Understanding the Poisson Distribution

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Questions and Answers

According to the BSP implementation of the 2017 classification of periodontal diseases, what is the first step in reaching a diagnosis in clinical practice?

  • Taking a thorough history, examination, and screening for periodontal disease, including BPE and assessment of historic periodontitis. (correct)
  • Performing a full periodontal assessment including a detailed 6-point pocket chart.
  • Undertaking initial periodontal therapy and reviewing in 3 months with localised 6-point pocket chart in the involved sextant(s).
  • Taking appropriate radiographs to assess bone loss.

In the BSP guideline, if a patient presents with code 3 without obvious interdental recession, what is the next recommended step?

  • Continue with code 0/1/2 pathway.
  • Appropriate radiographic assessment. (correct)
  • Prescribe a course of antibiotics.
  • Initiate a full periodontal assessment including a detailed 6-point pocket chart.

According to the BSP implementation of the 2017 classification, what clinical scenarios would lead you to continue with the code 4 pathway?

  • Pockets ≥4mm remain and/or radiographic evidence of bone loss. (correct)
  • Bleeding on probing scores are less than 10%.
  • The patient has clinical gingival health.
  • No pockets ≥4mm and no radiographic evidence of bone loss.

When staging periodontitis according to the BSP implementation of the 2017 classification, what is the key determinant for classifying a case as Stage III?

<p>Attachment loss extending to the mid-third of the root. (B)</p> Signup and view all the answers

According to the BSP implementation of the 2017 classification, what criteria defines periodontitis as 'currently in remission'?

<p>Bleeding on probing (BoP) ≥10%, Probing pocket depths (PPD) ≤4mm and No BoP at 4mm sites. (C)</p> Signup and view all the answers

What parameter is used to determine the Grade of periodontitis?

<p>Percentage bone loss divided by patient age. (D)</p> Signup and view all the answers

In what scenario would a radiographic assessment involve using CAL or bone loss from the cementoenamel junction (CEJ) instead of periapicals, OPG, or DPT?

<p>If periapicals, OPG, and DPT are not clinically justified, or only bitewings are available. (B)</p> Signup and view all the answers

Following the BSP implementation of the 2017 classification, a patient is diagnosed with 'Localised Gingivitis'. Based on this information alone, which of the following BPE scores would be most likely?

<p>10-30% bleeding on probing with no obvious evidence of interdental recession. (A)</p> Signup and view all the answers

How should a diagnosis statement be structured according to the BSP implementation of the 2017 classification of periodontal diseases?

<p>Extent - Periodontitis - Stage - Grade - Stability - Risk Factors (D)</p> Signup and view all the answers

A patient presents with probing depths of 6mm, bleeding on probing, and radiographic evidence of bone loss affecting less than 30% of teeth. According to the BSP guideline, after initial periodontal therapy, if pockets of ≥4mm persist, what is the MOST appropriate next step in their periodontal management?

<p>Staging and grading, current disease status and risk assessment. (D)</p> Signup and view all the answers

Flashcards

Clinical Gingival Health

Inflammation of the gums with <10% bleeding on probing and no interdental recession.

Localised Gingivitis

Inflammation of the gums with 10-30% bleeding on probing and no interdental recession.

Generalised Gingivitis

Inflammation of the gums with >30% bleeding on probing and no interdental recession.

Continue with code 0/1/2 pathway

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

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Continue with code 4 pathway

Pockets ≥4mm remain and/or radiographic evidence of bone loss due to periodontitis.

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Periodontitis Molar-Incisor Pattern

Periodontitis in a molar-incisor pattern of tooth loss.

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Periodontitis Stage I (Early/Mild)

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

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Periodontitis Stage II (Moderate)

Coronal third of root.

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Periodontitis Stage III (Severe)

Mid third of root.

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Periodontitis Stage IV (Very Severe)

Apical third of root.

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Periodontitis Grade A

Slow rate of progression.

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Periodontitis Grade B

Moderate rate of progression.

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Periodontitis Grade C

Rapid rate of progression.

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Currently Stable

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

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Currently in Remission

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

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Currently Unstable

PPD ≥5mm or PPD ≥4mm & BoP.

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Study Notes

The Poisson Distribution

  • It's a discrete probability distribution for the number of events in a fixed interval, with a known constant mean rate, independent of the last event's timing.
  • The probability mass function (PMF) is $P(X = k) = \frac{e^{-\lambda} \lambda^k}{k!}$ for $k = 0, 1, 2,...$
  • $e$ represents Euler's number ($e \approx 2.71828$).
  • $k$ is the number of event occurrences.
  • $k!$ is the factorial of $k$.
  • $\lambda$ is the expected number of occurrences.
  • If $X \sim Poisson(\lambda)$, then $E[X] = \lambda$ and $Var(X) = \lambda$.
  • For example, given an average of 2 goals in a soccer match, finding the probability of 5 goals being scored is $P(X = 5) = \frac{e^{-2} 2^5}{5!} = 0.0361$.

Poisson Sums

  • If $X_1, X_2,..., X_n$ are independent Poisson random variables with means $\lambda_1, \lambda_2,..., \lambda_n$, then $X_1 + X_2 +... + X_n$ is a Poisson random variable with mean $\lambda_1 + \lambda_2 +... + \lambda_n$.
  • Imagine two email accounts; the first receives emails at a rate of 3 per hour, and the second at a rate of 5 per hour; to find the probability of receiving 10 emails in total in one hour.
  • With $X \sim Poisson(3)$ and $Y \sim Poisson(5)$, then $X + Y \sim Poisson(3 + 5) = Poisson(8)$.
  • Solving this, $P(X + Y = 10) = \frac{e^{-8} 8^{10}}{10!} = 0.09926$.

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