12. Gingival and Periodontal Diseases Flashcards
what is periodontology?
the study of periodontal tissues in health and disease; including causes, prevention and the treatment of diseases of the periodontal tissues.
what is part of the peritoneum?
gingival
periodontal ligament
root cementum
alveolar bone
what is ACJ?
smell-cemental junction
- same as CEJ
what is CEJ?
cementoenamel junction
- same as ACJ
what are the ACJ and CEJ?
junctional enamel where the root meets the crown
how big is the sulcus in healthy gums?
1mm
what is periodontal health?
the outcome of the balance between bacteria of the dental plaque and the host immune system
does gingivitis always progress to periodontitis?
no
what rate does periodontitis progress?
at different rates at different sites in mouth and different people
what does gingivitis effect?
what is not effected?
no bone resorption or clinical attachment loss.
only effects soft tissue
what factor causes prevalence of periodontal disease to increase?
age
what is the definition of inflammation?
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.
why does periodontitis often go a long time without treatment?
there is no drastic symptoms so may not know unless told by dentist
- don’t seek help until function is impaired ie too late
what are the cardinal signs of inflammation?
pain
heat
redness
swelling
loss of function
how do you resolve inflammation in periodontitis?
no resolution
what happens do vessels during inflammation?
.dilation
.increased permeability of walls
.inflammatory exudate
.emigration if white blood cells from blood vessels into the connective tissue
what are the risk factors of periodontal disease?
general health
pathological conditions
genetics
function of immune system
what additional pathological condition effect periodontal health?
- viral infections
- bacterial infections
- diabetes mellitus
- hypoxia
- liver disease
how does general health effect periodontal disease?
stress
fatigue
smoking
diet
medications
hygienic habits
what are the 2 types of local risk factors for periodontal disease?
acquired
anatomical
describe the acquired local risk factor for periodontal disease?
plaque
calculus
overhanging
poorly contoured restorations
describe the anatomical local risk factor for periodontal disease?
malpositioned teeth
root grooves
concavities and furcations
enamel pearls
name the 2 systemic risk factors for periodontal disease?
non-modifiable
modifiable
what are non-modifiable systemic risk factors of periodontal disease?
ageing
genetic facts
what are modifiable systemic risk facts of periodontal disease?
smoking
poorly controlled diabetes
stress
medication
hormonal changes
poor nutrition
socioeconomic status
how can bacteria vary?
number
virulence
formation of biofilm
what is biofilm?
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).
where do biofilms from?
.on living or nonliving surfaces
. inside water or sewage pipes
. prevalent in natural, industrial and hospital settings
name a type of biofilm.
dental plaque
what 2 subcategories of biofilm is dental plaque?
subgingival
supragingival
how can you view dental plaque?
discolouring agents
what are the 4 stages of biofilm formation?
pellicle
association adhesion
growth
mature biofilm microcolonies
what happens at the first stage of biofilm formation?
pellice - proteins and glycoproteins of saliva - a few minutes to form
what happens at stage 2 of biofilm formation?
Association, adhesion - trailblazing bacteria - steptoccocus, antinomyces - possess adhesion molecules
what happens at stage 3 of biofilm formations?
growth - microcolonies - production of polysaccharide matrix
what is the last stage of biofilm formation?
mature biofilm microcolonies transition into metabolic complexes
what is keystone bacteria?
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
how does the immune system react to its own biofilm?
often launches inflammation against it
what disrupts the homeostasis in periodontal disease?
- genetic conditions associated with the impairment of immune system eg. down syndromme
- diseases leading to impairment of immune system eg. leukaemia
what happens when dental plaque becomes calcified?
turns to calculus
symptoms of gingivitis?
erythema (redness)
swelling
bleeding pn gentle probing
symptoms of periodontitis for patients?
- bleeding on brushing
- bad breath (halitosis) and taste]
- sensitivity
- drifting teeth
- mobility
- discomfort, pains occurs rarely most in necrotising ulcerative periodontal disease
signs of periodontitis upon clinical examination?
- bleeding on gentle probing
- erythema, fibrosis, loss of knife edge margin
- halitosis
- swelling - falls pocket formation
- bone loss (recession)
- mobility
- purulence
how do you detect bone loss in periodontitis upon clinical examination?
increase clinical probing depth to see true pocket formation
what is the difference between true pockets and false pockets in the gingiva?
true = loss of attachment (periodontitis)
false = gingival swelling (gingivitis )
