Shared Flashcard Set

Details

perio
perio
296
Dentistry
Undergraduate 1
02/11/2013

Additional Dentistry Flashcards

 


 

Cards

Term
Components of the periodontium that can be identified radiographically
Definition
include the alveolar bone, periodontal ligament space, lamina dura, and cementum.
Term
Cortical Bone
Definition
Maxilla—The bone is a thin shell.

Mandible—The bone is dense; appears as a thick white border.

Interdentally as a thin white line

Lattice-like filling interior p
Term
Crest of the Alveolar Bone
Definition
If the coronal bone level is within 3 mm of the CEJ, it is considered normal.The normal level is about 2 mm apical to the CEJ.It is difficult to detect bone loss on radiograph if the bone loss is less than 3 mm.
Term
Lamina Dura
Definition
Thin layer of dense bone that lines a normal tooth socket
Appears as a continuous white line around the tooth root
Radiographically, it is continuous with
Term
Periodontal Ligament Space
Definition
Functions as an attachment of the tooth to the lamina dura of the socket
Appears as a thin radiolucent line surrounding the tooth root
A widening of PDL space on radiograph indicates
Term
What are the benefits of using radiographs in a periodontal examination?
Definition
Tooth root morphology Relationship of the maxillary sinus to the periodontal deBony changes caused by diseaseformity
Widening of the PDL space
Advanced furcation involvement
Term
Radiographic Signs of Periodontal Disease
Definition
Early bony changes
Horizontal bone loss,Vertical bone loss,Bone defects
Furcation involvement
Term
triangulations
Definition
Widening of the PDL space caused by bone resorption on either the mesial or the distal of the interdental crestal bone
Term
Interseptal Bone Changes
Definition
Finger-like radiolucent projections extending from the crestal bone into the interdental alveolar bone,Represent a reduction of mineralized tissue adjacent to blood vessel channels in the alveolar bone
Term
Assessment of Furcation Involvemen
Definition
Is not seen on the radiograph until the bone resorption extends past the furcation area

Easier to see on mandibular than maxillary
Maxillary palatal root appears superimposed over furcation of the tooth.
Furcation involvement often is greater than it appears on the radiograph
Term
Recognizing Other Local Risk Factors
Definition
Faulty restorations
Calculus deposits
Trauma from occlusion
Term
Epidemiology
Definition
study of the health & disease within the total population rather than an individual
Term
Epidemiologist
Definition
study periodontal disease to determine its occurrence in the population & to identify risk factors for periodontal disease
Term
Prevalence
Definition
refers to the number of all cases both old & new of a disease that can be identified within a specified population at a given point in time
Term
Incidence
Definition
number of new disease cases in a population that occur over a given period of time - only new cases
Term
variables associated with the prevalence of disease
Definition
gender, education, age, access to dental care
Term
community & periodontal index of treatment needs (CPITN)
Definition
assesses probing depths & bleeding; developed to attain more uniform worldwide epidemiologic data; maybe used for measuring group periodontal needs
Term
Eastman interdental bleeding index (EIBI)
Definition
assess presence of inflammation & bleeding in the interdental area upon toothpick insertion
Term
gingival bleeding index (GBI)
Definition
assess presence of gingival inflammation by bleeding from interproximal sulcus wihtin 10 seconds of flossing
Term
gingival index (GI)
Definition
assesses severity of gingivitis based on color, consistency, & bleeding on probing
Term
periodontal screening & recording (PSR)
Definition
assesses periodontal health in a rapid manner including probing depths, bleeding & presence of hard deposits
Term
assessments can include:
Definition
soft tissue color, tissue swelling, loss of periodontal ligaments, loss of alveolar bone, bleeding upon probing, spontaneous bleeding, probing depths
Term
three main bacteria for perio
Definition
aggergatibacter actinomtcetemcomitans
tannerella forsythia
porphyromonas gingivalis
Term
how many bacteria with gingivitis
Definition
1,000-100,000 gram-negative 40%
Term
how many bacteria in perio
Definition
100,000-100,000,000 74% gram-neg
Term
anatomic areas(gingiva)
Definition
attached,free,interdental,gingival sulcus
Term
pathogenic
Definition
bac capable of causing harm
Term
gram-neg
Definition
double cell membranes
belived to play an imporant role in inflammatory perio
Term
aerobic bacteria
Definition
requires o2 to live
Term
anaerobic bac
Definition
can not live in the presents of O2
Term
facultative anaerbic bac
Definition
can exist with or without O2
Term
free floating bacteria
Definition
planktonic
Term
attached bac
Definition
more then 99% of all bac on earth are
Term
biofilm
Definition
a living film,well organized,organism and debris,anywere in nature,have a major onhuman life
Term
extracellular slim layer
Definition
a shield protecting the bac from antibiotices,antimicrobials, and the body immune system
Term
g.a.p
Definition
horizontal bone loss
Term
G.P.A
Definition
vertical boneloss
Term
what is cementun to enamale over lap
meet
gap
Definition
60%
30%
10%
Term
What is the HOST IMMUNE RESPONSE to periodontal pathogens?
Definition
The way that the body responds to periodontal pathogens is known as the
Term
what is the prime prurpose of the human immune system?
Definition
The prime purpose of the human immune system is to defend the life of the individual (host)
Term
The body’s defenses are employed
Definition
to save the life of the host,
NOT to preserve the tooth or its supporting periodontal tissues.
Term
Biochemical mediators
Definition
are biologically active compounds secreted by the immune cells that activate the body’s inflammatory response
Term
Inflammatory mediators of importance in periodontal disease are:
Definition
Prostaglandins Cytokine
Matrix metalloproteinases (MMPs)
Term
cytokines
Definition
Influence the behavior of other cells
Powerful mediators produced by immune cells
Signal to the immune system to send more phagocytes to site of infection
Term
Functions of Cytokines
Definition
Recruit cells (PMNs and macrophages) to infection site

