NBDHE: CASE STUDIES
1. CASE 1: PATIENT
SYNOPSIS:
2. CASE 1: PANO:
3. CASE 1: RADIOGRAPHS:
4. CASE 1: DENTAL
CHARTS:
5. Which should be the first phase of treatment for this patient?: Referral to Periodontist
This patient presents with multiple vertical bone defects, flaring of the maxillary anterior teeth, mobility, etc., which wou
warrant an immediate referral.
6. What is the most likely etiologic factor for the periodontitis present?: BAC- TERIAL PLAQUE
Plaque biofilm is always the primary etiologic factor in periodontitis.
7. The bacterial plaque located subgingivally on this patient is most likely which type of spirochete bacteria
predominantly?: Treponema denticola Treponema denticola is a Gram-negative, obligate anaerobic, motile and highly
pro- teolytic spirochete bacterium. It dwells in a complex and diverse microbial community within the oral cavity and is
highly specialized to survive in this environment.
T. denticola is associated with the incidence and severity of human periodontal disease. Elevated T. denticola levels in th
mouth is considered one of the main etiological agents of periodontitis.
8. The clinical presentation of the papillae can best be described as:: -
CRATERED
, NBDHE: CASE STUDIES
Cratered papilla is when the papilla appears to have been scooped out leaving a
, NBDHE: CASE STUDIES
concave depression in the mid proximal area. Cratered papilla are often associated with necrotizing ulcerative gingivitis.
9. This patient present with a/an:: AN IMPACTED CANINE TOOTH
10.Teeth numbers 22 through 27 were not probed during the comprehensive examination. The reason is most
likely:: Presence of pseudomembrane
The teeth were not probed due to a presence of a pseudomembrane (false mem- brane) as it would give inaccurate
measurements.
11.This patient is a candidate for surgical interventions for the following indications:: Probing depths in
excess of 5 mm, Presence of infrabony defects The patient is a candidate for surgical intervention due to the probing
depths in excess of 5 mm and presence of infrabony defects.
12.The RDH is responsible for the initial phase of therapy for this patient. The first phase of therapy includes:
- Removal of causative factors
- Control active disease sites
- Measures to reduce marginal inflammation
- Reduce surgical bleeding
INCLUDES ALL OF THE ABOVE: The first phase of dental hygiene therapy is to remove causative factors, control
active disease sites, and take measures to reduce marginal inflammation and to reduce surgical bleeding.
13.The periodontal surgery indicated will most likely be:: Guided tissue regen- eration
- Guided tissue regeneration is a dental surgical procedure that use barrier mem- branes to direct the growth of new bone
and gingival tissue at sites with insufficient volumes or dimensions of bone or gingiva for proper function, esthetics or
prosthetic restoration.
14.The radiopacity superimposed over the mandibular lateral incisors is the:-
: Mental ridge
- The mental ridge may appear as a dense white ridge of varying density extending from the anterior midline to the
bicuspid region, usually located below the anterior teeth, but occasionally superimposed over the apices.
15.The patient's periodontal condition is best classified as:: Type V: Necrotiz- ing Periodontal Disease
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and
alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection,
malnutrition and immunosuppression.
, NBDHE: CASE STUDIES
16.The most accurate indicator of damage to the periodontium is/are the:: -
Clinical attachment loss
- Clinical attachment loss is the most accurate indicator of damage to the periodon- tium.
17.Upon administration of anesthesia, the patient reports pain upon scaling tooth #27. The most likely reason
for the pain is due to:: Low pH of tissue
- A low tissue pH (acidic) will decrease the effectiveness of local anesthesia.
18.Prostaglandins and Leukotrienes are produced via this process:: Arachi- donic Acid Pathway
- The arachidonic acid pathway constitutes one of the main mechanisms for the production of pain and inflammation,
as well as controlling homeostatic function. This is the process that produces prostaglandins and leukotrienes.
19.Place the 4 stages of the healing dynamics in proper order:: Blood clotting, Wound cleansing, Rebuilding
tissue, Wound remodeling
- This is the proper order of healing dynamics.
