FCSP - staging and grading

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Questions and Answers

In the initial assessment of periodontal disease, when is a full periodontal assessment (including a detailed 6-point pocket chart) indicated?

  • When there is no obvious evidence of interdental recession.
  • When the initial periodontal therapy is completed and the localized 6-point pocket chart is reviewed in the involved sextant(s). (correct)
  • When bleeding on probing is less than 10%.
  • Only when a molar-incisor pattern of periodontitis is observed.

A patient presents with no pockets $\geq$4mm and no radiographic evidence of bone loss due to periodontitis. Following the BSP implementation guide, which pathway should be followed for further management?

  • Continue with code 3 pathway.
  • Continue with code 4 pathway.
  • Continue with code 0/1/2 pathway. (correct)
  • Initiate full periodontal assessment.

What is the significance of assessing 'historic periodontitis' in the context of implementing the 2017 classification of periodontal diseases?

  • It aids in identifying cases with interdental recession that may indicate previous disease activity, influencing diagnosis and management. (correct)
  • It is irrelevant as the 2017 classification focuses solely on current clinical parameters.
  • It helps in determining the current stability of the disease, regardless of past bone loss.
  • It is only important for epidemiological studies, not for individual patient management.

In the staging of periodontitis, what is the primary factor used to determine the stage when radiographic assessment is not clinically justified and bitewings are the only available radiographs?

<p>Clinical Attachment Loss (CAL) or bone loss from the cementoenamel junction (CEJ). (C)</p> Signup and view all the answers

When determining the 'grade' of periodontitis, the percentage of bone loss divided by the patient's age is calculated. What does this calculation primarily indicate?

<p>An indirect measure of the disease progression rate. (D)</p> Signup and view all the answers

A patient has bleeding on probing (BoP) scores of ≥10% and probing pocket depths (PPD) ≤4mm at all sites with no BoP at 4mm sites. According to the British Society of Periodontology (BSP) guidelines, how would you classify the current periodontitis status?

<p>Currently in remission. (D)</p> Signup and view all the answers

How does the presence of plaque retentive factors influence the diagnosis and management of a patient with a BPE code 2?

<p>Diagnosis should also include a comment on plaque retentive factors; management focuses on addressing these factors to improve periodontal health. (A)</p> Signup and view all the answers

A patient exhibiting 'Grade C' periodontitis is characterized by what rate of disease progression?

<p>Rapid rate of progression. (B)</p> Signup and view all the answers

In staging periodontitis, if interproximal bone loss is observed in the mid-third of the root, which stage of periodontitis is indicated?

<p>Stage III (Severe). (C)</p> Signup and view all the answers

According to the assessment of current periodontitis status, which clinical parameters define a case as 'Currently Unstable'?

<p>PPD $\geq$5mm or PPD $\geq$4mm with BoP. (B)</p> Signup and view all the answers

Flashcards

Clinical Gingival Health

No obvious interdental recession, and less than 10% bleeding on probing.

Localised Gingivitis

No obvious interdental recession, with 10-30% bleeding on probing.

Generalised Gingivitis

No obvious interdental recession, with more than 30% bleeding on probing.

Periodontitis Stable

No pockets ≥4mm and no radiographic evidence of bone loss due to periodontitis.

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Currently Stable

BoP <10%, PPD ≤4mm, No BoP at 4mm sites.

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Currently in Remission

BoP ≥10%, PPD ≤4mm, No BoP at 4mm sites.

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Currently Unstable

PPD ≥5mm or PPD ≥4mm & BoP.

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Periodontitis Stage I

Less than 15% (or <2mm) attachment loss from CEJ

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Periodontitis Grade C

Severe rate of progression

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Periodontitis Grade A

Slow rate of progression

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Study Notes

The Poisson Distribution

  • It is a discrete probability distribution.
  • It expresses the probability of a number of events happening in a fixed time or space interval.
  • These events occur at a known constant mean rate.
  • Each event happens independently after the last.

Definition

  • A discrete random variable $X$ has a Poisson distribution with parameter $\lambda > 0$.
  • The probability mass function (PMF) is: $P(X = k) = \frac{e^{-\lambda} \lambda^k}{k!}$, $k = 0, 1, 2,...$
  • $e$ is Euler's number ($e \approx 2.71828$).
  • $k$ is the number of event occurrences.
  • $k!$ is the factorial of $k$.
  • $\lambda$ is a positive real number.
  • $\lambda$ equals the expected number of occurrences during the interval.

Mean and Variance

  • If $X \sim Poisson(\lambda)$, then
  • $E[X] = \lambda$
  • $Var(X) = \lambda$

Example

  • Average goals in a soccer match = 2.
  • The probability of 5 goals being scored in a match is:
  • $P(X = 5) = \frac{e^{-2} 2^5}{5!} = 0.0361$

Poisson Sums

  • Let $X_1, X_2,..., X_n$ be independent Poisson random variables.
  • The means are $\lambda_1, \lambda_2,..., \lambda_n$, respectively.
  • $X_1 + X_2 +... + X_n$ is a Poisson random variable.
  • The mean is $\lambda_1 + \lambda_2 +... + \lambda_n$.

Example

  • The number of emails arriving to the first account follows a Poisson distribution with a rate of 3 emails per hour.
  • The number of emails arriving to the second account follows a Poisson distribution with a rate of 5 emails per hour.
  • $X \sim Poisson(3)$ and $Y \sim Poisson(5)$.
  • $X + Y \sim Poisson(3 + 5) = Poisson(8)$
  • The probability that you will receive a total of 10 emails in one hour is:
  • $P(X + Y = 10) = \frac{e^{-8} 8^{10}}{10!} = 0.09926$

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