Compre Perio questions

• Qualifications for gingivitis to be periodontitis include a susceptible host, virulent pathogens, and a local environment that allows anaerobic bacteria to increase.
• The 6 sides we check for periodontitis are the gingiva, bone, probing depth, attachment level, and radiographs.
• Types of bacterias in the oral flora include Streptococcus, Eubacteria, Fusobacterium, Capnocytophaga, Eubacteria, Staphylococcus, Eikenella, Porphyromona, Leptotrichia, Prevotella, Peptostreptococcus, Treponema, Actinomyces genera.
• Aerobic bacteria require oxygen for their growth and survival, utilizing it in their metabolic processes, such as respiration.
• Anaerobic bacteria thrive in environments without oxygen and can even be harmed or killed by its presence.
• Anaerobic bacteria utilize alternative processes, such as fermentation, to generate energy.
• Gram + bacteria becomes - due to the acquisition of genes that encode for components of the Gram-negative cell wall, such as lipopolysaccharides (LPS) and outer membrane proteins.
• Gingiva follows the contour of the bones due to their close anatomical relationship.
• The gingiva is supported by the alveolar processes of the upper and lower jaws, which are bony structures that hold the teeth.
• The gingiva adapts to the underlying bone to provide support and protection to the teeth.
• The alignment of the gingiva with the underlying bone is crucial for the overall health and stability of the teeth within the oral cavity.
• Any disruptions in the relationship between the gingiva and the underlying bone, such as periodontal diseases, can impact the supportive structures and lead to dental issues.
• Periodontitis results in loss of collagen and alveolar bone with deepening periodontal pockets.
• Components of the extracellular matrix of the gingiva and periodontal ligament are destroyed during periodontitis.
• Alveolar bone is resorbed during periodontitis.
• The pathogenesis of periodontitis involves an acute bacterial challenge phase, an acute inflammatory response phase, an immune response phase, and a regulation and resolution phase.
• it means it might not progress further

  Regulation and Resolution phase
• Qualification for gingivitis to be periodontitis


  Susceptible Host, Viral Pathogens, Local Environment
• What are the gram negative bacteria in periodontitis?

  Aggregatibacter actinomycetecomitans, P Gingivalis, T. Forsynthia
• What causes indirect tissue destruction

  Protein antigens and lipoolysaccharide
• Staging and grading for periodontitis involves categorizing the severity and extent of the disease based on clinical and radiographic findings. Staging refers to the extent and severity of periodontitis, while grading evaluates the risk factors and potential progression of the disease. This classification system helps in determining appropriate treatment plans and monitoring the progression of periodontal disease over time.
• Stage I: Early Periodontitis

     stage I is Mild periodontal destruction with minimal clinical attachment loss (< 25% of sites and Probing depths typically range from 1-2 mm with slight bleeding on probing.
• Stage II: Moderate Periodontitis. this is a Moderate periodontal destruction with moderate clinical attachment loss (25-50% of sites) and Probing depths increase to 3-4 mm with bleeding on probing and possible tooth mobility.
• Stage III: Severe Periodontitis with Potential for Tooth Loss

     - Severe periodontal destruction with significant clinical attachment loss (> 50% of sites).

     - Probing depths are typically 5 mm or greater with evidence of tooth mobility, furcation involvement, and potential tooth loss.
• Stage IV periodontitis is Advanced Periodontitis with Extensive Tooth Loss, Advanced periodontal destruction with extensive clinical attachment loss and tooth loss, Probing depths are often 6 mm or greater with severe bone loss and significant tooth mobility and This stage may involve the loss of multiple teeth and compromised function.
• Grade A: Slow Rate of Progression

  • Low risk of progression and attachment loss.

  • No or minimal loss of supporting structures.

  • Non-smoker or former smoker who quit more than 10 years ago.
• Grade B: Moderate Rate of Progression

  • Moderate risk of progression and attachment loss.

  • Some loss of supporting structures.

  • Current smoker or former smoker who quit within the past 10 years.
• Grade C: Rapid Rate of Progression

  • High risk of progression and attachment loss.

  • Significant loss of supporting structures.

  • Current smoker or former smoker who quit within the past 10 years with additional risk factors.
• Horizontal bone loss consists of a horizontal loss in the alveolar bone's height; i.e., the tissue destruction is symmetrical. Radiographically, vertical bone loss can be identified as a deformity in the alveolus extending apically along the root of the affected tooth from the alveolar crest.
• Horizontal bone loss consists of a horizontal loss in the alveolar bone’s height; i.e., the tissue destruction is symmetrical. Radiographically, vertical bone loss can be identified as a deformity in the alveolus extending apically along the root of the affected tooth from the alveolar crest.
• Porphyromonas gingivalis (formerly Bacteroides gingivalis), Tannerella forsythia (formerly Bacteroides forsythus), and Treponema denticola, otherwise known as the "red complex," are frequently associated with ongoing attachment and bone loss in chronic periodontitis
• Peri- odontitis is an age-associated, not an age-related, disease' In other words, it is not the age of the individual that causes the increase in disease prevalence, but rather the length of time that the periodontal tissues are challenged by chronic plaque accumulation
• Slight (mifd) periodontitis: Periodontal destruction is generally considered slight when no more than 1 to 2 mm of clinical attachment loss has occurred.

  Moderate periodontitis: Periodontal destruction is generally considered moderate when 3 to 4 mm of clinical attachment loss has occurred.

  Severe periodontitis: Periodontal destruction is considered severe when 5 mm or more of clinical attachment loss has occurred.
• Localized Aggressive Periodontitis (LAP): Localized aggressive periodontitis affects individuals between the ages of 16 and 30 years old. It is characterized by rapid attachment loss and bone resorption affecting one or two teeth at a time. The etiology of LAP is multifactorial, including genetic susceptibility, hormonal changes, and environmental factors such as smoking.
• Generalized Aggressive Periodontitis (GAP): Generalized aggressive periodontitis is similar to localized aggressive periodontitis except that multiple sites throughout the mouth are involved simultaneously. GAP also tends to affect younger patients, typically those under the age of 30 years old.
• chronic periodontitis when they notice that their gums bleed when brushing or eating; that spaces occur between their teeth as a result of tooth movement; or that teeth have become loose
• The red complex consists of P. gingivalis, Tannerella forsythia, andTieponema denticola. This complex is of particular interest because it is associated with bleeding on probing, which is an important clinical parameter of destructive periodontal disease
• The objective of Phase I

  therapy is to alter or eliminate the microbial etiology and contributing factors for gingival and periodontal diseases
• Phase I therapy for every patient is effective plaque control. Plaque control is the key objective of every therapeutic periodontal procedure, but it can be effectively accomplished only if the tooth surfaces are free of rough deposits and irregular contours so that they are readily accessible to oral hygiene aids