perio (1).png A 41 year old, diabetic female patient, Ms Bareng Lechesa, from Brits, who smokes a daily ‘joint’ of marijuana to combat emotional stress, consults at your surgery with the main complaint: “my gums bleed whenever I eat.” Two years previously she was treated for gum disease by one of the final year BDS students at Sefako Makgatho University’s Oral Health Centre. Medical history: The patient has had no previous illnesses and operations. List of current medication(s): Metformin 500mg and multivitamin supplements. Allergies: None Habits: The patient neither consumes alcohol nor smoke cigarettes. Extra-oral examination (including “JACCOL”) yielded no significant findings. Intra-oral soft tissues (except the gingivae, appeared normal. Details of the periodontal examination are reflected on the hard copy of the patient’s charting record provided to you. Radiographic examination: a panoramic taken on the day of this consultation revealed widespread areas of alveolar bone loss on both the upper and lower jaws. The periapical radiograph shown on the slide above depicts the patient’s worst affected site in terms of alveolar bone loss. At this site, the distance from the apex of the teeth to the cemento-enamel junction (CEJ) is 21mm, whilst the amount of the alveolar bone present is 11mm at the same site. NB: Please, utilize the radiograph depicted above and the hard copy of the patient’s dental chart provided to you to determine the following: The grade of the periodontal condition above is:

The direction of the migration of the gingival margin in the periodontal pathology depicted in the slide in question 3 is:

furc2.pngIn the horizontal classification of furcation lesions, the periodontal pathology depicted by the arrow in the slide above is classified as Class II furcation lesion if there is more than 3mm of horizontal ……………… (fill in)

Nabers.png What is the purpose of the instrument that is depicted in the slide above?

perio (1).png A 41 year old, diabetic female patient, Ms Bareng Lechesa, from Brits, who smokes a daily ‘joint’ of marijuana to combat emotional stress, consults at your surgery with the main complaint: “my gums bleed whenever I eat.” Two years previously she was treated for gum disease by one of the final year BDS students at Sefako Makgatho University’s Oral Health Centre. Medical history: The patient has had no previous illnesses and operations. List of current medication(s): Metformin 500mg and multivitamin supplements. Allergies: None Habits: The patient neither consumes alcohol nor smoke cigarettes. Extra-oral examination (including “JACCOL”) yielded no significant findings. Intra-oral soft tissues (except the gingivae, appeared normal. Details of the periodontal examination are reflected on the hard copy of the patient’s charting record provided to you. Radiographic examination: a panoramic taken on the day of this consultation revealed widespread areas of alveolar bone loss on both the upper and lower jaws. The periapical radiograph shown on the slide above depicts the patient’s worst affected site in terms of alveolar bone loss. At this site, the distance from the apex of the teeth to the cemento-enamel junction (CEJ) is 21mm, whilst the amount of the alveolar bone present is 11mm at the same site. NB: Please, utilize the radiograph depicted above and the hard copy of the patient’s dental chart provided to you to determine the following: The periodontal condition of the above-mentioned patient is:

All of the following, except one, can be determined by utilizing radiographic examination. Which one is the exception?

A 28 year old female, Ms Rosa van Niekerk, consults at your surgery in Rustenburg and presents with a main complaint of “my gums bleed when I brush my teeth or bite on hard food.” There had not been any swelling or pain associated with her gingivae and the patient has never had an episode like this before. The patient reports that she brushes her teeth once a day but does not floss at all.Medical history: There patient had no significant medical conditions. Blood pressure: 130/90 mmHg Medications: NoneAllergies: NoneHabits: The patient does not take alcohol but she is a smoker (started at age 23 and currently smokes 10 cigarettes per day).Extra-oral examination: No significant findings. The patient had no masses or swelling, and the temporomandibular joint was within normal limits.Intra-oral examination: The soft tissues of the mouth (except the gingival tissues) including the tongue appeared normal. Gingival examination revealed a mild gingival erythema, rolled gingival margins and swollen interdental papillae. Intra-orally, gingival oedema and erythema, which were present on 18 buccal, 11 buccal, 11 palatal, and the interdental papillae between 21 and 22, buccal gingival margins and interdental papillae of the mandibular incisors; rolled buccal gingival margins were noted on 18 mesio-buccal and 11 mesio-buccal aspects. There was also bleeding on probing on these areas. The patient’s plaque index is 79%. Periodontal probing depths were ranging between 1-3 mm across the entire mouth.Occlusal discrepancies There were no occlusal discrepancies or interferences.Radiographic examination: A panoramic radiograph was taken but revealed no alveolar bone loss.The correct diagnosis for this periodontal condition is:

perio (1).png A 41 year old, diabetic female patient, Ms Bareng Lechesa, from Brits, who smokes a daily ‘joint’ of marijuana to combat emotional stress, consults at your surgery with the main complaint: “my gums bleed whenever I eat.” Two years previously she was treated for gum disease by one of the final year BDS students at Sefako Makgatho University’s Oral Health Centre. Medical history: The patient has had no previous illnesses and operations. List of current medication(s): Metformin 500mg and multivitamin supplements. Allergies: None Habits: The patient neither consumes alcohol nor smoke cigarettes. Extra-oral examination (including “JACCOL”) yielded no significant findings. Intra-oral soft tissues (except the gingivae), appeared normal. Details of the periodontal examination are reflected on the hard copy of the patient’s charting record provided to you. Radiographic examination: a panoramic taken on the day of this consultation revealed widespread areas of alveolar bone loss on both the upper and lower jaws. The periapical radiograph shown on the slide above depicts the patient’s worst affected site in terms of alveolar bone loss. At this site, the distance from the apex of the teeth to the cemento-enamel junction (CEJ) is 21mm, whilst the amount of the alveolar bone present is 11mm at the same site. NB: Please, utilize the radiograph depicted above and the hard copy of the patient’s dental chart provided to you to determine the following: The extent and distribution is:

The objective of the cause-related phase of the non-surgical periodontal treatment plan is:

Kindly refer to the hard copy of the dental chart provided and calculate (to one decimal place) Ms Lechesa’s plaque index.The patient’s plaque index is: