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Questions and Answers
What is a primary characteristic of active disease sites in periodontitis?
What is a primary characteristic of active disease sites in periodontitis?
Which of the following best describes the nature of periodontal pockets?
Which of the following best describes the nature of periodontal pockets?
What happens to the junctional epithelium in a gingival pocket?
What happens to the junctional epithelium in a gingival pocket?
What is the average depth of a healthy gingival sulcus?
What is the average depth of a healthy gingival sulcus?
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How does attachment loss in periodontal pockets occur?
How does attachment loss in periodontal pockets occur?
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What is a significant factor in distinguishing between active and inactive disease sites?
What is a significant factor in distinguishing between active and inactive disease sites?
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What describes horizontal bone loss in periodontitis?
What describes horizontal bone loss in periodontitis?
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What role do periodontal ligament fibers play in periodontal health?
What role do periodontal ligament fibers play in periodontal health?
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What defines an infrabony defect in periodontal disease?
What defines an infrabony defect in periodontal disease?
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What type of defect is referred to as a one-wall intrabony defect?
What type of defect is referred to as a one-wall intrabony defect?
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In the context of bone contour in periodontal disease, what is described by an osseous crater?
In the context of bone contour in periodontal disease, what is described by an osseous crater?
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What is a characteristic feature of periodontitis compared to gingivitis?
What is a characteristic feature of periodontitis compared to gingivitis?
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How does furcation involvement manifest in multirooted teeth?
How does furcation involvement manifest in multirooted teeth?
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What distinguishes vertical bone loss from horizontal bone loss in periodontitis?
What distinguishes vertical bone loss from horizontal bone loss in periodontitis?
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What is a primary characteristic of vertical bone loss in periodontitis?
What is a primary characteristic of vertical bone loss in periodontitis?
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What happens to the crestal periodontal ligament fibers during bone loss in periodontitis?
What happens to the crestal periodontal ligament fibers during bone loss in periodontitis?
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Which condition is associated with permanent tissue destruction in periodontitis?
Which condition is associated with permanent tissue destruction in periodontitis?
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What occurs to the junctional epithelium during periodontitis?
What occurs to the junctional epithelium during periodontitis?
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What is a major factor affecting cleaning in interdental areas in periodontal disease?
What is a major factor affecting cleaning in interdental areas in periodontal disease?
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What is a common sign of periodontitis when probing the gums?
What is a common sign of periodontitis when probing the gums?
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What type of bone defect primarily affects just one tooth due to uneven bone resorption?
What type of bone defect primarily affects just one tooth due to uneven bone resorption?
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What type of attachment loss is observed in periodontal pockets associated with periodontitis?
What type of attachment loss is observed in periodontal pockets associated with periodontitis?
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Which of the following conditions results in an inflamed connective tissue exposed through ulcerations in the pocket epithelium?
Which of the following conditions results in an inflamed connective tissue exposed through ulcerations in the pocket epithelium?
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What characterizes the clinical picture of periodontitis observed in patients?
What characterizes the clinical picture of periodontitis observed in patients?
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Study Notes
Attachment Loss in Periodontal Pockets
- Characterized by destruction of fibers and bone
- Affects teeth support, spreading apically and laterally
- Can vary in depth on different root surfaces
Disease Sites
- Areas of tissue destruction
- Inactive disease site: junctional epithelium attachment level stays the same over time
- Active disease site: shows continued apical migration of junctional epithelium
- Assessed using a periodontal probe
Periodontal Pockets
- Areas of tissue destruction left by disease
- Not always an indicator of active disease
- Majority of pockets in adult patients are inactive disease sites
Gingival Sulcus
- Average depth in a healthy mouth is 1 to 3mm
- Junctional epithelium sits coronal to CEJ
- Attaches along the entire length of the tooth
Gingival Pockets or Pseudopockets
- A deepening of the gingival sulcus due to swelling
- Increased probing depth due to:
- Detachment of the coronal portion of junctional epithelium
- Increased tissue size from swelling
- False pockets
Periodontal Pockets
- Pathological deepening of the gingival sulcus
- Results of:
- Apical migration of junctional epithelium
- Destruction of periodontal ligament fibers
- Travels into the periodontal ligament space
Pathway of Inflammation in Vertical Bone Loss
- Travels through gingival connective tissue, into the periodontal ligament space and into the alveolar bone.
- Weakened crestal periodontal ligament fibers no longer provide a barrier
Bone Defects in Periodontitis
- Infrabony defect: base of the defect extends apical to the residual alveolar crest
- Intrabony defect: bone resorption occurs in an uneven, oblique direction, primarily affects one tooth
One-Wall Intrabony Defect
- Also known as a hemiseptal defect
- Half of the interdental septum is lost
- Other half remains attached to the tooth
Two-Wall and Three-Wall Intrabony Defects
- Multiple walls of alveolar bone lost
Proximal Bone Contour
- Bone contour from facial to lingual dips apically
- Forms osseous crater
- Affects two adjacent root surfaces
- Interdental area difficult to clean
Bone Loss in Furcation Areas
- Furcation involvement occurs on multirooted teeth when periodontal infection reaches the area between and around roots
- Alveolar bone loss between the roots
- May be hidden by gingival tissue or visible clinically
- Bleeding upon gentle probing
- Probing depths greater than 3 mm
Microscopic Picture of Gingivitis
- Hemidesmosomes remain attached to enamel
- Epithelial ridges extend from junctional epithelium into adjacent connective tissue zone
- Reversible damage to gingival fibers
- No infection in alveolar bone or periodontal ligament fibers, cementum is normal
Periodontitis
- Permanent tissue destruction
Characteristics of Periodontitis
- Apical migration of junctional epithelium
- Loss of connective tissue attachment
- Loss of alveolar bone
- Tissue destruction occurs intermittently at different rates throughout the mouth
Clinical Picture of Periodontitis
- Visible alterations in color, contour, and consistency
- Gingival margin may be swollen or fibrotic
- Interdental papillae may balloon out or be blunted
- Bleeding upon probing
- Suppuration (pus) possible
- Pocket depths of 4mm or greater
Microscopic Picture of Periodontitis
- Apical migration of junctional epithelium, coronal portion detaches from tooth surface
- Extracellular matrix of gingiva and collagen fibers destroyed
- Junctional epithelium and sulcular epithelium extend into the connective tissue
- Small ulcerations of pocket epithelium expose underlying inflamed connective tissue
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Description
This quiz focuses on the characteristics and classifications of attachment loss in periodontal pockets. It covers aspects such as tissue destruction, disease sites, and the importance of periodontal probing. Test your knowledge on gingival sulcus depth and the types of periodontal pockets.