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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
Q

Oral ecologic succession: what complexes are the first to colonize?

A

Yellow, green, purple complexes
(gram-positive early tooth colonizers)

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26
Q

Oral ecologic succession: what complexes are second to colonize?

A

Green (some), orange, red
(Gram-negatives)

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27
Q

Red complex organisms are ____ implicated in periodontal disease

A

Strongly

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28
Q

There is _____ associated with red complex organisms

A

biochemical interdependence

form red-red complexes together

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29
Q

What are the red complex organisms?

A
  • Porphyromonas gingivalis
  • Tannerella forsythia
  • Treponema denticola
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30
Q

P. gingivalis classification

A
  • gram-negative rod
  • non-motile
  • anaerobic
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31
Q

P. gingivalis virulence factors

A
  • fimbriae (adhesion)
  • LPS (endotoxin, inflammation)
  • Capsular polysaccharide to evade host defenses
  • Proteases: gingipains (PMN inhibition, tissue damage)
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32
Q

What is the function of P. gingivalis gingipains?

A
  • PMN inhibition
  • tissue damage
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33
Q

Mode of action of Porphyromonas gingivalis

A
  • P. gingivalis infection in periodontal pocket
  • hijacking of local complement system
  • amplification of local antimicrobial activity
  • profound change in local microbiota composition
  • chronic inflammation
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34
Q

P. gingivalis gingipains activate ____ in periodontal tissues

A

PAR2

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35
Q

Activation of PAR2 by gingipains induces the production of _____ in periodontal tissues. This leads to:

A

Pro-inflammatory cytokine mediators; periodontal breakdown

36
Q

Pro-inflammatory cytokine mediators associated with PAR2 activation

A

IL-1 beta, IL-2, IL-6, TNF-alpha, MMPs

37
Q

Periodontal breakdown from gingipains involves:

A
  • degradation of collagen and fibronectin, complement, PMN receptors
  • activate fibrinolytic system
  • tissue destruction
38
Q

P. gingivalis gingipains are strongly expressed after:

A

Incubation with T. denticola (spirochete)

39
Q

Gingipains further alter ______ of the periodontal pocket and may lead to _____

A

Microbial composition; chronic inflammation

40
Q

T. denticola classification

A
  • Gram-negative spirochete
  • anaerobic
41
Q

T. denticola is motile due to presence of:

A

Periplasmic flagella

42
Q

_____ has resistance to human beta-defensins

A

T. denticola

43
Q

What do human beta-defensins do?

A
  • form pores within bacterial cell membrane
  • causes permeation and leakage of intracellular contents
44
Q

Tannerella forsythia classification

A
  • Gram-negative
  • fusiform
  • anaerobic
45
Q

Main virulence factor of T. forsythia

A

Glycosidases

46
Q

Glycosidases function

A

Degrade complex carbohydrates (proteoglycan) to expose binding sites

47
Q

Orange complex organisms are _____ risk

A

Moderate

48
Q

What are the orange complex organisms?

A
  • Prevotella intermedia
  • Prevotella melaninogenica
  • Fusobacterium nucleatum
  • Campylobacter rectus
  • Eubacterium nodatum
  • Peptostreptococcus sp.
49
Q

P. intermedia classification

A
  • Gram-negative
  • Anaerobic
  • coccobacilli
50
Q

P. intermedia produces ____ which converts _____ to black pigment

A

Hemolysin; Hemoglobin

51
Q

F. nucleatum classification

A
  • Gram-negative
  • anaerobic
  • fusiform rod
52
Q

F. nucleatum is a ____ because it adheres to a wide range of organisms

A

Corn cob

53
Q

____ is a bridge species between early and late colonizers

A

F. nucleatum

54
Q

F. nucleatum is a part of the normal oral flora, and there is a huge increase in _____

A

Acute necrotizing ulcerative gingivitis

55
Q

Campylobacter rectus classification

A
  • Gram-negative
  • facultative anaerobic
  • motile rods (curved, S-shaped)
56
Q