Increase vascular permeability that increases movement of immune cells into the tissues

Can initiate tissue destruction and bone loss in chronic infections, such as periodontal disease
Term
prostaglandins
Definition
Powerful inflammatory mediators

Series of prostaglandins—D, E, F, G, H, I

Most cells can produce prostaglandins
Term
funtions of the prostaglandins
Definition
Increase permeability and dilatation of blood vessels to promote increased movement of immune cells and complement to the infection site

Trigger osteoclasts—bone-consuming cells—to destroy the alveolar bone
Term
Functions of Prostaglandins (cont.)
Definition
Promote the overproduction of destructive MMP enzymes

Prostaglandins of the E series (PGE) initiate most of the alveolar bone destruction in periodontitis.
Term
Matrix Metalloproteinases (MMPs)
Definition
Produced by various cells of the body—PMNs, macrophagFamily of at least 12 different enzymeses, fibroblasts, JE cells

Enzymes act together to breakdown connective tissue matrix

Doxycycline- inhibit MMP-Periostat
Term
Function of MMPs in Health
Definition
In health, MMPs facilitate normal turnover of the periodontal connective tissue matrix.
Term
MMPs—Chronic Bacterial Infection
Definition
MMPs are released in an attempt to kill invading bacteria.

Overproduction of MMPs results in breakdown of connective tissue of the periodontium
Term
Host Response
Definition
In periodontal disease, the immune system fights to defend the body from periodontal pathogens, NOT to preserve the periodontium or teeth.

It is the body’s response to the periodontal pathogens that is the cause of nearly all the destruction seen in periodontitis.
Term
Cytokines—
Definition
—recruit PMNs and macrophages to the infection site
Term
Prostaglandins
Definition
—increase vascular permeability allowing immune cells and complement to move to the infection site
Term
MMPs—
Definition
—facilitate normal turnover of the connective tissue matrix
Term
Cytokines
Definition
—initiate tissue destruction and bone loss
Term
Prostaglandins
Definition
—alveolar bone destruction
Term
Does a bacterial infection of the periodontium always result in periodontitis?
Definition
No
Term
What role does the immune system play in tissue destruction?
Definition
causes tissue destruction in an attempt to stop bacterial infection
Term
Intensity of immune response to periodontal pathogens varies considerably from one individual to another.T/F
Definition
T
Term
Local immune response can vary in intensity from site to site within a patient’s mouth.T/F
Definition
T
Term
Some people with abundant bacterial plaque exhibit only mild disease T/F
Definition
T
Term
Others with light bacterial plaque suffer severe disease. T/F
Definition
T
Term
Untreated gingivitis does not always lead to periodontitis. T/F
Definition
T
Term
will Everyone infected with pathogens get periodontal disease?
Definition
No
Term
The Host Response
Definition
Pathogenic bacteria infect the periodontium.

The body responds by mobilizing defensive cells.

Cells release a series of chemicals to fight bacteria.
Term
Complex interactions between periodontal pathogens and host response determine ?.
Definition
the onset and severity of periodontal disease.
Term
Early bacterial accumulation phase
Definition
Early gingivitis—plaque overgrowth phase

Established gingivitis—subgingival plaque phase

Periodontitis—tissue destruction phase
Term
Early gingivitis—
Definition
—plaque overgrowth phase
Term
Established gingivitis—
Definition
—subgingival plaque phase
Term
Periodontitis—
Definition
s—tissue destruction phase
Term
Early Bacterial Accumulation Phase
Definition
Bacteria colonize the tooth near the gingival margin.
Bacteria initiate host response.
PMNs pass from bloodstream into the gingival connective tissue.
PMNs release cytokines that destroy gingival connective tissue, allowing PMNs to move quickly through the tissue.
PMNs migrate into the sulcus and phagocytize bacteria
Term
Early Gingivitis—Plaque Overgrowth Phase
Definition
Bacteria penetrate into the connective tissue.
More PMNs are attracted to the site; they release more cytokines causing more localized destruction of the connective tissue.
Macrophages are recruited to the connective tissue. They release cytokines, PGE2, and MMPs.
Term
Established Gingivitis—Subgingival Plaque Phase
Definition
Plaque biofilm extends subgingivally and disrupts the attachment of the coronal-most portion of the JE.
Macrophages and lymphocytes are most numerous in the connective tissue; PMNs continue to fight bacteria in the sulcus.
Host cells produce more toxic chemicals—cytokines, PGE2, and MMPs.
Term
Periodontitis—Tissue Destruction Phase
Definition
Plaque biofilm grows along the root surface.
The immune response becomes chronic; intense inflammation begins to harm the periodontium.
Cytokines destroy the connective tissue and PDL fibers.
Cytokines, PGE2, and MMPs destroy the connective tissue and bone.
PGE2 initiates bone
Term
Mechanisms of
Alveolar Bone Destruction
Definition
Macrophages produce cytokines, PGE2, and MMPs.
These mediators stimulate fibroblasts to secrete PGE2 and MMP.
Mediators from the macrophages and fibroblasts result in destruction of the connective tissue.
PGE2 stimulates osteoclasts to resorb the crest of the alveolar bone
Term
Periodontal disease
Definition
is a bacterial infection of the periodontium.
Term
The presence of bacteria, ?
Definition
, however, does not necessarily mean that an individual will experience periodontitis.
Term
the bodys defense mechanism is
Definition
referred to as the host defense.
Term
For the periodontium to remain healthy,
Definition
the bacterial infection must be controlled so as not to trigger a chronic, exaggerated host immune response
Term
The body’s immune response to the bacteria causes
Definition
most of the tissue destruction in the periodontal tissues
Term
What are the characteristics of the gingival tissues in health?
Definition
Healthy tissue is free of inflammation and has not been altered by disease or trauma
Term
What are the characteristics of the gingival tissues in gingivitis?
Definition
Plaque biofilm at the gingival margin stimulates the host immune response.

