12. Gingival and Periodontal Diseases

Question 1

what is periodontology?

Answer 1

the study of periodontal tissues in health and disease; including causes, prevention and the treatment of diseases of the periodontal tissues.

Question 2

what is part of the peritoneum?

Answer 2

gingival
periodontal ligament
root cementum
alveolar bone

Question 3

what is ACJ?

Answer 3

smell-cemental junction
- same as CEJ

Question 4

what is CEJ?

Answer 4

cementoenamel junction
- same as ACJ

Question 5

what are the ACJ and CEJ?

Answer 5

junctional enamel where the root meets the crown

Question 6

how big is the sulcus in healthy gums?

Answer 6

1mm

Question 7

what is periodontal health?

Answer 7

the outcome of the balance between bacteria of the dental plaque and the host immune system

Question 8

does gingivitis always progress to periodontitis?

Answer 8

no

Question 9

what rate does periodontitis progress?

Answer 9

at different rates at different sites in mouth and different people

Question 10

what does gingivitis effect?
what is not effected?

Answer 10

no bone resorption or clinical attachment loss.
only effects soft tissue

Question 11

what factor causes prevalence of periodontal disease to increase?

Answer 11

age

Question 12

what is the definition of inflammation?

Answer 12

biological response to harmful stimuli, such as pathogens, damaged cells or irritants. inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate healing process.

Question 13

why does periodontitis often go a long time without treatment?

Answer 13

there is no drastic symptoms so may not know unless told by dentist
- don’t seek help until function is impaired ie too late

Question 14

what are the cardinal signs of inflammation?

Answer 14

pain
heat
redness
swelling
loss of function

Question 15

how do you resolve inflammation in periodontitis?

Answer 15

no resolution

Question 16

what happens do vessels during inflammation?

Answer 16

.dilation
.increased permeability of walls
.inflammatory exudate
.emigration if white blood cells from blood vessels into the connective tissue

Question 17

what are the risk factors of periodontal disease?

Answer 17

general health
pathological conditions
genetics
function of immune system

Question 18

what additional pathological condition effect periodontal health?

Answer 18

• viral infections
• bacterial infections
• diabetes mellitus
• hypoxia
• liver disease

Question 19

how does general health effect periodontal disease?

Answer 19

stress
fatigue
smoking
diet
medications
hygienic habits

Question 20

what are the 2 types of local risk factors for periodontal disease?

Answer 20

acquired
anatomical

Question 21

describe the acquired local risk factor for periodontal disease?

Answer 21

plaque
calculus
overhanging
poorly contoured restorations

Question 22

describe the anatomical local risk factor for periodontal disease?

Answer 22

malpositioned teeth
root grooves
concavities and furcations
enamel pearls

Question 23

name the 2 systemic risk factors for periodontal disease?

Answer 23

non-modifiable
modifiable

Question 24

what are non-modifiable systemic risk factors of periodontal disease?

Answer 24

ageing
genetic facts

Question 25

what are modifiable systemic risk facts of periodontal disease?

Answer 25

smoking poorly controlled diabetes stress medication hormonal changes poor nutrition socioeconomic status

Question 26

how can bacteria vary?

Answer 26

number virulence formation of biofilm

Question 27

what is biofilm?

Answer 27

a biofilm is an aggregate of microorganisms in which cells adhere to each other on a surface. these adherent cells are embedded within a self-produced matrix pf extracellular polymeric substance (DNA, proteins, polysaccharide).

Question 28

where do biofilms from?

Answer 28

.on living or nonliving surfaces . inside water or sewage pipes . prevalent in natural, industrial and hospital settings

Question 29

name a type of biofilm.

Answer 29

dental plaque

Question 30

what 2 subcategories of biofilm is dental plaque?

Answer 30

subgingival supragingival

Question 31

how can you view dental plaque?

Answer 31

discolouring agents

Question 32

what are the 4 stages of biofilm formation?

Answer 32

pellicle association adhesion growth mature biofilm microcolonies

Question 33

what happens at the first stage of biofilm formation?

Answer 33

pellice - proteins and glycoproteins of saliva - a few minutes to form

Question 34

what happens at stage 2 of biofilm formation?

Answer 34

Association, adhesion - trailblazing bacteria - steptoccocus, antinomyces - possess adhesion molecules

Question 35

what happens at stage 3 of biofilm formations?

Answer 35

growth - microcolonies - production of polysaccharide matrix

Question 36

what is the last stage of biofilm formation?

Answer 36

mature biofilm microcolonies transition into metabolic complexes

Question 37

what is keystone bacteria?

Answer 37

contain low abundance microbial pathogens can cause inflammatory disease by increasing the quantity of the normal microbiota and by changing its condition and by interfering with the host immune system

Question 38

how does the immune system react to its own biofilm?

Answer 38

often launches inflammation against it

Question 39

what disrupts the homeostasis in periodontal disease?

Answer 39

1. genetic conditions associated with the impairment of immune system eg. down syndromme 2. diseases leading to impairment of immune system eg. leukaemia

Question 40

what happens when dental plaque becomes calcified?

Answer 40

turns to calculus

Question 41

symptoms of gingivitis?

Answer 41

erythema (redness) swelling bleeding pn gentle probing

Question 42

symptoms of periodontitis for patients?

Answer 42

- bleeding on brushing - bad breath (halitosis) and taste] - sensitivity - drifting teeth - mobility - discomfort, pains occurs rarely most in necrotising ulcerative periodontal disease

Question 43

signs of periodontitis upon clinical examination?

Answer 43

- bleeding on gentle probing - erythema, fibrosis, loss of knife edge margin - halitosis - swelling - falls pocket formation - bone loss (recession) - mobility - purulence

Question 44

how do you detect bone loss in periodontitis upon clinical examination?

Answer 44

increase clinical probing depth to see true pocket formation

Question 45

what is the difference between true pockets and false pockets in the gingiva?

Answer 45

true = loss of attachment (periodontitis) false = gingival swelling (gingivitis )