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DEN 7108 Micro and Immuno Concepts Part II > 1/16 Nguyen Microbiology of Periodontal Disease > Flashcards

1/16 Nguyen Microbiology of Periodontal Disease Flashcards

1
Q

Define periodontitis

A

Bacterial infection of supporting tissue around teeth

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2
Q

Periodontitis is a _____ disease

A

Chronic inflammatory

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3
Q

With periodontitis, local environment changes correlates with a shift in _____. There is a decrease in _____ and an increase in ______

A

bacterial population; Gram positive bacteria; oral treponemes and gram negative bacteria

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4
Q

Development of gingivitis follows what pattern?

A
  1. Biofilm formation
  2. Plaque development
  3. gingivitis
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5
Q

What happens after cessation of dental hygiene for 7 days?

A

Biofilm on tooth surfaces, leads to plaque and gingivitis

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6
Q

At first, biofilm formation is started by ____ bacteria. After 48 hours, there is a ____ in Streptococci. After 10 days, the bacteria found are?

A

70% streptococci; decrease; highly diverse, orange and red complex bacteria

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7
Q

Plaque hypothesis: non-specific plaque

A

All plaque is bad, large amount produces periodontitis

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8
Q

Plaque hypothesis: specific plaque

A

Specific organisms cause periodontitis

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9
Q

Plaque hypothesis: ecological plaque

A
  • Stressors induce changes towards diseases
  • shift balance towards disease
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10
Q

Ecological plaque hypothesis - examples of stressors

A
  • physiologic
  • environmental
  • chemical
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11
Q

Describe the pathway of gingivitis onset (ecological plaque hypothesis)

A
  1. Increased plaque with stress produces increased inflammation
  2. Environmental change causes high GCF flow, inc. pH, low Eh
  3. Ecological shift causes increase in Gram negative flora
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12
Q

Periodontal disease main risk factor

A

Smoking (greatest independent factor, 3-8x risk)

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13
Q

Example of a local factor that attributes towards periodontal disease

A

Appliances (brackets)

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14
Q

Good oral health has what kind of bacterial population?

A
  • microbial diversity
  • more commensal/facultative organisms
  • fewer gram +/- rods
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15
Q

In periodontitis, there is a marked shift towards:

A

Gram-negative anaerobes (bacilli)

Anaerobes that live in deep crevices

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16
Q

Where is gingivitis located around the tooth/gums?

A
  • Small amount that ends near CEJ
  • less recession, smaller
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17
Q

Where is periodontitis located around the tooth/gums?

A
  • more plaque, deeper, can extend to the root
  • more recession
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18
Q

Gram positive streptococci are considered _____ colonizers

A

Pioneer and early colonizers

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19
Q

Pioneer organisms attach to:

A

Tooth surface covered with acquired pellicle

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20
Q

____ link pioneer organisms to late colonizers using adhesion/receptor mechanisms

A

Early colonizers

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21
Q

Gram-negative bacteria are considered ____ colonizers

A

Late/secondary and tertiary

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22
Q

Which bacteria are highly associated with periodontitis?

A
  • Aggregatibacter actinomycetemcomitans
  • Porphyromonas gingivalis
  • Tannerella forsythia
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23
Q

