1.Q: Types of frenum and attachment,clinical significance.

A: Depending upon the extension of attachment of fibers, frenum have been classified as:

1. Mucosal – when the frenal fibers are attached up to mucogingival junction

2. Gingival – when fibres are inserted within attached gingival
3. Papillary – when fibres are extending into inter dental papilla
4. Papilla penetrating – when the frenal fibres cross the alveolar process and extend up to palatine
papillaPapilla penetrating

Other variations of normal frenal attachment include:

simple frenum with a nodule
Simple frenum with appendix
Simple frenum with nichum

 Bifid labial frenum

 Persistent tectolabial frenum
 Double frenum
 Wider frenum
Clinical significance:
 2.Q: Grading of calculus and stains
A: GRADING OF CALCULUS

0 No calculus present

1 Supragingival calculus covering not more than third of the exposed tooth surface.

2 Supragingival calculus covering more than one third but not more than two thirds
of the exposed tooth surface or the presence of individual flecks of subgingival calculus around
the cervical portion of the tooth or both.

3 Supragingival calculus covering more than two third of the exposed tooth surface
or a continuos heavy band of subgingival calculus around the cervical portion of the tooth or
both.

GRADING OF STAINS

0 No stains present

1 Stains covering not more than of tooth surface

2 Stains covering not more one third , but more than two thirds ,of the exposed tooth
surface

3 Stains covering more than two of exposed tooth surface.

3.Q: Diagnosis of gingivitis (Acute & chronic), periodontitis (acute & chronic)

A: ACUTE GINGIVITS:

CHRONIC GINIGIVITIS:

-Clinical diagnosis: Inflammatory enlargement with ballooning of papilla around teeth

will give clue to diagnosis.
 -Laboratory diagnosis: There is proliferative features of chronic inflammation. Lesions
may contain preponderance of inflammatory cells with vascular engorgement.

PERIODONTITIS

CHRONIC PERIODONTITIS:

-Clinical diagnosis: Gingival recession, pocket formation with mobility of tooth will
diagnose the condition

-Radiological diagnosis: Horizontal and vertical bone loss is present.

-Laboratory diagnosis: The enlarged free marginal gingiva is densely infiltrated with
lymphocytes and plasma cells. The apical borders of the inflamed area approach the crest
of the alveolar bone and the crestal fibers of the periodontal ligament.

4.Q: Plunger’s cusp

A. A cusp whose movement during mastication forces food into interproximal areas.

5.Q: Fremitus test

A. It is a measurement of vibratory pattern of the teeth when the teeth are placed in contacting
position and movements.

The classification systems are used:

CLASS I FREMITUS: Mild vibration or movement detected

CLASS II FREMITUS: Easily palpable vibration but no visible movement

CLASS III FREMITUS: Movements visible with naked eyes.

6.Q: Causes of halitosis

A. Oral conditions causing halitosis:

1 Retention of food around the teeth.

2 Gingival and periodontal disease.

3 Deep carious lesion and necrotic pulp.

4 Coated tongue.
 5 Mouth breathing.

6 Poor maintenance of appliances.

7 Oral soft tissue and hard tissue lesions.

8 Smoker’s breath.

B. Odors from systemic disorders:

1 Odors from nasopharynx.

2 Pathological conditions of lungs and bronchi.

3 Disease of GI tract.

4 Metabolic diseases.

5 Blood disorders:
ANEMIA,AGRANULOSYSTOSIS,LEUKEMIA,THROMBOCYTOPENIA.

6 Salivary gland disorders.

7 Aromatic substances

8 Drugs.

7.Q: Changes in periodontium in diabetes mellitus

A. Includes

- Increased tendency towards enlarged gingiva,

- Sessile or pedunculated gingival polyps,

- Polypoid gingival proliferation,

- Abcess formation,

- Periodontitis and loosened teeth.