Inflammatory response to bacteria results in clinical changes.

Changes involve free and attached gingiva and papilla.
Term
Acute gingivitis—
Definition
—short duration; resolves upon professional and good self-care
Term
Chronic gingivitis—
Definition
—may exist for years without ever progressing to periodontitis; resolves upon professional and good self-care
Term
Acute gingivitis—
Definition
—increased blood flow causes tissue to appear bright red
Term
Chronic gingivitis
Definition
—tissue appears bluish red or purplish red
Term
Size in Gingivitis
Definition
Increased tissue fluid enlarges marginal and interproximal gingival tissue.

Can be localized to a few areas or involve the whole mouth
Term
Local Factors
Definition
can play a role in gingivitis.
Term
Inflammation
Definition
causes the gingival tissues to bleed easil
Term
Inflammation

Bleeding
Definition
(A) results in ulceration of the pocket wall
(B) is an important indicator of inflammation.
Term
Localized inflammation—
Definition
—confined to tissue of a single tooth or group of teeth
Term
Generalized inflammation
Definition
—occurring in all or most of the mouth
Term
Papillary—
Definition
—Inflammation is confined to the papilla.
Term
Marginal—
Definition
—Inflammation is confined to the gingival margin and papilla
Term
Diffuse—
Definition
—Inflammation is throughout the gingival margin, papilla, and attached gingiva; extending to the mucogingival junction
Term
In health, the gingiva
Definition
is a uniform pink color, with tapered margins, pointed papilla, and a firm consistency
Term
In gingivitis,
Definition
, the gingiva is red to purplish red, with rolled margins, altered papillae, and a spongy consistency
Term
Healthy tissue does not bleed T/F
Definition
TRUE
Term
Characteristics Common to ALL Gingival Diseases
Definition
No attachment loss associated with the inflammation
Signs of inflammation confined to the gingiva
Initiated by plaque biofilm
Inflammation reversible with plaque removal
May progress to periodontitis if left untreated
Term
Dental Plaque-Induced Gingival Diseases
Definition
periodontal diseases involving inflammation of the gingiva in response to dental plaque
Term
Dental Plaque-Induced Gingival Diseases
Definition
Dental plaque-induced gingival diseases
Plaque-Induced Gingivitis on a Periodontium with NO Attachment Loss
Reduced but Stable Periodontium
Gingival Diseases
with Modifying Factors
Plaque-Associated Gingival Diseases
Modified by Medications
Gingival Diseases Modified by
Systemic Factors
Term
What are the non–plaque-induced lesions?
Definition
Gingival Diseases of Specific Bacterial Origin
Term
Gingivitis on a Reduced but Stable Periodontium
Definition
This type occurs in patients who have been successfully treated for PERIODONTITS.
At a later date, after successful treatment of the periodontitis, the patient develops gingivitis.
At this later date when the GINGIVITIS occurs, periodontitis is NOT present
Term
Gingivitis on Reduced but Stable Periodontium (cont.)
Definition
Pre-existing bone loss from previous history of periodontitis

