Periodontology and Biologic Width Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What does biological width refer to?

The cumulative dimensions of the junctional epithelium and connective tissue attachment (correct)

The space between adjacent teeth in the dental arch

The measurement of the distance from the tooth to the alveolar bone

The total height of the tooth above the gum line

Which factor does NOT influence the design of tooth-supported prosthesis?

The psychological profile of the patient (correct)

The anatomy of the periodontium

The materials used in fabrication

The position of the natural teeth

Which of the following describes supracrestal attachment?

A fixed distance between tooth roots

The area of the gum tissue above the bone level (correct)

The joint area between the periodontal ligament and the bone

The space between the enamel and the cementum

What is a consequence of inadequate restoration margins on supracrestal tissues?

Enhanced plaque retention Signup and view all the answers

Which statement is true regarding cervical enamel projections (CEP)?

CEP can lead to increased plaque accumulation Signup and view all the answers

What role does dental calculus play in periodontitis?

It contributes to the development and progression of periodontitis Signup and view all the answers

Which assessment method is effective for determining the dimensions of junctional epithelium and supra-crestal connective tissue?

Histological examination Signup and view all the answers

What is a key factor in increasing plaque retention according to tooth anatomy?

Irregular crown contours Signup and view all the answers

What is the correct measurement of biologic width that is recommended to maintain periodontal health?

3 mm Signup and view all the answers

What is bone sounding primarily used for in periodontal assessment?

To engage alveolar bone for probing Signup and view all the answers

What consequence may arise from violating the zone of biologic width with a restoration?

Gingival inflammation and pocket formation Signup and view all the answers

How many categories of biologic width did Kois propose based on bone sounding measurements?

Three categories Signup and view all the answers

What is the significance of the 3 mm recommended measurement in relation to restoration margins?

To maintain adequate biologic width despite restoration placement Signup and view all the answers

What type of radiographic technique is advised for evaluating the dento-gingival unit?

Standardized periapical radiographs Signup and view all the answers

What are the components that make up the total biologic width, according to the recommended 3 mm?

1 mm sulcus depth, 1 mm junctional epithelium, 1 mm connective tissue Signup and view all the answers

Which of the following statements about supracrestal attached tissue is accurate?

It is measured using bone sounding procedures. Signup and view all the answers

What is the characteristic feature of group I regarding crown margins and alveolar bone crest distance?

Margins are less than 1 mm from the alveolar crest Signup and view all the answers

Which factor was associated with increased probing depths (PD) in group I?

Location of crown margins within supra-crestal tissue Signup and view all the answers

What conclusion can be drawn regarding the effects on the periodontium when restoration margins encroach upon supra-crestal tissue?

They can be attributed to a combination of factors Signup and view all the answers

How does the presence of overhangs greater than 0.2 mm affect periodontal health?

It is associated with crestal bone loss Signup and view all the answers

What effect does the removal of overhangs during periodontal therapy generally lead to?

Resolution of gingival inflammation and decreased probing depths Signup and view all the answers

What qualitative microbial shift is likely caused by overhanging margins?

A shift towards subgingival microflora associated with periodontitis Signup and view all the answers

Which group is characterized as having normal distance from the crown margin to the alveolar crest?

Group II Signup and view all the answers

What clinical observation is noted regarding gingival inflammation in class II restorations?

Greater around subgingival margins than supragingival margins Signup and view all the answers

What is the minimum roughness threshold suggested for alloys used in prostheses to minimize plaque retention?

Ra < 0.2 μm Signup and view all the answers

Which metal ions are primarily associated with hypersensitivity reactions potentially causing gingivitis?

Ni and Pd Signup and view all the answers

What is one of the conditions to ensure a favorable periodontal prognosis with distal extension removable dental prostheses (RDPs)?

Treating any present periodontal disease Signup and view all the answers

What can happen if distal extension RDPs are not properly maintained and relined?

They may increase forces on abutment teeth Signup and view all the answers

What is the impact of cervical enamel projections (CEPs) on periodontal health?

They can lead to furcation invasion Signup and view all the answers

What role does patient motivation play in maintaining periodontal health?

It enhances compliance with self-care Signup and view all the answers

How do dental materials affect the onset of gingivitis?

They can act similarly to enamel in retaining plaque Signup and view all the answers

What should be established prior to performing prosthodontic manipulations?

A complete periodontal assessment Signup and view all the answers

What is a common result of vertical root fractures?

Localized pockets associated with the fracture Signup and view all the answers

Which classification of root resorption can facilitate communication with the subgingival microbial ecosystem?

Cervical resorption Signup and view all the answers

What dental condition is most often associated with poor tooth alignment and crowding?

Increased gingival recession Signup and view all the answers

What impact does cemental tears have on periodontal health?

Localized periodontal breakdown Signup and view all the answers

Which tooth position issue is associated with greater clinical attachment loss?

Cross-bite malposition Signup and view all the answers

What characteristic of a periodontal biotype influences the risk of mucogingival deformities?

Thin periodontal biotype Signup and view all the answers

What is a consequence of inadequate proximal tooth contacts?

Higher likelihood of food impaction Signup and view all the answers

Which factor is least likely to affect plaque retention and periodontal health?

Type of toothpaste used Signup and view all the answers

What is the primary cause of gingival inflammation?

Bacterial plaque Signup and view all the answers

Where is supragingival calculus most frequently located?

On the lingual surfaces of mandibular anterior teeth Signup and view all the answers

Which type of calculus is located apical to the gingival margin?

Subgingival calculus Signup and view all the answers

What can facilitate the movement of bacteria closer to the alveolar bone?

Mineralization of biofilms Signup and view all the answers

What can lead to increased probing depth (PD) in periodontal areas?

