Integrated Theory Semester 2 Part 2

Is the following an example of primary or secondary occlusal trauma?

Prosthetic replacements creating excessive force on abutment teeth

True or False

Although secondary occlusal trauma involves a diseased periodontium, both primary AND secondary occlusal trauma have clinically similar features (i.e. attachment loss/pocket formation)

Is the following a cause of acute or chronic occlusal trauma?

New restorations or prosthetic appliances that interfere with or change direction of occlusal forces on teeth

Statement 1: Tooth mobility is a symptom of acute occlusal trauma

Statement 2: Chronic occlusal trauma is more common than accute occlusal trauma

Recall the definition of Secondary Occlusal Trauma

Explain why patients suffering secondary occlusal trauma may experience non-pathological tooth mobility

Define fremitus

A patient presents to the clinic needing a bitewing radiograph. You notice on their patient file that the patient suffers from chronic secondary occlusal trauma.

What would you expect to find on their bitewing?

True or False

While there is great variability, any non-class-1occlusion will cause some degree of damage to the periodontium. As such, most patients exhibit at least minor signs of occlusal trauma

True or False

Increases in occlusal forces are not traumatic if the periodontium can "handle" it

Complete the following

Traumatic occlusal forces lead to ________ mobility in teeth with normal support, whereas they lead to ________ mobility in teeth with reduced support

A thickened PDL, increased PDL fibres, and increased alveolar bone density are all associated with what kind of changes in occlusal force?

a) Changes in magnitude
b) Changes in direction
c) Changes in duration
d) Changes in frequency

Which occlusal force directions pose the greatest risk to periodontal fibre integrity?

a) Posterior and superior
b) Lateral and posterior
c) Mesial and torque
d) Lateral and torque

True or False

In occlusal trauma, excessive forces which are constant are more injurious to the periodontium than intermittent forces

Which of the following IS a condition caused by traumatic occlusal forces? (Based on current evidence)

a) Attachment loss
b) PDL inflammation
c) Abfraction
d) Acceleration of existing periodontitis
e) Gingival recession

Assuming plaque control and oral hygiene are poor, how might orthodontic forces adversely affect the periodontium?

What occurs during the Injury (Stage 1) stage of the tissue response to incfreased occlusal forces?

After damaged tissue is removed, what new structures/tissues are formed during the Repair (Stage 2) stage of the tissue response to increased occlusal forces?

What changes occur in the periodontium when excessive forces exceed the repair rate and adaptive remodelling takes place?

While assisting a dentist, you notice them ask the patient to close their mouth then clench. The dentist then places a finger on the buccal surface of the tooth to detect movement.

What is the dentist testing for?

Once oral hygeine instructions and debridement have been completed, how should an OHT manage a patient with occlusal trauma?

Name the bacteria of significant aetiological importance to periodontitis in children

Name 3 Oral Manifestations of Contraceptives

Name 4 oral/immune changes a patient may experience as a result of the menstrual cycle

After how many weeks does the foetus gain the ability to move and swallow

Identify 3 factors which may cause teratogenic effects during pregnancy

In what weeks of pregnancy do the foetal tooth buds develop?

What material other than titanium may be used for implant bodies?

In what months of pregnancy does initial mineralisation of the foetal tooth buds occur?

In what weeks of pregnancy do the lips and palate develop?

When does cleft lip and cleft palate become apparent during pregnancy?

What weeks of pregnancy encompass the 2nd trimester?

True or False

A baby born at 36 weeks rather than 40 is considered premature

How light is a low birth weight baby?

True or False

Periodontal pathogens can cause inflammation of both the foteal tissue AND the amniotic fluid

Name 3 pregnancy complications related to the presence of infection

True or False

Periodontal diseases occur in 3 out of every 4 pregnancies

What changes occur to the GCF during pregnancy

Name 2 symptoms of preeclampsia

What is the role of prostaglandins (PGs) in pregnancy?

What considerations should be given for pregnant patients on medications?

How common is "pregnancy gingivitis?"

What changes occur to the biofilm microflora during pregnancy?

Which oral condition is known to arise during pregnancy as a result of "morning sickness?"

Where in the mouth are pyogenic granulomas more commonly found?

A pregnant patinet presents to the clinic needing an x-ray

How should you proceed?

Although it can occur at any time in the pregnancy, in what trimester is scaling, debridement, and polishing ideally performed?

What seating accommodations should be made for a pregnant patient?

Name the syndrome wherein compression to the inferior vena cava reduces blood flow to the foetus and identify the trimester(s) it can occur in

At what age does menopause generally occur and how is it diagnosed?

What mucosal changes are associated with menopause?

Identify the cause of osteoporosis

Identify the treatment (injectable) which may reduce adverse effects on bone metabolism produced by osteoporosis in postmenopausal women

Identify 3 medications which inhibit bone resorption in osteoporosis patients

Which hormone stimulates bone formation?

Complete the following

Osteoporosis patients, along with their existing osteoporosis medications, should take _______ and Vitamin _ simultaneosuly

Describe the appearance and symptoms of BRONJ lesions

A patient presents to the clinic with a large pus-filled lesion exhibited on their mandible. Beneath the pus you notice exposed bone. The patient informs you that the lesion has been there for 8 weeks and assures you they have not received any radiation therapy. When you ask what medication they're taking, you are told bisphosphonates.

What is the most likely diagnosis?

Describe the radiographic appearance of BRONJ

True or False

Evidence for hyperbaric oxygen treatment for BRONJ management is inconclusive

Where must an oral ulcerative lesion spread before it can be classified as necrotising stomatitis (NS)?

Beginning at the tips of the interdental papillae, what colour are necrotising gingivitis lesions and its associated pseudomembrane?

Explain the mechanism behind stress-induced Necrotising Gingivitis

What bacteria are related to necrotising gingigvitis?

Identify 4 known risk factors for Necrotising Gingivits

In the treatment of necrotising gingivits, which of the following is NOT used in the first appointment?

a) Chlorhexidine 0.12%
b) Warm saltwater
c) Diluted hydrogen peroxide 3%
d) Antibiotics e.g. metronidazole
e) Essential oil rinses e.g. Listerine

True or False

Because removal of bacteria is a top priority in the treatment of necrotising gingivitis, both supragingival and subgingival scaling should be completed in the first appointment if possible

What unique characteristics separate necrotising periodontitis from regular periodontitis?

The microorganism vincent vicella is uniquely associated with

a) Necrotising gingivitis
b) Necrotising periodontitis
c) Necrotising stomatitis

Statement 1: Antibiotics can be used in the treatment of necrotising gingivitis

Statement 2: Antibiotics can be used in the treatment of necrotising periodontitis

What rinse might HIV+ patients consider using in the treatment of necrotising periodontitis?

Which of the following is NOT treated with NSAIDs

a) Rhematoid Arthritis
b) Systemic Lupus Erythematous
c) Necrotising periodontitis
d) Graves' Disease