 Hello everybody, Andrea Mayesky here. I'm finally starting to feel better, hence why the video is turned on. If the video is ever turned off, honestly, it's because I'm doing the rationale as late at night. I'm literally in my pajamas, or I just feel like I look bad for that day. So I thought today, since I'm finally starting to feel better, I can turn on the video because some of you did say that it's easier for you to understand things if you can actually see me at the same time. So I do hope that that does help. But we are continuing on with Perio here. Continuing on with the questions, this will be Perio video number four. And we are about, so right now there's 89 questions altogether. There will be more added. So keep on watching. I add the questions based on what questions you are all getting wrong so that I know what to add. You know, there's no sense adding more questions similar to the ones that everybody's getting right because that tells me they're too easy. Okay, so keep on checking back. And I do add the rationals. Usually Wednesdays and Sundays, I was adding them every day, but then the app tended to get slow, which is another reason why now the rationals, you can view them on a playlist on YouTube. So if you guys download the YouTube app on your phone or tablet, it's a lot easier to see it that way as well. And the developers of the app told me that the videos were using up too much space. So who knew, right? I don't know how to make apps. This is all a new thing for me. So thank you guys for your patience. Okay, let's continue on with the questions. So question number 47, when C overhangs on the radiograph, what is this considered? So what are overhangs pretty much? Look at the answers. And if you guys notice, a lot of them kind of sound correct, right? But the best answer, of course, is the defective restoration. So super calculus, you could see, well, depending on where the filling is, if the filling is above the gum line, technically you could see an overhang above the gum line. But that means that the work by the dentist is pretty bad. If they can't see that that needs to be polished off, because what overhangs are, is they're underneath the gum line, interproximately, and it's not always the dentist's fault. I mean, yes, it is the dentist's fault, but believe me, me being a restorative hygienist, I know it can be very, very difficult to polish interproximately. So that's where the overhangs happen is when the band around the tooth wasn't seated perfectly, and it wasn't polished interproximately perfectly either. Because if you polish too much, you open up the contact. If you polish not enough, you have an overhang. So believe me, it's a lot harder than it sounds. So supergenital calculus isn't correct because that would be more considered spurs of calculus, OK? Peridontal abscess is not correct because it's not an abscess. As we know, abscesses are at the roots of the teeth. A defective overhang, well, technically it is a defective overhang, but all overhangs are considered defective because you don't want the overhang there. So defective restoration is the best answer. The dentist tells you that he can tell from the radiograph that the patient has occlusal trauma. What does the dentist see? So when the dentist is looking at the x-ray saying, I see occlusal trauma, you might be going, what are they talking about? And then the patient might ask you afterwards, what's the dentist talking about? You don't want to say, I couldn't tell you. So because sometimes the dentist will say something like that and then literally just leave the room, or they'll be talking about something else and they will forget to explain that part of the appointment. So then the patient will ask you afterwards, so what does that mean? Occlusal what? So it's nice to know. So it is when the PDL space, so the periodontal ligament space, is a little more wide because it's not supposed to be wide, it's not supposed to be open, right? So that's what that means. Actually, let me see if I can find a quick image. Oh, sorry guys, let me see if I can find a quick image on my computer. I'm just going to pause this for one moment. OK, you guys, can everybody see my screen? OK, so I just did a quick search on the internet here. Notice how the radio lucency here is wide, but notice how on this tooth, it's not wide at all. So on this tooth, yes it is. This tooth, yes it is, right here, not here and not here. So this is what a widened PDL space looks like. So just so you guys know. OK, so back to the questions. So if you see that, the patient has been clenching or grinding for a long period of time. That's what that means. You should be able to see evidence of that inside the mouth if you see it in the x-rays. Because remember, if you see it in the x-rays, it's going to be worse than inside the mouth. Just like if you see bone loss in the x-rays, it's pretty bad. You know, the teeth might be loose or they're getting loose. You can tell there's pockets. You know that type of thing. So if you see it in the x-rays, you know it's pretty bad. That's the best answer. A lower PDL space will technically, if it's wide, it's lower. But that's why widened is the best answer. Because that's what you're looking for for occlusal trauma. Increased lamina dura, well, that's just not true. Too much lamina dura just isn't true either, right? Actually, let me pause this again. Okay, so I pause it again. I pause it again. I just quickly looked up something online here. So lamina dura is not to be confused with widened PDL space. So do you guys see this like thin line here? Just outside of that is considered the lamina dura. So the widened PDL space is just basically that space wider. Okay. So if you want to be really specific, the lamina dura is slightly outside and slightly inside of the PDL space. So does that make more sense? If not, let me know. Okay, next one. Let's see here. What is normal aviolar bone height? You always have to know what is normal. So that is 1.5 to 2.0 millimeters. Is this something you have to know for the real world? You know what? I would actually say yes. I was going to say no initially, but I would say yes. Because I know for me, and this comes with experience, I talk about things like a step further with the patients. So if I'm looking at the x-rays with a patient and I tell them, you have moderate bone loss. See this line here on the x-ray? This is where your bone is. The bone line should be up here because normal bone height is 1.5 to 2 millimeters. And then I might say to them, this looks like it's quite a lot lower. So possibly 1 millimeters, not quite a millimeter. You know, so I always take it a step further. You don't have to. I don't know a lot of people that would mention the normal bone height. But patients also know that I teach, at least the ones that I see often. So this is just something that I do think is a good idea to know. And they have asked this on the board exam before. They'd like to know, obviously, what's normal and what's not normal. So that's the best answer, a straight definition. What radiograph has little diagnostic value in the identification of periodontal disease? So we actually talked about this a little bit in the last video. We talked about which radiographs are the best to see periodontal disease. So now you have to know which ones don't really help when you're looking at period. And that would be the panoramic x-ray. And I did even mention that in the last one. So hopefully, if you guys were paying attention, things are starting to come together. So when you read this question, hopefully you were thinking, oh, well, Andrea talked about that in the last video. So I know out of these ones here, out of these answers, excuse me, the least effective for looking at period is the panoramic x-ray. Next one. Joe has been a regular patient of yours for many years. He has advanced periodontal disease. You notice angular bone loss, especially. Where is this more common? So where is, pick out the key words, where is angular bone loss more common? So if you had no clue, always just check the answers and then say, OK, advanced period, angular bone loss, more common. So the answer could not be everywhere. So it could not be A, because that's not saying that something's more common. So you know it has to be localized to a certain area. When you look at the next one, localized. Well, OK, that might be the right answer, because we know that this has to be localized somewhere because it's talking about where is it the most common. The next one, periodontal disease. Well, that can't be the right answer because that's what the question is asking. So is angular bone loss more common in periodontal disease? Well, that is saying that the patient has perio. So yes, technically, C is correct, but that's not what the question is asking. We know that the patient has advanced perio because that's what it says in the question. So C isn't wrong, but that's not the best one. And then anteriors, well, is it more common to have angular bone loss than anteriors? No. So we know that D is not the right answer. So we're looking at localized and periodontal disease. Well, localized is the best answer because it's more localized, if that makes sense. That isn't very good English, but you guys know what I'm saying, right? So B is more correct than C. OK, let's see here.