Plaque at the gingival margin

All other signs of plaque-induced
Term
Plaque-Induced Gingivitis on a Periodontium with NO Attachment Loss
Definition
Most common form
Plaque at gingival margin
Redness, tenderness
Swollen margins
Bleeding upon probing
Damage reversible with good patient
Term
Gingivitis Associated with Dental Plaque Only (cont.)
Definition
or character of the bone.No attachment loss in the gingivitis
Radiographs reveal no changes in the height of bone
Term
Plaque-Induced Gingivitis on a Reduced but Stable Periodontium
Definition
This type occurs in patients who have been successfully treated for PERIODONTITS.
At a later date, after successful treatment of the periodontitis, the patient develops gingivitis.
At this later date when the GINGIVITIS occurs, periodontitis is NOT present.
Term
Three main categories of gingival diseases with modifying factors are:
Definition
Systemic factors
Medications
Malnutrition
Term
Gingival Diseases Modified by Systemic Factors
Definition
n this form of gingival disease, plaque initiates the disease and then specific systemic factors found in the host modify the disease process.
Term
The signs of inflammation seem exaggerated in relation to the amount of plaque present in this 12-year-old female patient
Definition
Example—Puberty-Associated Gingivitis
Term
Example—Pregnancy-Associated Gingivitis
Definition
An exaggerated inflammatory response; usually occurring during the 2nd and 3rd trimesters of pregnancy
Term
Example—Pregnancy-Associated Pyogenic Granuloma (“Pregnancy Tumor”)
Definition
A localized mushroom-shaped gingival mass projecting from the gingival margin or gingival papilla during pregnancy
Term
Pyogenic Granuloma (“Pregnancy Tumor”
Definition
It is a mushroom-like growth.
It is more common in the maxilla and in gingival papillae.
Growths are not cancerous.
Growths are usually not painful.
There is an exaggerated response to an irritation.
Growth bleeds easily if disturbed.
Growth usually regresses after giving birth.
Term
Drug-influenced gingivitis
Definition
—an exaggerated inflammatory response to dental plaque and a systemic medication
Term
Drug-influenced gingival enlargement—
Definition
—an increase in size of the gingiva resulting from systemic medications
Term
will Plaque accumulation initiation of gingival enlargement?
Definition
no, but it will exacerbate the gingival disease
Term
Meticulous plaque control can reduce but will not eliminate gingival overgrowth.
T/F
Definition
T
Term
Gingival Enlargement
Definition
Onset within 3 months of taking medication
Higher prevalence in children
Gingiva on anterior sextants most commonly affectedExaggerated response to plaque
Enlargement first observed at the interdental papilla
Term
Gingival Enlargement
Definition
Good daily self-care control limits the severity of gingival overgrowth
Term
who are At risk for vitamin deficiencies:
Definition
Infants
Institutionalized elderly
Alcoholics
Term
Ascorbic Acid-Deficiency Gingivitis
Definition
An inflammatory response to dental plaque aggravated by chronically low ascorbic acid (vitamin C) levels
Term
Ascorbic Acid-Deficiency Gingivitis (cont.)
Definition
Bright red
Swollen
Ulcerated
bleeds easly
Term
Gingival Diseases of Specific Bacterial Origin are ?
Definition
characterized by a bacterial infection of the gingiva by a specific bacterium that is not a common component of the bacterial plaque biofilm
Infection by a bacterium that is not usually considered to be a periodontal pathogen
Term
Atypical Mycobacterial Infection
Definition
Term
Primary Herpetic
Gingivostomatitis
(PHG)
Definition
Primary herpetic gingivostomatitis—the initial oral infection with the herpes simplex type-1 virus (HSV-1)

Characterized by redness and multiple vesicles (tiny fluid-filled blisters) that easily rupture to form painful ulcers

Usually affects infants and young children but may affect young adults
Term
Primary Herpetic Gingivostomatitis (cont.)
Definition
In some individuals, the initial infection presents with intensely painful gingivitis and vesicles that rupture to form painful ulcers.
Once infected, most people develop immunity to the virus.
In some individuals, the HSV-1 can remain latent and be responsible to recurrent oral herpetic lesions (cold sores).
Term
Primary Herpetic Gingivostomatitis (cont.)
Definition
red marginal gingivaFiery
Swollen papillae that bleed easily
Painful
Yellowish ulcers surrounded by red halo
Fever
Dehydration is a concern.
Term
Primary Herpetic Gingivostomatitis (cont.)how can spread
Definition
Infection is contagious during the vesicular stage!
Infection can be spread to eyes by touching the mouth and then eyes.
Infection can be spread to others by kissing.
Term
Linear Gingival Erythema?
Definition
Characterized by inflammation that is exaggerated for the amount of plaque present
A gingival manifestation of immunosuppression
Does not respond well to improved oral self-care or professional therapy
Term
Linear Gingival Erythema (cont.)Characterized by
Definition
a distinct red band that is limited to the free gingiva
Often associated with HIV infection
Term
Lichen Planus
Definition
Disease of the skin and mucous membranes
Term
Lichen Planus Characterized
Definition
Characterized by an itchy, swollen rash on the skin or in the mouth
Term
Lichen Planus Exact cause
Definition
Exact cause unknown
Term
Lichen Planus May be an
Definition
May be an allergic or immune reaction
Term
Oral Lichen Planus looks like
Definition
Intense redness of the gingiva
Ulcerations
Interlacing white lines may be present.
Raised white lesions may be present.
Term
Erythema Multiforme is
Definition
Disorder of the skin and mucous membranes
Term
Erythema Multiforme May be due to
Definition
May be due to allergic reaction or infection
Term
Erythema Multiforme looks like
Definition
Large red blotches, resembling targets, appear all over the skin.
Blisters and ulcers occur on the oral mucous membranes.
Term
Erythema Multiforme (cont.)lookes like
Definition
Ulcerations of the gingivaCrust formation on the lower lip
Term
Allergic Reactions of the Gingiva can happen how
Definition
Can occur to ingredients in toothpastes, mouthwashes, or chewing gum
Usually a result of a flavor additive or a preservative in the product
Cinnamon and carvone are two flavor additives known to cause allergic reactions of the gingiva.
Term
Allergic Reaction to Toothpaste
Definition
Reaction to additive in toothpaste
Most common in those with history of other allergies
Tissue sloughing of mucosa
Term
Gingival diseases are the:
Definition
Most common form of periodontal disease
Mildest form of periodontal disease
Term
The two major subdivisions of gingival diseases are:
Definition
Dental plaque–induced gingival diseases
Non–plaque-induced gingival diseases
Term
The objective of supragingival irrigation is to?
Definition
diminish gingival inflammation by disrupting biofilms coronal to the gingival margin.
Term
The goal of subgingival irrigation is?
Definition
to reduce the number of bacteria in the periodontal pocket space.
Term
Dental Water Jet?
Definition
Device that delivers pulsed irrigation of water or other solution supragingivally and subgingivally

Also known as dental water irrigator, home irrigator, water flosser
Term
Dental Water Jet—Mechanism of Action are?
Definition
Delivers a pulsating fluid that incorporates a compression and decompression phase

This creates two zones of fluid movement called hydrokinetic activity.
Term
This creates two zones of fluid movement called ?
Definition
hydrokinetic activity.
Term
Delivers a pulsating fluid that incorporates a ?
Definition
compression and decompression phase
Term
Impact zone?
Definition
initial fluid contact with an area of the mouth
Term
Flushing zone?
Definition
depth of fluid penetration within a subgingival sulcus or periodontal pocket
Term
II – ?
Definition
II – HIGH abuse potential, no refills
Term
I –?
Definition
MOST ABUSED, no Rx use
Term
III ?
Definition
MOD abuse potential, 5 refills in 6 month period
Term
Benefits of Home Irrigation?
Definition
Biofilm removal

Bleeding reduction

Gingival inflammation reduction

Periodontal pathogens reduction

Reduction in inflammatory and destructive host
Term
Indications for Recommendation?
Definition
Individuals on periodontal maintenance

Individuals who are noncompliant with dental floss

Individuals with special needs

Individuals with dental implants
Individuals with diabetes
Individuals with orthodontic appliances
Individuals with prosthetic bridgework and crowns
Term
Bacteremia?
Definition
Incidence of bacteria is similar to other oral healthcare devices.

Before recommending a water jet to a patient who is at high risk for infective endocarditis, dental healthcare providers should consider both the patient’s overall medical and oral health status.

Consultation with a physician is advisable for
Term
Irrigating Solutions?
Definition
Water

Antimicrobial solutions
Chlorhexidine
Essential oils
Other solutions
Term
Water as an Irrigant?
Definition
Simple tap water has been shown to be highly effective as an irrigant in numerous studies.

Water has advantages as an irrigant.
Readily available
Cost-effective
No side effects
Term
Chlorhexidine (CHX) as an Irrigant?
Definition
CHX should be diluted with water for home use.
It is available by prescription only.
In the United States, the maximum strength is 0.12 percent.
Term
Essential Oils as Irrigants?
Definition
Only effective when used at full strength
Available over-the-counte
Term
Standard Irrigation Tip?T/F
Definition
T
Term
Standard Irrigation Tip made of ?
Definition
Made of plastic material
Term
Subgingival Irrigation Tip?
Definition
Has a soft rubber-tipped end
Term
Subgingival Irrigation Tip?
Definition
Has a soft rubber-tipped end
Term
Orthodontic Irrigation Tip?
Definition
Have a soft tapered brush that facilitates biofilm removal around ortho. appliances
Term
Placement of the Standard Irrigating Tip?
Definition
Place the tip at a 90-degree angle at the neck of the tooth

Use the water spray to trace along the gingival margin
Term
Placement of the Subgingival Irrigating Tip?
Definition
Adjust water pressure to lowest setting

Slide rubber tip gently beneath the gingival margin

Direct tip at 45-degree angle
Term
Placement of the Orthodontic Irrigating Tip?
Definition
Place the tip at a 90-degree angle
Term
There is no long-lasting substantivity of the antimicrobial agent due to the continuous flow of gingival crevicular fluid from the periodontal pocket.
T/F
Definition
T
Term
A substantive antimicrobial agent, such as chlorhexidine gluconate, would have to be retained in the pocket and be released slowly over time to have a beneficial effect.
T/F
Definition
T
Term
Currently, there is insufficient evidence to indicate that professional subgingival irrigation routinely should be used as a supplemental in-office procedure.
T/F
Definition
t
Term
IV – ?
Definition
IV – LOW abuse potential, 5 refills in 6 month period
Term
V – ?
Definition
LOWEST abuse potential, OTC
Term
Potency ?
Definition
inverse related to dose, needed for effect
Term
Efficacy ?
Definition
max effect, not dose related
Term
Onset –?
Definition
time → effect
Term
Duration – ?
Definition
length of effect
Term
Half Life – ?
Definition
time → half of drug out of the body
Term
Parenteral ?
Definition
– bypass GI
Term
Enteral ?
Definition
inside GI tract
Oral, Rectal,
Term
Oral meds-
In order to get absorbed they have 4 D's are?
Definition
Disruption →Disintegration →Dispersion → Dissolution →
Term
Side Effect ?
Definition
predictable, dose related, on non-target
Term
Allergy ?
Definition
not predictable, not dose related
Term
Teratogenicity ?
Definition
congenital abnormalities
Term
I -reaction?
Definition
immediate/severe
Term
II – reaction?
Definition
cytotoxic; antibody related
Term
III – reaction?
Definition
immune complex; antibody related
Term
IV – reaction?
Definition
delayed/ least severe; cell mediated
Term
Antibiotic Premed For?
Definition
Art. Heart valves, Hx- IE,
Congenital heart defects: unrepaired/incomplete repaired cyanotic disease, repaired with prosthetic
Heart Transplant w/ valve issue
Renal dialysis shunts
Ventriculoatrial hydrocephalic shunt (NOT STENTS)
Term
Regime: 1hr prior to Tx?
Definition
Amox- 2000mg
Cephalexin- 2000mg
Clindamycin- 600mg
Macrolides- 500mg
Term
Anti-virals
Definition
Tx Oral Herpes
Inhibit Viral DNA synth