Presence of open contacts Signup and view all the answers

Which of the following is NOT considered a predisposing factor for gingival inflammation?

Daily flossing Signup and view all the answers

What is the visibility status of subgingival calculus during a direct oral examination?

Not visible Signup and view all the answers

What does non-mineralized dental biofilm entrap from the oral cavity?

Particles including bacteria, proteins, and food remnants Signup and view all the answers

Study Notes

Study aims to understand the impact of dental prostheses and tooth-related factors on gingivitis and periodontitis development and progression.
Learning outcomes include: determining factors related to tooth-supported prostheses, identifying supracrestal attachments and their variability, understanding restoration margin effects on attached tissues, evaluating tooth anatomy's impact on plaque retention, and recognizing calculus' role in periodontitis development.
Classification of periodontal diseases and conditions is crucial in evaluating associated factors.
Factors discussed include tooth anatomy, tooth position, biological width, dental materials, restorative procedures, and patient compliance.
Biological width is the cumulative dimensions of the junctional epithelium and supra-crestal connective tissue attachment.
This width needs to be maintained to prevent inflammation and bone loss. Improper restoration can violate this space/width.
Methods for assessing biologic width include histology, transgingival probing, and standardized periapical radiographs.
Bone sounding measures the distance from the gingival crest to the alveolar crest.
Different categories of biological width exist based on bone crest levels (normal, high, low).
Overhangs greater than 0.2mm related to direct restorations have been linked to crestal bone loss.
Overhangs greater than 0.5-1mm associated with indirect restorations also lead to a more apical crestal bone level and increased gingival inflammation.
Subgingival margins are strongly associated with increased gingival inflammation and probing depths.
Patient compliance significantly impacts periodontal health following prosthetic therapy.
Prosthodontic procedures, required for fixed prosthodontics fabrication, can negatively affect the periodontium.
Direct and indirect restorations with overhanging margins are associated with localized gingivitis, increased probing depths (PD), and interproximal bone loss.
Localized pockets are common on fractured teeth.
Root resorption can occur at various locations in teeth (internal, external, cervical, apical).

Tooth Anatomy and Position

The anatomy of the periodontium impacts gingival recession likelihood.
Shallow probing depths and a narrow band of gingiva increase gingival recession risk.
Complete periodontal assessment before prosthodontic work is essential.
Cross-bite, misalignment, rotation, and crowding affect plaque retention, gingivitis, increased PDs, and bone loss.
Tooth position and periodontal biotype, along with their interaction, influence mucogingival deformities.
Subjects experiencing tooth trauma from brushing or malposition within the alveolar process are at greater risk for gingival recession.
Tooth anatomy and shape affects interproximal papilla height.

Open Contacts

Adequate proximal tooth contacts prevent food impaction between teeth.
Open contacts, while not a direct causal factor in gingivitis or increased probing depths, are statistically linked to increased food impaction and increased PDs.

Role of Dental Calculus

The primary cause of gingival inflammation is bacterial plaque. Calculus is a secondary factor for inflammation.
Calculus forms by mineralization of dental plaque on tooth and prosthesis surfaces.
Calculus is categorized based on location (supragingival vs. subgingival).
Supragingival calculus is located coronal to the gingival margin and visible; subgingival calculus is located apical to the gingival margin and invisible upon visual inspection.
Calculus impacts plaque retention, increasing biofilm deposition and serving as a toxic bacterial product reservoir.
Calculus is an important secondary etiological factor in periodontitis.

5 -Removable Dental Prostheses

Favorable periodontal prognosis for distal extension removable complete dentures depends on treated periodontal disease, established plaque control, maintained periodontal health, and patient compliance with plaque control and maintenance.
Distal extension removable dentures, when improperly maintained and relined, can apply excessive forces on abutment teeth, leading to mobility.

6 - Tooth Anatomy and Position: Cervical Enamel Projections

Cervical enamel projections (CEPs) may be associated with furcation invasion, increased probing depths, and loss of clinical attachment.
CEPs extend toward the furcation area and are graded based on extent into that area.

Enamel Pearls (EPs)

Enamel pearls are spheroidal, occurring in ~1-5.7% of molars.
EPs vary in size (0.3-2 mm) and frequently occur in isolated areas, including the furcation areas of molars.
These serve as a plaque-retentive component in periodontitis progression, leading to integration into the subgingival microbial ecosystem; thereby causing inflammation.

Developmental Grooves

Palatal grooves are the most common developmental grooves.
40% of grooves do not extend beyond 5mm of the CEJ, and 10% extended beyond 10mm of the CEJ.
Developmental grooves can lead to plaque retention, localized gingivitis, and periodontitis.
Grooves are most prevalent in interproximal areas.

Tooth and Root Fractures

Tooth fractures coronal to the gingival margin generally do not initiate gingivitis or periodontitis unless the fracture area predisposes to plaque retention.
Fractures in more coronal locations do not necessarily affect prognosis, but fractures in cervical regions may have poorer prognosis; this is related to plaque retention potential in this area.
Vertical root fractures usually begin on the internal canal wall and extend to the external root surface. These are most frequent in endodontically treated teeth.
Localized pockets are associated with the fracture line; deep osseous defects are commonly present and related to bacterial infections from the gingival margin.

Root Resorption

Root resorption classifications are based on anatomical location.
Resorption in the cervical third of the root can easily interact with subgingival microbial ecosystems.

Cemental Tears

Cemental tears are localized cementum detachments from underlying dentin.
These can lead to localized periodontal breakdown.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on biologic width, periodontal health, and restoration impacts in dentistry. This quiz covers key concepts related to tooth anatomy, calculus effects, and junctional epithelium assessment methods. Answer questions about design factors for prosthesis and the significance of biologic width measurements.