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Chp 5: Local Contributory Factors for Periodontal Diseases (Note to self:…
Chp 5: Local Contributory Factors for Periodontal Diseases (Note to self: all are considered secondary. Only bacteria is primary cause)
Calculus
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a.k.a. tartar, or calcified dental plaque
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Self: In clinic, identification of calculus is imperative to properly finishing pt. Though in beginning it is also taught to "scale to 360" so all tooth surfaces are scaled and no calculus is missed
Root morphology
cervical enamel projections (CEPs): continuity of CEJ on unusual surface of tooth or father distance. Cause deeper pocket. Can cause furcation involvement.
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palatoginigival grooves: present on 5-8% max incisors. Cause narrow, deep pockets.
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Placement in arch
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Open contacts can cause food impaction, tissue inflammation.
Self: we learned the importance of such anatomy in Dental Anatomy I and II, so as to be able to find areas that "hide calculus" we may no initially feel/find.
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Traumatic Factors
Factitious Disease: self gauging or scratching gingiva, such as fingernail, as habit or out of nervousness/stress. Common on anteriors, causes loss of attachment.
Food impaction: Very common, after calculus, local factor for contributing to periodontal diseases. Harbors bacteria and increases plaque retention in localized area.
Toothbrush trauma: abrasion, causes loss of attachment.
Chemical injury: such as topically applied aspirin, cocaine, tobacco, Orajel, H2O2. Can cause ulceration/burning of tissues and can interfere with plaque control and cause inflammation in localized area.
Self: Have seen chemical/drub burns on several patients when I was assistant. Dr would recommend Chlorhexidine rinses to help flush bacteria from area until healed.