-clovir ending for viral meds

ADR's- bone marrow depress → anemias, bleeding gingiva/ oral ulcers
Term
Anti-fungals?
Definition
Tx Oral Candidiasis:
Pseudomembranous,
Chronic aplastic = denture stomatits,
Chronic hyperplastic,
Angular chelitits
Tx:
Nystatin- tablets or suspensions
5ml QID, 2wks
Term
Angina Pectoris ?
Definition
NTG as Vasodilator will increase blood supply to heart, sublingual admin
Term
Congestive Heart Failure ?
Definition
cardiac glycosides to increase force of contraction (+ inotropic effect); caution w/ VCs
Term
Anti-Coagulant Therapy ?
Definition
to prevent stroke, MI; reduce intravascular clots; increases risk of gingival hemorrhage; warfarin → prevents active Vit K
Term
High Cholesterol ?
Definition
“statins”; antihyperlipedemics
Term
Diuretics ?
Definition
water pills, help excrete Na+ and H2O; thiazide vs loop; *xerostomia and hTN
Term
ACE inhibitors ?
Definition
“pril”, block angiotensin II → VD; *dysgeusia (change in taste), hTN
Term
Beta Blockers ?
Definition
“olol”, decrease CO, propranolol is a non-selective BB; avoid Epi w/ NSBB
Term
Cocaine?
Definition
CNS Stimulant, super VC, Dilates Pupils
Term
Crack abusers ?
Definition
active decay
Term
Heroin?
Definition
CNS/Resp depressor, Pinpoint Pupils
Term
Methamphetamine?
Definition
CNS Stimulant, rampant caries, xerostomia, poor diet;
Term
Methamphetamine age/sex?
Definition
Males 19-40
Term
Sympathetic Nervous System?
Definition
Fight or flight
Emergency/crisis
Increased BP (vasoconstriction)
Increased HR
Bronchodilator
Dilates pupils
Preganglionic NT: acetylcholine
Postganglionic NT: norepinephrine
Adrenergic drugs
Term
Parasympathetic Nervous System?
Definition
Rest and digest
Normal/rest
Increased blood flow to digestive organs
Accelerates peristalsis
Bronchoconstriction
Constricts pupils
Preganglionic NT: acetylcholine
Postganglionic NT: acetylcholine
Cholinergic drugs
Term
Adrenergic drugs?
Definition
Mimic the sympathetic NS
Examples:
Albuterol inhaler to tx asthma (bronchodilator)
Epinephrine to tx anaphylaxis
Epinephrine as vasoconstrictor
Epinephrine to tx cardiac arrest to stimulate heart
Dopamine to tx shock, Parkinson's, low BP
Adverse effects: CNS (anxiety, fear, tremor, headache), cardiac arrhythmia, hypertension, xerostomia
Avoid adrenergics with angina, uncontrolled hypertension, uncontrolled hyperthyroidism
Term
Adrenergic-blocking drugs?
Definition
Block sympathetic NS
Tx cardiac arrhythmias, hypertension, angina, glaucoma, MI
Beta blockers (-olol)
Propranolol- tx hypertension
Timolol- tx glaucoma
Term
Cholinergic drugs?
Definition
Mimic parasympathetic NS
Example: Pilocarpine- increase salivary flow, tx glaucoma
Contraindications: asthma, ulcers, cardiac diseases
Term
Anticholinergic Drugs?
Definition
Block parasympathetic NS
Examples:
Atropine- decrease salivary flow
Imodium- tx diarrhea
Dramamine- tx motion sickness
Adverse reactions: blurred vision, bladder retention, constipation, dry mouth
Term
Aspirin- ?
Definition
Nonopioid, MOA: prostaglandin synthesis
Effects: Analgesic (pain reducer), Antipyretic (fever reducer), Anti-inflammatory, Anti-platelet (blood thinner)
Adverse effects: Interferes with clotting (contraindicated with warfarin), GI irritation, Hypersensitivity (allergic rxn), Reye’s syndrome (severe rxn in children, avoid aspirin in children), Tinnitus (ringing in ears)
Term
Acetaminophen?
Definition
Nonopioid,
Effects: Analgesic, Antipyretic, NOT anti-inflammatory
Adverse effects: Hepatotoxicity and liver necrosis at high doses
DOC for children, pts on anticoagulants ulcers, post-op pain after periodontal tx
Term
Ibuprofen
Nonopioid, NSAID, Motrin, Advil,?
Definition
, MOA: inhibit prostaglandin synthesis
Effects: Analgesic, Antipyretic, Anti-inflammatory
Adverse effects: Interferes with clotting, GI irritation
Contraindicated with ulcers, can decrease effects of many drugs
Term
Narcotics/Opioids ?
Definition
Block pain receptors to brain
Effects: analgesic, antitussive, sedation, euphoria
Adverse effects- respiratory depression, nausea, vomiting, constipation, addiction
Term
Naloxone?
Definition
opioid antagonist, reverses effects of opioid, tx overdose
Term
Methadone?
Definition
tx addiction and withdrawa
Term
Local Anesthesia
Definition
MOA- block peripheral nerve conduction by decreasing sodium permeability of the nerve membrane. Inhibit influx of sodium by blocking Na channels in membrane.
Small unmyelinated affected 1st, large myelinated fibers affected last.
LA are WEAK BASES, work poorly in inflamed tissues.
Aspiration is best way to reduce risk of toxicity.
Term
Contents of LA solution?
Definition
LA
Vasoconstrictor
Sodium bisulfite (preservative)
Sodium hydroxide (makes solution basic)
Sodium chloride (makes solution isotonic with body),
Sterile water
Term
Amides?
Definition
metabolized in liver, low allergenicity
Lidocaine (Xylocaine)- most commonly used in dentistry, available as topical, safe in pregnancy, medium duration
Mepivicaine (Carbocaine)- SHORTEST duration
Priolocaine (Citanest)- medium duration
Bupivacaine (Marcaine)- LONGEST duration
Articaine (Septocaine)- 4%, increase risk of paresthesia (with mandibular block)
Term
Vasoconstrictors?
Definition
Prolong and increase depth of LA, delay absorption, decrease toxicity, decrease hemorrhage
Epinephrine & Levonordefrin
MRD= .2mg healthy pt,.04mg in medically compromised pt
Term
Benzodiazepines?
Definition
Short-term tx of anxiety and insomnia
CNS depression/sedation
anxiety reduction/sedation
anticonvulsant,
muscle relaxant
NOT ANALGESIC
Used in dentistry to reduce anxiety, ex) diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax)
Term
Barbiturates?
Definition
tx of epilepsy (phenobarbital)
CNS depression/sedation
Term
Nitrous oxide?
Definition
conscious sedation
anxiety reduction
raises pain threshold
excreted through exhalation
not metabolized in body
overdose may cause nausea and vomiting
Contraindications- COPD, upper respiratory infection, pregnancy, emotional instability, abuse potential
Prolonged exposure- tremors, spontaneous abortion, numbness and tingling in extremities
Term
Dilantin (phenytoin) ?
Definition
depress CNS to decrease seizures in pts with epilepsy
gingival hyperplasia occurs in 50% of pts
Term
Phenobarbital?
Definition
barbiturate used to manage epilepsy
causes SEDATION
Term
Carbamazepine (Tegretol)?
Definition
used to tx seizures
used to tx trigeminal neuralgia
Term
Diphenhydramine (Benadryl)?
Definition
Tx mild allergic reactions
Side effects: sedation & xerostomia
MOA- blocks histamine receptors
Term
Insulin ?
Definition
tx type I (insulin dependent),
subcutaneous injection,
hypoglycemia most common side effect
Term
Metformin?
Definition
increase body’s sensitivity to insulin
Term
Glyburide?
Definition
stimulate release of insulin from b-cells of the pancreas
Term
Medications used to tx upper respiratory ?
Definition
respiratory infections:
Nasal decongestants-adrenergic drugs, vasoconstrictor
Expectorants- remove exudate and mucus
Antitussives- cough suppressant, may be opioids
Term
Albuterol?
Definition
adrenergic drug, bronchodilator, inhaler for immediate relief
Term
Corticosteroids?
Definition
Ex) Fluticasone, long term treatment to prevent attacks, not for immediate use
Long acting bronchodilators
relieve symptoms for longer periods of time
Term
Combination Drugs?
Definition
Corticosteroid and bronchodilator
Term
Theophylline?
Definition
oral medication to tx asthma, emphysema, chronic bronchitis
Term
Sodium bicarbonate?
Definition
antacid, may be contraindicated in CVD pts because of sodium
Term
Proton-pump inhibitors?
Definition
inhibit gastric acid secretion, ex) Prilosec
Term
Histamine blocking agent?
Definition
block H2 receptors, reducing acid secretions, ex) Tagamet and Pepcid
Term
Bisphosphonate Drugs?
Definition
Used to tx cancer, osteoporosis (Fosamax)
Associated with osteonecrosis of jaw
Can cause impaired wound healing
Risk remains for years after administration
Term
Estrogen?
Definition
Steroid hormone
Used for contraception, menopause, menstrual disturbances,
May increase gingival inflammation
May promote cancer (breast cancer)
Term
Prednisone?
Definition
Steroid (glucocorticoid) used to tx autoimmune and inflammatory diseases, Addison’s disease, allergy
Reduces inflammatory response and is an immunosuppressant
Increases risk of infection and delays healing
May be at increased risk of adrenal crisis during stress exposure, may need to increase steroid dose
Term
ac-?
Definition
-before meals
Term
pc- ?
Definition
after meals
Term
hs?
Definition
at bedtime
Term
Adrenergic drugs?
Definition
Mimic the sympathetic NS
Term
Adrenergic-blocking drugs?
Definition
Block sympathetic NS
Term
Cholinergic drugs?
Definition
Mimic parasympathetic NS
Example: Pilocarpine- increase salivary flow, tx glaucoma
Term
Anticholinergic Drugs?
Definition
Block parasympathetic NS
Term
Cementum
No Blood vessels or nerves
T/F
Definition
T
Term
OMG! Overlap ?% Meet ? Gap ?* exposed dentin pt. may experience discomfort during instrumentation
Definition
OMG! Overlap 60% Meet 30% Gap 10%*
Term
Alveolar Bone Proper?
Definition
Thin layer of bone that lines the socket to surround the root of the tooth.
Term
Cortical Bone?
Definition
Forms the hard outside wall of the man/max. Will not show up radiographically.
Term
Cancellous Bone?
Definition
Lattice like bone that fills the interior portion of the alveolar process
Term
Periosteum?
Definition
Layer of connective tissue covering the outer surface of bone
Term
Periodontal Ligament**
Functions-?
Definition
Supporter
Attaches teeth to bone
Nutrients
Sensory
** Shock Absorber for nerves and vessels MAINFUNCTION
Term
Oblique** fiber?
Definition
Largest and most significant fiber group, extends from cementum coronally to bone
Term
Fibroblast?
Definition