Campylobacter rectus virulence factors

A
  • Flagella (motility)
  • cytotoxins
  • slime layer
57
Q

Slime layer in C. rectus provides:

A

Adhesion

58
Q

Cytotoxins in C. rectus function

A

Tissue damage

59
Q

Eubacterium - orange complex species

A
  • E. yurii
  • E. nodatum
60
Q

E. nodatum/E. yurii classification

A
  • Gram-positive bacilli
  • anaerobe
61
Q

Eubacterium sp. facilitate:

A

Corn cob formation (facilitate inter-species interaction)

62
Q

Eubacterium virulence factors

A
  • Adhesion (implants, brackets)
  • Butyric acid (inhibits wound healing)
  • Can cause pelvic inflammatory disease
63
Q

Peptostreptococcus sp. classification

A
  • Gram-positive streptococcus
  • Obligate anaerobe
64
Q

Peptostreptococcus virulence factors

A
  • can produce capsular material
  • can facilitate co-aggregation
  • acid, protease production
  • can cause fatal endocarditis
65
Q

Green complex organisms are _____ risk

A

Moderate

66
Q

Green complex organisms

A
  • Eikenella corrodens
  • Captocytophagia species
67
Q

Eikenella corrodens classification

A
  • gram-negative pleiomorphic rod
  • facultative anaerobe
68
Q

Eikenella corrodens is mainly a ____ of the oral cavity but can also cause disease

A

Commensal

69
Q

____ is associated with braces and poor oral hygiene

A

Eikenella corrodens

70
Q

Eikenella corrodens main virulence factor

A

type 2 autoinducer, quorum sensing molecules

71
Q

Captocytophagia sp. classification

A
  • Gram-negative bacilli
  • facultative anaerobe
  • opportunistic pathogen
72
Q

Captocytophagia virulence factors

A
  • resistance to 3rd gen. cephalosporins
  • CfxA
  • facilitates co-aggregation, F. nucleatum
  • Endocarditis
73
Q

What is CfxA?

A

Broad spectrum beta lactamase

74
Q

Aggregatibacter actinomycetemcomitans (AA) is a _____ complex pathogen

A

Purple (but technically Green)

75
Q

Aggregatibacter actinomycetemcomitans (AA) classification

A
  • Gram-negative coccobacilli
76
Q

Aggregatibacter actinomycetemcomitans (AA) is a _____ pathogen found in _____

A

High risk; localized aggressive periodontitis

77
Q

Aggressive Early Onset Periodontitis is ____ in children and young adults

A

Uncommon

78
Q

Aggressive Early Onset Periodontitis is a result of:

A

Highly virulent bacteria and/or highly susceptible subject

79
Q

Aggressive Early Onset Periodontitis is caused by what bacteria?

A

Aggregatibacter actinomycetemcomitans (AA)

80
Q

Aggregatibacter actinomycetemcomitans (AA) virulence factors

A
  • Leukotoxin A
  • chemotactic factor
  • immunosuppressive factor
  • ompA (Fc binding protein)
81
Q

What does leukotoxin A do?

A
  • Kills PMN (Leukocytes, CD18) by forming pores
  • depletes neutrophils
  • damaged PMN release lysosomes to further damage periodontal tissues
82
Q

Overall, leukotoxin A causes:

A
  • periodontal destruction
  • impaired defense
  • microbial nutrition
83
Q

What is acute necrotizing ulcerative gingivitis (ANUG)?

A

Severe form of periodontitis in an impaired host

84
Q

Acute necrotizing ulcerative gingivitis (ANUG) symptoms

A

Severe necrosis of free gingival margins, crest of gingiva, interdental papilla

85
Q

Acute necrotizing ulcerative gingivitis (ANUG) involves ____ infections, including many _____

A

Mixed anaerobic; different anaerobic microbes

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

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