DH 120 - Periodontics I

Credits: 3
Instructional Contact Hours: 3

1. Identify anatomy of the periodontium.

1. Identify and describe the function that each of the following tissues serve in the periodontium:
   1. 1. Gingiva
      2. Periodontal ligament
      3. Cementum
      4. Alveolar bone
2. Identify anatomical structures of the following gingiva and explain their function:
   1. 1. Free gingiva
      2. Gingival sulcus
      3. Interdental gingiva
      4. Attached gingiva.
      5. Gingival margin
      6. Free gingival groove
      7. Mucogingival junction
3. Compare and contrast various colors, contours, and consistencies of gingival anatomy in health and disease.
4. Describe the shape and contour of the alveolar crest bone in health.
5. Describe the nerve and blood supply of the periodontium.
6. Explain the lymphatic system role in the health of the periodontium.

2. Demonstrate knowledge of the microscopic anatomy of the periodontium.

1. Describe the histology of the periodontium and the function of different tissue layers.
2. Describe the composition and function of connective tissue and epithelial tissue.
3. Describe the epithelial-connective tissue interface.
4. Describe the term cell junction and describe its function in the epithelial tissues.
5. Describe the location and function of the gingival epithelium, oral epithelium, sulcular epithelium, and junctional epithelium.
6. Explain the difference between keratinized and non-keratinized gingival epithelium.
7. Describe the type of epithelial connective tissue interface boundary of various anatomical areas of the gingiva tissue in health.
8. Compare and contrast the function of supra gingival fiber bundles and periodontal ligament in the periodontium.
9. Identify the fiber groups and anatomy of the periodontal ligament.
10. List the relationship that the cementum may have in relation to the enamel and the cementoenamel junction.
11. Define the term alveolar bone and describe its function in the periodontium.

3. Display understanding of periodontal health status using the current classification system.

1. Define the term disease progression.
2. Define the term periodontal disease and contrast it with the term periodontitis.
3. Compare and contrast the position of the junctional epithelium, characteristics of the epithelial connective tissue interface, and the position of the alveolar crest bone in health, gingivitis and periodontitis.
4. Describe the progressive destruction of alveolar bone that occurs in periodontitis.
5. Describe the pathway of inflammation that occurs in horizontal bone loss and vertical bone loss.
6. Compare and contrast the characteristics of gingival and periodontal pockets.
7. Identify the clinical signs of periodontal health and periodontal disease.
8. Utilize clinical findings to explain whether the patient's disease is gingivitis or periodontitis.
9. Explain the difference between suprabony and infrabony pockets.
10. Define prevalence and incidence as measurements of periodontal disease.
11. Explain the rationale for a classification system of periodontal disease.
12. List the major categories of periodontal diseases and conditions for natural teeth and dental implants and provide examples for each.
13. Explain why clinicians need to be familiar with terminology used in prior disease classification systems.
14. Compare and contrast the etiologic factors, radiographic findings, and clinical characteristics of all conditions outlined in the current classification system.
15. Provide examples of a well-constructed AAP statement for each.
16. Describe the difference between intact and reduced periodontium.
17. Explain its significance in staging and grading periodontitis.
18. Differentiate between the terms recurrent and refractory as they pertain to periodontitis.

4. Demonstrate understanding of mucogingival deformities associated with periodontal disease.

1. Differentiate between normal mucogingival conditions and mucogingival deformities in periodontal disease.
2. Explain the significance of periodontal biotype and be able to describe and distinguish features of each.
3. Define the term gingival recession and explain what factors must be taken into consideration during assessment and treatment planning.
4. Explain the Miller and Cairo classification system used to classify gingival recession.

5. Explain dental implants.

1. Describe the components of dental implants and associated restorations.
2. Compare and contrast the periodontium of a natural tooth versus the peri-implant tissues that surround a dental implant.
3. Define the clinic and radiographic findings of peri-implant health, peri-implant mucositis, and peri-implantitis and distinguish the key differences.
4. Define the terms osseointegration, biomechanical forces, and biomechanical overload as they apply to dental implants.
5. Describe the appropriate maintenance interval for a patient with dental implants.
6. Select the appropriate aid(s) for a patient to effectively remove biofilm around dental implants.

6. Identify risk factors associated with periodontal disease.

1. Define the term risk factor and provide examples.
2. Example biologic equilibrium and describe how certain factors can disrupt the balance between health and disease.
3. Explain the difference between modifiable and non-modifiable risk factors.
4. Name systemic diseases and conditions that can modify the host response to periodontal pathogens.
5. Explain the importance of collaborating with other health care professionals in shared patient-centered problem solving.
6. Explain the importance of educating patients about their relationship between oral health and systemic diseases.
7. Discuss potential implications of systemic conditions and the periodontium.
8. Discuss how hormone alteration may affect the periodontium.
9. Define the term osteoporosis and explain the link between skeletal osteoporosis and alveolar bone loss.
10. Describe the implications of Down syndrome on the periodontium.
11. List three types of medications that can cause gingival enlargement.
12. Contrast the terms association and causation.
13. Understand the importance of establishing collaborative relationships with other health care providers to ensure the highest standard of care for periodontal patients with systemic diseases and conditions.
14. Describe how local factors contribute to the retention and accumulation of biofilm.
15. Explain how local contributing factors differ from systemic contributing factors.
16. Identify and describe the location, composition, modes of attachment, mechanisms of mineralization, and pathologic potential of supragingival and subgingival calculus deposits.
17. Explain how local contributing factors can lead to direct damage of the periodontium.
18. Explain the role of trauma from occlusion as a possible contributing factor to periodontal disease.

7. Demonstrate knowledge of oral biofilm and its role on periodontal disease.

1. Describe the structural features of gram-positive and gram-negative bacteria.
2. Define the term biofilm and explain its significance in periodontal disease.
3. Explain the life cycle of biofilm.
4. Summarize the evolution of hypotheses to explain the role of bacteria in periodontal disease.

8. Explain the role of the immune system in relation to periodontal disease.

1. Describe the function of the immune system.
2. Compare and contrast innate immunity and adaptive immunity.
3. Describe the role and function of immune cells and their byproducts in the inflammatory response.
4. Explain the complement system and explain the role it plays in the immune response.
5. Compare characteristics of acute versus chronic inflammation
6. Define inflammatory mediator and provide explained related to the periodontium.
7. Define the term host response and describe the function.
8. Define the term biochemical mediator and list examples.
9. Explain the phases of ordinary modeling describe the link between periodontitis and RANKL-mediated bone resorption.
10. Explain the host immune response throughout the histological stages of gingivitis and periodontitis including the following:

1. Bacterial accumulation phase
2. Early gingivitis phase
3. Establish individual phase
4. Periodontitis phase

9. Identify characteristics of clinical periodontal assessments.

1. List components of a comprehensive periodontal assessment
2. Describe how to evaluate each component of comprehensive periodontal assessments.
3. Compare and contrast periodontal screening and evaluation and comprehensive periodontal assessment.
4. Calculate correctly and document clinical attachment levels and width of attached gingiva for patients with health, gingivitis, and periodontitis