20.CASE 2::
21.CASE 2: DENTAL CHARTS:
22.CASE 2: PANO:
23.CASE 2: RADIOGRAPHS:
1. CASE 1: PATIENT
SYNOPSIS:
2. CASE 1: PANO:
3. CASE 1: RADIOGRAPHS:
4. CASE 1: DENTAL
CHARTS:
5. Which should be the first phase of treatment for this patient?: Referral to Periodontist
This patient presents with multiple vertical bone defects, flaring of the maxillary anterior teeth, mobility, etc., which wou
warrant an immediate referral.
6. What is the most likely etiologic factor for the periodontitis present?: BAC- TERIAL PLAQUE
Plaque biofilm is always the primary etiologic factor in periodontitis.
7. The bacterial plaque located subgingivally on this patient is most likely which type of spirochete bacteria
predominantly?: Treponema denticola Treponema denticola is a Gram-negative, obligate anaerobic, motile and highly
pro- teolytic spirochete bacterium. It dwells in a complex and diverse microbial community within the oral cavity and is
highly specialized to survive in this environment.
T. denticola is associated with the incidence and severity of human periodontal disease. Elevated T. denticola levels in th
mouth is considered one of the main etiological agents of periodontitis.
8. The clinical presentation of the papillae can best be described as:: -
CRATERED
, NBDHE: CASE STUDIES
Cratered papilla is when the papilla appears to have been scooped out leaving a
, NBDHE: CASE STUDIES
concave depression in the mid proximal area. Cratered papilla are often associated with necrotizing ulcerative gingivitis.
9. This patient present with a/an:: AN IMPACTED CANINE TOOTH
10.Teeth numbers 22 through 27 were not probed during the comprehensive examination. The reason is most
likely:: Presence of pseudomembrane
The teeth were not probed due to a presence of a pseudomembrane (false mem- brane) as it would give inaccurate
measurements.
11.This patient is a candidate for surgical interventions for the following indications:: Probing depths in
excess of 5 mm, Presence of infrabony defects The patient is a candidate for surgical intervention due to the probing
depths in excess of 5 mm and presence of infrabony defects.
12.The RDH is responsible for the initial phase of therapy for this patient. The first phase of therapy includes:
- Removal of causative factors
- Control active disease sites
- Measures to reduce marginal inflammation
- Reduce surgical bleeding
INCLUDES ALL OF THE ABOVE: The first phase of dental hygiene therapy is to remove causative factors, control
active disease sites, and take measures to reduce marginal inflammation and to reduce surgical bleeding.
13.The periodontal surgery indicated will most likely be:: Guided tissue regen- eration
- Guided tissue regeneration is a dental surgical procedure that use barrier mem- branes to direct the growth of new bone
and gingival tissue at sites with insufficient volumes or dimensions of bone or gingiva for proper function, esthetics or
prosthetic restoration.
14.The radiopacity superimposed over the mandibular lateral incisors is the:-
: Mental ridge
- The mental ridge may appear as a dense white ridge of varying density extending from the anterior midline to the
bicuspid region, usually located below the anterior teeth, but occasionally superimposed over the apices.
15.The patient's periodontal condition is best classified as:: Type V: Necrotiz- ing Periodontal Disease
- Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and
alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection,
malnutrition and immunosuppression.
, NBDHE: CASE STUDIES
16.The most accurate indicator of damage to the periodontium is/are the:: -
Clinical attachment loss
- Clinical attachment loss is the most accurate indicator of damage to the periodon- tium.
17.Upon administration of anesthesia, the patient reports pain upon scaling tooth #27. The most likely reason
for the pain is due to:: Low pH of tissue
- A low tissue pH (acidic) will decrease the effectiveness of local anesthesia.
18.Prostaglandins and Leukotrienes are produced via this process:: Arachi- donic Acid Pathway
- The arachidonic acid pathway constitutes one of the main mechanisms for the production of pain and inflammation,
as well as controlling homeostatic function. This is the process that produces prostaglandins and leukotrienes.
19.Place the 4 stages of the healing dynamics in proper order:: Blood clotting, Wound cleansing, Rebuilding
tissue, Wound remodeling
- This is the proper order of healing dynamics.
20.CASE 2::
21.CASE 2: DENTAL CHARTS:
22.CASE 2: PANO:
23.CASE 2: RADIOGRAPHS:
