Periodontology Flashcards

What is the BPE (Basic Periodontal Examination) code that indicates a need for complex treatment (specialist referral consideration)?

Answer: Code 4

BPE Code 4 indicates pocket depths of 6 mm or more, requiring complex periodontal treatment and consideration of specialist referral for appropriate management.

Which instrument design is most effective for subgingival debridement in a narrow 5 mm pocket?

Answer: Gracey curette (e.g., Gracey 11/12 for mesial surfaces)

Area-specific Gracey curettes are designed to adapt to specific root surfaces, providing effective subgingival debridement in defined pocket depths.

What is the primary aim of periodontal regeneration using GTR (guided tissue regeneration)?

Answer: Selective repopulation of periodontal ligament cells before epithelium

GTR uses membranes to exclude epithelium and gingival connective tissue, allowing PDL and bone cells to repopulate the defect and achieve true periodontal regeneration.

Necrotising periodontal disease (NPD) is characterised by which pathognomonic feature?

Answer: Necrosis and punched-out interdental papillae with pseudomembrane

NPD presents with necrosis and ulceration of interdental papillae, which appear punched-out with a grey pseudomembranous slough, often with pain and halitosis.

Which risk factor has the strongest evidence for worsening periodontal disease outcomes?

Answer: Cigarette smoking

Cigarette smoking is the most robustly evidenced modifiable risk factor for periodontitis, associated with deeper pockets, more bone loss, and poorer treatment outcomes.

In BSP periodontal staging, what clinical finding upgrades a case to Stage IV?

Answer: Masticatory dysfunction or need for complex multidisciplinary rehabilitation

Stage IV is distinguished from Stage III by the presence of masticatory dysfunction — such as drifting, flaring, tooth loss due to periodontitis, or bite collapse.