Essential Perio Therapy

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Epidemiology - Dr. Craig Ririe
What is epidemiology?: Studying the distribution of disease in human populations and the factors that influnce the distribution
What is (probably) the most successful public health intervention?: Fluoridation of water to prevent caries
Why do epidemiological studies matter so much to periodontists?: Because it is an evidence-based practice
Define prevalence. How is it calculated?: The percentage of people in a population who have disease at a given point in time. # of people with the disease / # of people in the population
Define incidence. How is it calculated?: The average percentage of unaffected people who will develop disease during a specific period of time, or the measure of how much new disease there is. # of new cases / # of persons at risk when the study began
Prevalence or incidence: Tells the risk/probability that a person will become a new case.: Incidence
Name the two overall types of studies done for prevalence or incidence.: 1 - Observational 2 - Experimental
Name the three types of observational studies.: 1 - Cross-sectional 2- Cohort 3- Case-control
Most epidemiological studies are (observational/experimental).: Observational
Name the most common type of experimental study.: Drug trials
What are two synonyms for Cross-sectional studies?: 1 Disease freqency studies 2 Prevalence studies
If a cross-sectional study is repeated at regular intervals, what are two advantages?: 1 Gives information on trends in disease over time 2 Shows effectiveness of prevention/treatment programs
Name two reasons why cross-sectional studies are better than cohort or case-control studies.: 1. Cheaper 2. Quicker to conduct
What does a cohort study reveal about a population?: Whether an exposure or characteristic is associated with development of disease
What kind of study starts off with all subjects free of disease?: Cohort study
Name 2 disadvantages to cohort studies.: 1 Requires long observation periods 2 Expensive
What kind of study starts off with 2 groups; patients with or patients without disease?: Case-control study
Name 2 disadvantages to case-control studies.: 1 Can't determine prevalence 2 Can't determine incidence
If you want to calculate prevalence, what type of study should you do?: Cross-sectional study
If you want to calculate incidence, what type of study should you do?: Cohort study
If you want to study association between exposure and disease, what type of study should you do?: Case-control study
Sensitivity or Specificity: The percentage of people who have the disease who test positive.: Sensitivity
Sensitivity or Specificity: The percentage of people who don't have the disease who test negative.: Specificity
Define risk. Define risk factor.: Risk = The likelihood that a patient will get a disease in a specific time period. Risk factor = Characteristics that place a patient at risk for getting a disease
What are three ways for exposure to occur?: 1 Single point in time 2 Episodic 3 Continuous
If you eliminate a risk factor, does it prevent new disease? Does it get rid of existing disease?: Prevents - yes. Eliminates - no.
Name 2 true risk factors for periodontal disease.: 1 Smoking 2 Diabetes
Once a patient has periodontal disease, what are two things we must do?: 1 Reduce risk at healthy sites 2 Increase risk for positive prognosis in diseased sites
What are 2 different definitions of gingivitis?: 1 Inflammation on teeth with no attachment loss 2 Inflammation on tooth with healthy, stable, non-progressing attachment loss
What is gingival index used for?: It's used to quantify amount and severity of disease in individuals/populations, over time
What does a gingival index compare: Prevalence or incidence?: Prevalence
Name 4 features of an "ideal index".: 1 Quick to use 2 Accurate 3 Reproducible 4 Quantitative
Gingival index is (subjective/objective). Gingival bleeding index is (subjective/objective) for diagnosing inflammation.: Gingival index: Subjective⬦ Gingival bleeding index: objective.
What happens first in gingiva: bleeding or color change?: Bleeding always occurs first!
Describe how you differentiate gingivitis from periodontitis using bleeding index.: Gingivitis: Drag a perio probe (2 mm) through each sulcus, wait a few seconds, then note bleeding⬦. Periodontitis: Base of pocket, then note bleeding
What is the direct cause of gingivitis (that all studies have shown)?: Bacterial plaque
When and who performed the "classic" experimental gingivitis study?: 1965 - Loe
Why have there been no experimental studies on chronic periodontitis?: Because it is an irreversible destruction of the connective tissue
Maxillary _________ and mandibular __________ have the most attachment loss of any tooth.: MOST: Maxillary molars, mandibular incisors
Maxillary _________ have the least attachment loss of any tooth.: LEAST: Maxillary incisors
T/F: Increased pocket depth correlates with age.: False! It does not!
Periodontitis becomes clinically significant after age ____.: 30
According to the 'new paradigm' for the etiology of periodontitis, what determines the clinical extent and severity of the disease?: Host inflammatory response
Smokers are ____ times as likely to develop severe periodontitis than non-smokers.: 5
What is the most important host factor for developing periodontitis?: Cigarette smoking
What ist he most important predictor for periodontitis?: Oral hygiene
Periodontitis is (more severe with/not affected by) the following risk factors: Low socioeconomic/educational status; osteoporosis; HIV/AIDS; infrequent dental visits.: Low socioeconomic/educational status - more severe; osteoporosis - not affected; HIV/AIDS - not affected; infrequent dental visits - not affected by.
Periodontitis is (more severe with/not affected by) the following risk factors: bacteria; bleeding on probing; previous periodontal disease; genetic factors; stress.: bacteria - more severe; bleeding on probing - more severe; previous periodontal disease - more severe; genetic factors - more severe; stress - more severe.
Non-Surgical Periodontal Therapy - Dr. Juliana Carvalho
What is Scaling? What is Root planing?: Scaling = Removing calculus, food, plaque on enamel AND cementum. Root planing = Removing calculus and contaminated cementum ONLY on root
With scaling and root planing, the oral flora shifts from Gram (-/+) to Gram (-/+) aerobes.: From gram - to Gram +
Name the three classes of bacteria that are bad for oral health.: 1 Motile rods 2 spirochetes 3 Any black pigmented bacteria
What researchers' study had 3 periodontists scale/cavitron, and found that deep pockets were affected much more than shallow pockets (even had destroyed periodontal fibers)?: Sherman
What were the results of Sherman's study?: Deeper pockets gained attachment with 3 SRP & Cavitrons, but shallow pockets had no change, or even lost attachment
What researchers' study compared open (surgical) to closed (non-surgical) treatment and found that in deeper pockets, less calculus was left but there was no difference for shallow pockets?: Buchanan
What were the results of Buchanan's study?: Surgical calculus removal has no affect on pockets less than 6 mm, but there is significant change for deeper pockets when surgical SRP is done
What very important study compared different SRP techniques on furcations?: Matia
What were the results of Matia's study?: Ultrasonics must be used on furcations because the tip is smaller! Also, surgical is more effective
How many days does it take, after SRP, to get bacteria to levels of health?: 3!
If maintenance of plaque control is absent, it takes __ to ___ weeks to repopulate the pocket with bad bacteria.: 4-8 weeks
What researchers' study found that SRP was equally effective as surgical therapy?: Lindhe and Nyman
What researchers' study found that at pocket depths greater than 7 mm, there was no difference between surgical and non-surgical treatment?: Ramfjord
What researchers' study found that RP, and surgical procedures produced similar gains in pockets greater than 7 mm?: Kaldahl
What is substantivity?: The ability of an agent to bind to tissue surfaces and be released over time
What item in dentistry has high substantivity?: Chlorhexidine
Chapters 41 and 42
Why are gracey curettes the best for subgingival SRP?: They provide the best adaptation to root anatomy
What kind of fulcrum is best for using the Gracey 11-12?: Extraoral or opposite arch
Ultrasonics vibrate between __,000 and __,000 cycles/second.: 20-45,000
The ideal angle between the face of the blade and the lateral surface of any curette is __ to ___ degrees.: 70-80

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Number of cards 71