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Questions and Answers

What is mobility?

The loosening of a tooth in its socket. Results from loss of bone support around the tooth.

What is horizontal mobility?

The ability to move the tooth in a facial-lingual direction in its socket.

How do you assess horizontal mobility?

Using the ends of two handles, gently apply alternating pressure against the tooth, first from the facial and then from the lingual aspect.

What can you use as a point of reference when assessing tooth mobility?

<p>An adjacent tooth.</p> Signup and view all the answers

What is vertical mobility?

<p>The ability to depress the tooth in its socket.</p> Signup and view all the answers

How do you assess vertical mobility?

<p>Use the end of an instrument to exert gentle pressure against the occlusal surface or incisal edge of the tooth.</p> Signup and view all the answers

What is Class 1 mobility?

<p>Slight mobility, up to 1 mm of horizontal displacement in a facial-lingual direction.</p> Signup and view all the answers

What is Class 2 mobility?

<p>Greater than 1 mm but less than 2 mm of horizontal displacement in a facial-lingual direction.</p> Signup and view all the answers

What is Class 3 mobility?

<p>Greater than 2 mm of horizontal displacement in a facial-lingual direction or vertical mobility.</p> Signup and view all the answers

What are two types of single-ended instruments?

<p>Probe and mirror.</p> Signup and view all the answers

When can you assume mobility?

<p>When there is bone loss.</p> Signup and view all the answers

Can you visually look at mobility without doing anything to the tooth?

<p>False</p> Signup and view all the answers

What is fremitus?

<p>A palpable vibration or movement.</p> Signup and view all the answers

What is the procedure for the determination of fremitus?

<p>Put finger on the maxillary cervical third of canine and record findings.</p> Signup and view all the answers

What kind of trauma can fremitus cause and why?

<p>Occlusal trauma because of miscontoured restoration.</p> Signup and view all the answers

What can you do to fix occlusal trauma?

<p>If occlusion is distributed unevenly and it is wobbly, a dentist may splint teeth together so they function as one unit.</p> Signup and view all the answers

How do you measure the width of attached gingiva?

<p>By measuring from the gingival margin to the mucogingival junction on the buccal/facial aspect of the tooth. You then measure the probing depth. Subtract the probing depth from the total width to get the width of attached gingiva.</p> Signup and view all the answers

If there is inadequate attached gingiva, what will you see?

<p>Recession.</p> Signup and view all the answers

What can be used to fix recession?

<p>A gingival graft provides protection for the recessed area.</p> Signup and view all the answers

What do they do with excess gingiva?

<p>Gingivectomy (removing).</p> Signup and view all the answers

What is attached gingiva?

<p>The part of the gingiva that is tightly connected to the cementum on the cervical-third of the root and to the connective tissue cover of the alveolar bone.</p> Signup and view all the answers

Why is the width of attached gingiva important for dentistry?

<p>It is important when planning restorative procedures.</p> Signup and view all the answers

If there is no attached gingiva, what is it hard to do?

<p>The dentist is limited in the types of restorations that can be placed.</p> Signup and view all the answers

The attached gingiva extends from where to where?

<p>The attached gingiva extends from the base of the sulcus or pocket to the mucogingival junction.</p> Signup and view all the answers

What is furcation?

<p>The place on a multirooted tooth where the root trunk divides into separate roots.</p> Signup and view all the answers

What type of probes are used to evaluate furcations?

<p>Naber's probe.</p> Signup and view all the answers

What is bifurcation?

<p>Two roots, mandibular molars, facial and lingual.</p> Signup and view all the answers

What is trifurcation?

<p>Three roots, maxillary molars, facial, mesial, distal.</p> Signup and view all the answers

What instrument is good for debriding furcation areas?

<p>Ultrasonic scalers.</p> Signup and view all the answers

What types of offices have Naber's probes?

<p>Periodontal offices.</p> Signup and view all the answers

What is furcation involvement?

<p>Is a loss of alveolar bone and periodontal ligament fibers in the space between the roots of a multirooted tooth.</p> Signup and view all the answers

Furcation involvement is detected more frequently in maxillary molars by?

<p>Radiographs than by clinical exam.</p> Signup and view all the answers

Furcation involvement is detected more frequently in mandibular molars by?

<p>Clinical exam than by radiographs.</p> Signup and view all the answers

Clinically visible furcation areas are visible due to?

<p>Bone loss and tissue recession.</p> Signup and view all the answers

Are most furcation involvements visible or not?

<p>False</p> Signup and view all the answers

In health, can furcation areas be probed? Why or why not?

<p>The furcation area cannot be probed because it is filled with bone and periodontal ligament fibers.</p> Signup and view all the answers

What is the lingual root in maxillary molars also called?

<p>Palatal root.</p> Signup and view all the answers

What is a furcation probe?

<p>Type of periodontal probe used to evaluate the bone support in the furcation areas of multirooted teeth.</p> Signup and view all the answers

What is N1 (Naber's probe) used for?

<p>Used for assessment of mesial and distal furcation areas.</p> Signup and view all the answers

What is N2 (Naber's probe) used for?

<p>Used for assessment of facial and lingual furcation areas.</p> Signup and view all the answers

The crest of the alveolar bone from the CEJ is how long in health?

