Perio Client Case Type- Quiz 1

Casey type 0

Normal healthy - NO bone loss

Case type I

Gingivitis - NO bone loss

Case type II

Early periodontitis - <20% bone loss

Case type III

Moderate periodontitis - 20-50% bone loss

Case type IV

Advanced periodontitis ->50% bone loss

Case type V

Refractory periodontitis

Periodontal maintenance

Bone loss present with no active disease

Which two case types will look the same on x-rays and what must be done

0 and 1 - need to follow up with clinical examination

How do you read bone loss percentage

In a range of 5%

What is the reference point for interproximal bone loss

CEJ

Where does bone loss occur

1-2mm below CEJ

Occurs in a plane parallel to the CEJ of adjacent teeth

Horizontal bone loss

Occurs in an angular plane to the CEJ of adjacent teeth

Vertical bone loss

Vertical bone loss can be ______ or ______

Localized or generalized

In order to be vertical, the bone loss percentage must be at least ______% or case type ___

20%; III or IV

Base of the pocket is below the height of the alveolar crest

Infrabony

Base of the pocket is above the height of the alveolar crest

Suprabony

Infraobony is always ______

Vertical

Suprabony is always _______

Horizontal

How to determine bone loss

Find CEJ
Locate apex
Determine half way point
Determine a range of 5%
Determine case type/horizontal/vertical/etc.

Document the bone levels according to the amount that is _____

Lost

Radiolucent

Low density - shades of dark gray to black

Radiopaque

High density - shades of light gray to white

In health, where is the junctional epithelium

JE is coronal to CEJ

In health, gingival fibers are _____

Intact

In health, PDL fibers are ____

Intact

In health, alveolar bone is _____

Intact

In gingivitis, where is the junctional epithelium

JE is at CEJ

In gingivitis, gingival fibers are ____

Damaged

In gingivitis, PDL fibers are _____

Intact

In gingivitis, alveolar bone is ____

Intact

In periodontitis, where is the junctional epithelium

JE is apical to CEJ

In periodontitis, the gingival fibers are _____

Completely destructed

In periodontitis, the PDL fibers are____

Completely destructed and there is exposure of cementum

In periodontitis, the alveolar bone is _____

Completely destructed, along with interproximal bone and interradicular bone

Acute gingivitis

Lasts for a short period of time

Chronic gingivitis

Lasts for months or years

Periodontitis is characterized by

-Apical migration of the JE
-Loss of CT attachment
-Loss of alveolar bone

Gingivitis is characterized by

Changes in color, contour, consistency of gingival tissues

Gingivitis is ____

Reversible

Periodontitis is ____

Irreversible