____ is associated with aggressive periodontitis

A

Aggregatibacter actinomycetemcomitans

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24
Q

_____ is associated with chronic periodontitis

A
  • Porphyromonas gingivalis
  • Tannerella forsythia
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25
Oral ecologic succession: what complexes are the first to colonize?
Yellow, green, purple complexes (gram-positive early tooth colonizers)
26
Oral ecologic succession: what complexes are second to colonize?
Green (some), orange, red (Gram-negatives)
27
Red complex organisms are ____ implicated in periodontal disease
Strongly
28
There is _____ associated with red complex organisms
biochemical interdependence | form red-red complexes together
29
What are the red complex organisms?
- Porphyromonas gingivalis - Tannerella forsythia - Treponema denticola
30
P. gingivalis classification
- gram-negative rod - non-motile - anaerobic
31
P. gingivalis virulence factors
- fimbriae (adhesion) - LPS (endotoxin, inflammation) - Capsular polysaccharide to evade host defenses - Proteases: gingipains (PMN inhibition, tissue damage)
32
What is the function of P. gingivalis gingipains?
- PMN inhibition - tissue damage
33
Mode of action of Porphyromonas gingivalis
- P. gingivalis infection in periodontal pocket - hijacking of local complement system - amplification of local antimicrobial activity - profound change in local microbiota composition - chronic inflammation
34
P. gingivalis gingipains activate ____ in periodontal tissues
PAR2
35
Activation of PAR2 by gingipains induces the production of _____ in periodontal tissues. This leads to:
Pro-inflammatory cytokine mediators; periodontal breakdown
36
Pro-inflammatory cytokine mediators associated with PAR2 activation
IL-1 beta, IL-2, IL-6, TNF-alpha, MMPs
37
Periodontal breakdown from gingipains involves:
- degradation of collagen and fibronectin, complement, PMN receptors - activate fibrinolytic system - tissue destruction
38
P. gingivalis gingipains are strongly expressed after:
Incubation with T. denticola (spirochete)
39
Gingipains further alter ______ of the periodontal pocket and may lead to _____
Microbial composition; chronic inflammation
40
T. denticola classification
- Gram-negative spirochete - anaerobic
41
T. denticola is motile due to presence of:
Periplasmic flagella
42
_____ has resistance to human beta-defensins
T. denticola
43
What do human beta-defensins do?
- form pores within bacterial cell membrane - causes permeation and leakage of intracellular contents
44
Tannerella forsythia classification
- Gram-negative - fusiform - anaerobic
45
Main virulence factor of T. forsythia
Glycosidases
46
Glycosidases function
Degrade complex carbohydrates (proteoglycan) to expose binding sites
47
Orange complex organisms are _____ risk
Moderate
48
What are the orange complex organisms?
- Prevotella intermedia - Prevotella melaninogenica - Fusobacterium nucleatum - Campylobacter rectus - Eubacterium nodatum - Peptostreptococcus sp.
49
P. intermedia classification
- Gram-negative - Anaerobic - coccobacilli
50
P. intermedia produces ____ which converts _____ to black pigment
Hemolysin; Hemoglobin
51
F. nucleatum classification
- Gram-negative - anaerobic - fusiform rod
52
F. nucleatum is a ____ because it adheres to a wide range of organisms
Corn cob
53
____ is a bridge species between early and late colonizers
F. nucleatum
54
F. nucleatum is a part of the normal oral flora, and there is a huge increase in _____
Acute necrotizing ulcerative gingivitis
55
Campylobacter rectus classification
- Gram-negative - facultative anaerobic - motile rods (curved, S-shaped)
56
Campylobacter rectus virulence factors
- Flagella (motility) - cytotoxins - slime layer
57
Slime layer in C. rectus provides:
Adhesion
58
Cytotoxins in C. rectus function
Tissue damage
59
Eubacterium - orange complex species
- E. yurii - E. nodatum
60
E. nodatum/E. yurii classification
- Gram-positive bacilli - anaerobe
61
Eubacterium sp. facilitate:
Corn cob formation (facilitate inter-species interaction)
62
Eubacterium virulence factors
- Adhesion (implants, brackets) - **Butyric acid** (inhibits wound healing) - Can cause **pelvic inflammatory disease**
63
Peptostreptococcus sp. classification
- Gram-positive streptococcus - Obligate anaerobe
64
Peptostreptococcus virulence factors
- can produce capsular material - can facilitate **co-aggregation** - acid, protease production - can cause fatal endocarditis
65
Green complex organisms are _____ risk
Moderate
66
Green complex organisms
- Eikenella corrodens - Captocytophagia species
67
Eikenella corrodens classification
- gram-negative pleiomorphic rod - facultative anaerobe
68
Eikenella corrodens is mainly a ____ of the oral cavity but can also cause disease
Commensal
69
____ is associated with braces and poor oral hygiene
Eikenella corrodens
70
Eikenella corrodens main virulence factor
type 2 **autoinducer**, quorum sensing molecules
71
Captocytophagia sp. classification
- Gram-negative bacilli - facultative anaerobe - opportunistic pathogen
72
Captocytophagia virulence factors
- resistance to 3rd gen. cephalosporins - **CfxA** - facilitates co-aggregation, F. nucleatum - Endocarditis
73
What is CfxA?
Broad spectrum beta lactamase
74
Aggregatibacter actinomycetemcomitans (AA) is a _____ complex pathogen
Purple (but technically Green)
75
Aggregatibacter actinomycetemcomitans (AA) classification
- Gram-negative coccobacilli
76
Aggregatibacter actinomycetemcomitans (AA) is a _____ pathogen found in _____
High risk; localized aggressive periodontitis
77
Aggressive Early Onset Periodontitis is ____ in children and young adults
Uncommon
78
Aggressive Early Onset Periodontitis is a result of:
Highly virulent bacteria and/or highly susceptible subject
79
Aggressive Early Onset Periodontitis is caused by what bacteria?
Aggregatibacter actinomycetemcomitans (AA)
80
Aggregatibacter actinomycetemcomitans (AA) virulence factors
- Leukotoxin A - chemotactic factor - immunosuppressive factor - ompA (Fc binding protein)
81
What does leukotoxin A do?
- Kills PMN (Leukocytes, CD18) by forming pores - depletes neutrophils - damaged PMN release lysosomes to further damage periodontal tissues
82
Overall, leukotoxin A causes:
- periodontal destruction - impaired defense - microbial nutrition
83
What is acute necrotizing ulcerative gingivitis (ANUG)?
Severe form of periodontitis in an impaired host
84
Acute necrotizing ulcerative gingivitis (ANUG) symptoms
Severe necrosis of free gingival margins, crest of gingiva, interdental papilla
85
Acute necrotizing ulcerative gingivitis (ANUG) involves ____ infections, including many _____
Mixed anaerobic; different anaerobic microbes

DEN 7108 Micro and Immuno Concepts Part II (27 decks)

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