<p>2 mm.</p> Signup and view all the answers

Where is the furcation area of mandibular molars located?

<p>Located between mesial and distal roots.</p> Signup and view all the answers

How do you enter the buccal furcations of the maxillary molars?

<p>Enter furcation between the distobuccal and mesiobuccal roots from the facial aspect.</p> Signup and view all the answers

How do you assess the distal proximal furcation of maxillary molars?

<p>Access distal proximal furcation from the lingual aspect and furcation probe wraps around palatal root to enter furcation.</p> Signup and view all the answers

How are the maxillary premolar furcations assessed?

<p>Because the first premolar may have a buccal and palatal root, the proximal furcation is entered from the lingual aspect.</p> Signup and view all the answers

How many classes of furcation are there?

<ol start="4"> <li></li> </ol> Signup and view all the answers

What is Class 1 furcation?

<p>Concavity can be felt with probe. Probe tip cannot enter the furcation area.</p> Signup and view all the answers

What is Class 2 furcation?

<p>Probe tip can partially enter the furcation. Extends about one-third of the tooth. NOT able to pass completely through.</p> Signup and view all the answers

What is Class 3 furcation?

<p>Mandibular molars- probe passes completely through the furcation. Maxillary molars- probe touches the palatal (lingual) root.</p> Signup and view all the answers

What is Class 4 furcation?

<p>Same as Class 3 except that the furcation is visible clinically due to tissue recession.</p> Signup and view all the answers

How do you document furcation involvement?

<p>Symbols.</p> Signup and view all the answers

Study Notes

Tooth Mobility

  • Mobility refers to the loosening of a tooth in its socket due to bone support loss around the tooth.
  • Horizontal mobility is the ability to move the tooth in a facial-lingual direction within its socket.
  • Assess horizontal mobility by applying alternating pressure to the tooth from facial and lingual aspects.
  • An adjacent tooth can serve as a point of reference during assessment.
  • Vertical mobility indicates the ability to depress the tooth in its socket, typically resulting in exudate.
  • Assess vertical mobility by applying gentle pressure on the occlusal surface or incisal edge of the tooth.

Classes of Mobility

  • Class 1: Slight mobility with up to 1 mm horizontal displacement.
  • Class 2: Horizontal displacement greater than 1 mm but less than 2 mm.
  • Class 3: Greater than 2 mm horizontal displacement or any vertical mobility.

Instruments for Assessment

  • Common single-ended instruments include probes and mirrors.
  • Assumption of mobility can be made when there is evidence of bone loss.
  • Visual inspection alone cannot adequately assess mobility.

Fremitus

  • Fremitus is a palpable vibration or movement detectable in tooth movement.
  • To determine fremitus, place a finger on the maxillary cervical third of the canine and record findings.
  • Oclusal trauma may result from miscontoured restoration leading to fremitus.
  • Repair of occlusal trauma may involve splinting teeth together to function as a single unit.

Width of Attached Gingiva

  • Measure width by determining the distance from the gingival margin to the mucogingival junction and subtracting the probing depth.
  • Recession appears when there is inadequate attached gingiva.
  • Gingival grafts can provide protection for areas of recession.
  • A gingivectomy may be performed to remove excess gingiva.
  • Attached gingiva connects tightly to the cementum on the cervical-third of the root and to the connective tissue of the alveolar bone.
  • The width of attached gingiva is crucial for planning restorative procedures.
  • Absence of attached gingiva limits the types of restorations feasible.

Furcation Anatomy

  • The furcation is where the root trunk of a multirooted tooth splits into separate roots.
  • Naber's probe is used to evaluate furcations.
  • There are bifurcations (2 roots, e.g., mandibular molars) and trifurcations (3 roots, e.g., maxillary molars).
  • Ultrasonic scalers effectively debride furcation areas.

Furcation Involvement

  • Furcation involvement indicates loss of alveolar bone and periodontal ligament fibers between the roots.
  • Maxillary molar furcation involvement is more easily detected via radiographs; mandibular molars are often detected via clinical exams.
  • Clinically visible furcation areas arise from bone loss and tissue recession, but most are not visible and require probing for detection.
  • In health, furcation areas cannot be probed due to the presence of bone and periodontal ligament fibers.

Maxillary and Mandibular Tooth Furcation Assessment

  • Lingual root in maxillary molars is also known as the palatal root.
  • A furcation probe evaluates bone support in multirooted teeth.
  • Naber's probes have specific designs for assessing mesial, distal, facial, and lingual furcation areas.
  • The crest of the alveolar bone from the CEJ measures 2 mm in health.
  • Access buccal furcations of maxillary molars between the distobuccal and mesiobuccal roots and assess distal proximal furcations from the lingual aspect.

Classes of Furcation

  • Class 1: Concavity felt with a probe; tip cannot enter the furcation.
  • Class 2: Probe tip partially enters furcation, extending about one-third through without complete passage.
  • Class 3: Probe completely passes through mandibular molar furcation; touches palatal root in maxillary molars.
  • Class 4: Same as Class 3 but clinically visible due to tissue recession.

Documentation

  • Furcation involvement is documented using symbols for clarity.

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