Periodontal Assessment and Treatment Flashcards

According to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases, Stage III periodontitis is characterized by:

Answer: Tooth loss due to periodontitis, bone loss to the middle or apical third of the root, or furcation class II or III involvement

Stage III periodontitis is characterized by tooth loss attributable to periodontitis, bone loss extending to the middle or apical third of the root, and/or furcation class II or III defects, distinguishing it from less severe stages.

Which type of bone defect is characterized by bone loss on one root surface only, maintaining normal height on adjacent roots?

Answer: One-wall (hemiseptal) defect

A one-wall (hemiseptal) defect has bone remaining on only one side of the defect — the least favorable for regenerative treatment as it provides minimal bony walls for clot stabilization.

During a periodontal chart, the dental hygienist records a probing depth of 4 mm at the midbuccal of tooth #19 with 2 mm of recession. The clinical attachment level (CAL) is:

Answer: 6 mm

CAL = probing depth + recession (when the gingival margin is apical to the CEJ): 4 mm + 2 mm = 6 mm clinical attachment loss.

Scaling and root planing (SRP) is classified as which level of periodontal therapy?

Answer: Phase I (cause-related/non-surgical) therapy

SRP is the cornerstone of Phase I (cause-related/initial) periodontal therapy, aimed at disrupting and removing subgingival bacterial biofilm and calculus deposits before any surgical decisions are made.

Which systemic condition is most strongly associated with necrotizing periodontal diseases (NPD)?

Answer: HIV infection/immunosuppression and malnutrition/stress

Necrotizing periodontal diseases (NUG, NUP, necrotizing stomatitis) are strongly associated with HIV infection and other immunosuppressive states, as well as severe malnutrition and stress.

Chlorhexidine gluconate 0.12% mouthrinse is used as an adjunct in periodontal therapy primarily because of its:

Answer: Broad-spectrum antimicrobial action and substantivity (prolonged binding to oral tissues)

Chlorhexidine's efficacy as a chemical plaque control agent is due to its cationic nature (binds to negatively charged bacterial surfaces) and substantivity — it binds to oral mucosa and is released over 8–12 hours, providing prolonged antimicrobial activity.