PDTCP TUTORIALS

• What site will require RSD?

  Sites 5mm or deeprer, or 4mm with bleeding
• What indications are required for continuing step 3 periodontal management?

  Continued Pt engagment: PI <20% BI <30%, presence of modifiable risk factors, pt attendance/motivation, sites 4mm and bleeding or 5mm or deeper, previous resoultion from previous RSD tx, radiographic evidence of bone loss, genetic disease
• How is healing of the periodontum achieved?

  RSD removes calculus and flushes bacterial biofilm withing the periodontal pockets to remove endotoxins, previously inhibiting fibroblasts. Now fibroblasts can act to recreate teh PDL. Slight reattachment of long junctional epithelium. Resolution og inflammation of gingivae leading to recession. Some resolution of bone at the base of pocket.
• You commence RSD and your patient requests LA. Within a few minutes of administering LA, Mr A starts to feel unwell. He continues to deteriorate with difficulty breathing and you note his lips start to swell. Discuss your diagnosis and medical management of the patient?

  Type 1 Hypersensitivity reaction, Anaphylaxis. STOP and get help.
• name systemic risk factors of perio?

  • diabetes
  • cardiovasular disease
  • smoking
  • obesity
  • hormones
  • stress
  • diet/nutrition
  • stress
  • haematological disorders
• local risk factors of perio and whether their acquired/developmental or iatrogenic?

  • smoking - aquired
  • overhangs/roughness/subgingival margins - iatrogenic
  • medications - aquired
  • HGF - development
  • Calculus - aquired
  • notched on root surface/open contacts - iatrogenic
  • crowding/canine fossa/open contacts - developmental
• local - within oral cavity

  systemic - full body
• what is a fistula?

  epithelial lined tract in which pus can drain from one body cavitity to another or from one organ to another
• five signs of acute inflammation?


  Redness, swelling, heat, pain, loss of function.
• 3 bacteria associated with orange complex?

  • prevotella intermedia
  • prevotella nigrescens
  • fusobacterium nucleatum
  • campylobacter rectus
  • selemonas constellatus
• definition of furcation involvement?

  loss of attachment/ perio disease that extends apically to expose space between roots of multi-rooted teeth
• tx opt for a pt with one lower molar tooth with grade 3 furcation involvement?

  • non-surgical - OHI, sub/supra gingival PMPR, RDS
  • surgical - tunnelling, root amputation, hemisection, premolarise and close furction, GTR?
• clinical features of an initial periodontal lesions?

  no clinical signs, maybe a presence of plaque?
• clinical features of an early perio lesion?

  • erythema
  • oedema
  • pitting on pressure
• clinical features of established lesion of perio?

  • erythema
  • oedema
  • bleeding on probing
• clinical features of advanced lesion of perio?

  • pocket formation
  • loss of attachment
  • abscess formation
  • pus excudate
  • bone loss
• name of the constituents of pus?

  white blood cells, dead/alive organisms, tissue debris, fibrin, pyogenic bacteria
• gingival recession?


  location of gingival margin apical to CEJ exposing the root surface
• most common cause of generalised gingival recession?

  periodontal disease
• most common anatomical cause of localised gingival recession?

  dehiscence
• what is dehiscence?

  isolated area of root is not covered by bone
• complication for probing depth?

  • calculus
  • incorrect probe
  • pt sensitivity
  • probing pressure
  • lack of vision - blood/saliva
  • access
  • root anatomy?
• 2 changes that might occur with overzealous tooth brushing?

  • recession
  • more fibrous
• clinical signs of acute herpatic gingivostomatitis?

  • red fiery gingivae
  • BOP
  • Halitosis
  • crops of vesicles with red halo
  • ruptured ulcers will coalesce
  • hyper salivation
• two salellites lesions in acute herpatic gingivostomatitis?

  • herpes labial
  • hepatic eczema
  • herpatic whitlow
• possible clinical appearance of desquamative gingivitis?

  • bright red, painful gingivae
  • bleeding
  • tenderness on probing
  • halitosis
  • ID papilla ulcerated
  • loss of stippling
  • ulcer covered with yellow/grey slough
  • high temp/ lymphadenopathy
• what is vit c important in gingival health?

  • antioxidant so mops up free radicals, inhibiting reactive O2 species
  • helps produce collagen in healing and granulation tissue
• true or false? relating to lateral periodontal abcess?

  • tooth usually vital - true
  • discharge usually at apex - false
  • gingival swelling - true
  • apical rarefaction - false
  • swelling before pain - true
  • gingival tenderness - true
• clinical appearance of gingival epulis?

  • red, fat gingival overgrowth
  • can be pedunculated or sessile
  • painless, may bleed
  • normally maxillary anterior region
• in drug induced gingival overgrowth which cells are most affected and what substance do they produce?

  • fibroblasts
  • collagen
• types of healing and their differences?

  • primary and secondary intention: same healing just on different area/type of wound
  • repair: replacement with granulation tissue forming scars
  • regeneration: replacement of similar tissue type by proliferation of surrounding undamaged cells
  • reconstitution: coordinated regeneration, several types of lost tissue eg whole organs
• in a healing skin wound, which layer of epithelium lines the wound and why?

  • stratum germinativum
  • only layer than can carry out mitosis
• which type of immunoglobin is prevalent in saliva?

  IgA
• what is a sialogogue? Implications and example

  • A substance that stimulates saliva production.
  • where glandular function remains
  • sugar free gum
• Systemic condition that change electrolyte balance of saliva leading to hyposalivation/xerostomia?

  • temporary - dehydrations, drugs, trauma,
  • perm - lupus, diabetes, reynounds, parkinsons
• hyperplasia - increase in cell number, not increase in size, no change in shape
• hypertrophy: the enlargement of an organ or tissue from the increase in size of its cells
• 3 clinical factors affecting recal of a perio pt?

  • risk factors
  • ohi and motivation
  • stability?
• aetiology?


  The study of causation or origins of diseases.
• factors that delay wound healing?

  • smoking
  • infection
  • lack of vit c
  • movement
  • glucocoriticosteriors