction leaving a hollowed-out; apical; has accompanying infrabony pockets.

Vertical or Angular Defects

Check the mechanism of bone destruction.

Bacterial Mediated, Host Mediated

Mechanism where products induce the differentiation of bone progenitor cells into osteoclasts and stimulate gingival cells to release mediators that has the same effect.

Bacterial Mediated

Mechanism released by inflammatory cells that are capable of inducing bone resorption.

Host Mediated

Check all the host factors released by inflammatory cells.

Prostaglandins, Interleukin-1a, Interleukin-B, Tumor Necrosis Factor Alpha

T or F. Trauma from occlusion may aggravate the bone destruction caused by inflammation when combined.

True

Changes caused by trauma from occlusion vary from _______ compression and tension of periodontal ligament and ______ osteoclasis of alveolar bone to necrosis.

Increase - Increase

I'm the absence of inflammation, the localized bone loss caused by trauma from occlusion is _______.

Reversible

Check all factors determining bone morphology in periodontal disease.

Defects that cannot form in thin facial or lingual alveolar plates which has little or no cancellous bone between outer and inner cortical layer.

Angular Osseous

Refers to the invasion of the bifurcation and trifurcation of multirooted teeth by periodontitis.

Furcation Involvement

Extension of the inflammation into the bone promotes _______ and _______ in bone height and leads to furcation being unveiled.

Resorption - Reduction

Used to determine the extent of furcation involvement.

Nabers Probe

Early stage; suprabony pocket primarily affects soft tissues; unseen radiographic changes.

Grade I

Cul-de-sac furcation with a definite horizontal component particularly with max. molar; radiographic overlap of root.

Grade II

Opening may be filled with soft tissue but is not visible; properly exposed.

Grade III

Interdental bone is destroyed; visible tunnel or opening.

Grade IV