MOST prominent cell; responsible for collagen synthesis and degradation
Term
Glycoprotiens from saliva ?
Definition
are ADSORBED onto the tooth structure
Term
Actinobacillus actinomycetemcomitans causes?
Definition
aggressive perio
Term
Porphromoans gingivalis ** ?
Definition
Most common periopathogen ( Mr. PERIO)
Term
Provitella intermedia ?
Definition
(NUP/NUG hormonal)
Term
Camphylobacter rectus?
Definition
perio
Term
Fusobacterium nucleatum ?
Definition
(NUP/NUG) thought to play a role in biofilm formation
Term
Know that Vasodilatation immediately follows vasoconstriction in the acute inflammatory process
** Know the movement of cells to the site of inflammation is termed CHEMOTAXIS
T/ F
Definition
T
Term
Disease Classification?
Definition
Chronic Periodontitis
Gingival Disease
Aggressive Periodontitis
Periodontitis as a manifestation of a systemic disease
Periodontitis associated with genetic disorders
Necrotizing Periodontal Disease
Abscesses of the Periodontium
Term
Acute perio?
Definition
Rapid development
Apparent Inflammation
Pain
Term
Chronic perio?
Definition
Slow development
May appear “normal”
May not be painful
Term
** know that the MOST obvious result of vasodilation of the peripheral circulation was EDEMA
T/F
Definition
T
Term
Periodontitis Gingival Contour?
Definition
Normal
Cleft
Bulbous
Festooned
Receded
Blunted
Hyperplastic
ACUTE (aggressive):Ulcerated, fiery red
Term
Chronic Periodontitis
Signs?
Definition
Loss of attachment
Bone loss
Bleeding
Exudate
Clinically you can notice but it is NOT reliable
Firm, Fibrotic tissue, Blunted, Heavy plaque
Term
Mild perio?
Definition
1-2 mm CAL
Term
Moderate perio?
Definition
3-4 mm CAL
Term
Severe perio?
Definition
>5mm CAL
Term
Aggressive Periodontitis?
Definition
Less Common
Individuals under 30
RAPID destruction of PLD and Bone
Attachment loss is Episodic
Poor response to therapy
Small amounts of plaque
High amounts of Aggregatibacter actinomycetemcomitans Aa
Term
Acquired neutropenia?
Definition
Low amount of neutrophils
Primary dentition is lost and permanent is exfoliated as soon as erupted
Term
Leukemia?
Definition
Abnormal WBC’s that do not function properly
Term
HIV
Linear gingival erythema?
Definition
Linear red band limited to free gingival margin, does not respond well treatment
Term
Familia and cyclic neutropenia**?
Definition
Low neutrophils
Term
Papillion- LeFe’vre syndrome**?
Definition
Hyperkeratosis of the palms of hands and feet
Severe periodontal destruction
Term
Chediak-Higashi syndrome**?
Definition
Impairment of neutrophil chemotaxis
Term
UP/NUG
Bacteria responsible?
Definition
Spirochetes- Treponema denticola**
Fusobacterium
Prevotella intermedia
Porphyromonas gingivali
Term
NUP/NUG treatment?
Definition
Tetracycline is often the drug of choice because it concentrates in gingival crevicular fluid
Term
Gingival Abscess?
Definition
Results from the injury to or infection of the surface gingival tissue
Term
Periodontal Abscess (lateral periodontal abscess)?
Definition
Results when infection spreads into perio pocket where drainage is blocked *** can occur after periodontal debridement
Term
Pericoronal Abscess?
Definition
Develops in inflamed dental follicular tissue overlaying the crown of a partially erupted tooth 3rd molars are most common
Term
Periapical Abscess?
Definition
Results from a pulp infection usually secondary to deep tooth decay
Term
Class I- you can feel the roof top of the furcation
Class II- you can enter into the furcation
Class III- you can pass through entire furcation
Class IV- Same as III but you can visually see it
T/F
Definition
T
Term
Width of Attached Gingiva?
Definition
Extends from the sulcus/pocket base to the mucogingival junction
Widest on the anterior teeth
Narrowest in premolars
Term
Gingival Pocket?
Definition
is a deepening of the gingival sulcus as a result of swelling or enlargement of the gingival tissue
Term
Periodontal Pocket?
Definition
is a pathological deepening of the gingival sulcus as a result of: apical migration of JE, destruction of periodontal ligament fibers, destruction of alveolar bone.
Term
-Suprabony pockets (Supracrestal?
Definition
Occurs when there is horizontal bone loss and the base of pocket is coronal to the crest of the alveolar bone.
Term
Infrabony pockets ( Subcrestal)?
Definition
Occurs when there is vertical bone loss and the base of pocket is apical to the crest of the alveolar bone.
Term
Signs and symptoms of occlusal trauma?
Definition
Increased mobility

Tooth migration

Sensitivity to pressure

Radiographic widening of periodontal

ligament (enlarged funnel-shaped periodontal ligament space)

Alveolar bone resorption
Term
Systemic risk factors definition:?
Definition
conditions or diseases that increase an individual’s susceptibility to periodontal infection by modifying or amplifying the host response to the bacterial infection.
Supporting users have an ad free experience!