Kuwait Dental Board Periodontics flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Biologic width

The supracrestal attached tissues comprising junctional epithelium (about 0.97 mm) and connective tissue attachment (about 1.07 mm); a minimum of 3 mm from restoration margin to bone is the clinical rule.

Transseptal fibers

Gingival fiber group running from cementum of one tooth across the interdental septum to the adjacent tooth; they regenerate earliest after periodontal surgery and resist tooth separation.

Oblique fibers

The most numerous principal periodontal ligament fibers, running from cementum apically and coronally into bone; they are the main support against axial occlusal loading.

Junctional epithelium

Nonkeratinized epithelium attached to the tooth by hemidesmosomes, 15-30 cells coronally and 1-3 apically, with wide intercellular spaces that permit leukocyte migration.

Red complex

The cluster of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, strongly associated with periodontitis and forming late in biofilm succession.

Keystone pathogen

A low-abundance organism such as P. gingivalis that can dysregulate the whole biofilm and host response, converting a symbiotic community into a destructive one.

RANKL

Receptor activator of nuclear factor kappa-B ligand, produced by T cells and stromal cells, which binds RANK on osteoclast precursors to drive bone resorption; OPG is its decoy receptor.

Calculus

Mineralized dental plaque composed mainly of calcium phosphate; it is always covered by unmineralized biofilm and acts as a retentive factor rather than a direct cause of attachment loss.

Stage III periodontitis

CAL of 5 mm or more, radiographic bone loss extending to the middle third and beyond, and four or fewer teeth lost; severity is not modified by extent.

Grade B periodontitis

Moderate progression defined by percentage bone loss divided by age between 0.25 and 1.0, with modifiers of former smoking or less than 10 cigarettes daily and HbA1c below 7.0%.

PSR code 4

Periodontal screening code assigned when a sextant has a probing depth of 5.5 mm or more; it triggers full-mouth periodontal charting and diagnosis.

Clinical attachment level

The distance from the cementoenamel junction to the base of the sulcus or pocket, calculated as probing depth plus recession or minus gingival enlargement.

Amoxicillin-metronidazole adjunct

Systemic regimen of amoxicillin 500 mg plus metronidazole 400-500 mg three times daily for 7 days, best supported as an adjunct to scaling and root planing in severe periodontitis.

Subantimicrobial doxycycline

Doxycycline 20 mg twice daily used for host modulation by inhibiting matrix metalloproteinases, not for its antibiotic effect, as an adjunct in selected periodontitis patients.

Chlorhexidine substantivity

The property of chlorhexidine 0.12-0.2% that binds to oral surfaces and is released over about 12 hours, providing prolonged antiplaque action but causing staining and taste change.

Guided tissue regeneration

A surgical technique using a barrier membrane to exclude epithelium and allow periodontal ligament and bone cells to repopulate a defect, most predictable in intrabony defects and Class II furcations.

Modified Widman flap

An open debridement flap that preserves tissue, removes pocket lining, and allows root instrumentation while minimizing recession; it does not include osseous resection.

Enamel matrix derivative

A regenerative material derived from developing porcine tooth germs, applied to exposed root surfaces to promote periodontal regeneration; it shows benefits in intrabony defects.

Peri-implant mucositis

Reversible inflammation limited to peri-implant soft tissue, characterized by bleeding on probing and no progressive bone loss; treated with debridement and improved hygiene.

Peri-implantitis

Inflammation of peri-implant tissues with progressive bone loss beyond initial remodeling; risk factors include smoking, periodontitis history, and poor plaque control.

Implant placement timing

Type 1 immediate, Type 2 early (2-8 weeks), Type 3 early delayed (8-16 weeks), and Type 4 late (>16 weeks) after extraction; timing depends on socket integrity and infection.

Coronally advanced flap

A pedicle flap raised and advanced coronally to cover a denuded root; combined with a connective tissue graft it achieves about 80-90% root coverage in Miller Class I-II defects.

Miller Class I recession

Marginal tissue recession not extending to the mucogingival junction with no interdental bone or soft tissue loss; complete root coverage is predictable.

Connective tissue graft

A subepithelial graft, usually from the palate, used to increase tissue thickness and achieve root coverage; it is the best-documented graft for Miller Class I-II recession.

Diabetes-periodontitis link

A bidirectional relationship in which hyperglycemia worsens periodontal destruction and periodontal therapy reduces HbA1c by about 0.3-0.4%, especially in type 2 diabetes.

MRONJ

Medication-related osteonecrosis of the jaw associated with bisphosphonates, denosumab, and antiangiogenic drugs; risk rises with intravenous therapy and longer duration.

Drug-influenced gingival enlargement

Gingival overgrowth caused by phenytoin, cyclosporine, and calcium channel blockers; management includes plaque control, drug substitution, and surgery when indicated.

Supportive periodontal care

Individualized recall with periodontal reassessment and debridement, typically every 3 months for high-risk patients and 6-12 months for low-risk patients; compliance reduces tooth loss.

Lang-Tonetti risk assessment

A tool using bleeding on probing, residual pockets of 5 mm or more, tooth loss, bone loss divided by age, systemic factors, and smoking to classify patients as low, moderate, or high risk.

PICO framework

A structured approach to clinical questions specifying Population, Intervention, Comparison, and Outcome, used to build searches and appraise evidence.

Sensitivity and specificity

Sensitivity is true positives divided by all diseased; specificity is true negatives divided by all healthy; predictive values additionally depend on disease prevalence.

Informed consent

A voluntary documented agreement after disclosure of diagnosis, proposed treatment, alternatives, risks, benefits, and consequences of refusal, respecting patient autonomy.