2. Microbiology and Smoking Flashcards
What papillae are present in the tongue?
- Filiform (Most Numerous)
- Fungiform
- Foliate
- Circumvellate
What antibodies are in GCF?
IgA
IgG
What are the seven levels of evidence supports the bacterial etiology of periodontal disease?
- Clinical Observation
- Perio Dx in germ free animals
- Observation of monoinfected animals
- Experimental disease in animals and humans
- Plaque control in humans
- Epidemiological Studies
- Pathogenic potential of bacterial plaque
Discuss Loe’s work in 1965
- Plaque causes gingivitis
- 10-21 days are required to develop clinically detectable gingivitis
- Resolves with OH in 1 week
- Plaque changes from gram (+) (90-100%) to gram (-) (40-50%)
Discuss the non specific plaque hypothesis
The whole bacteria community causes periodontal disease
Discuss the specific plaque hypothesis
Certain bacteria cause the disease
only about 20 bacteria that are associated with the progression of periodontal disease
What is the bacterial flora in health?
- gram-positive
- Non Motile
- Streptococci and Actinomyces
(majority (75-80%) is gram-positive Streptococci and Actinomyces)
What is the bacterial flora in gingivitis?
Gram + rods
A Viscous
Löe–> A. Viscosus was significantly associated with marginal gingivitis
What is the bacterial flora in perio dx
- Gram Negative
- Increasing motility
- S Sanguis, F Nucleatum
Bacterial Flora in ANUG
Spirochete - T Pallidium
Bacterial Flora in ANUP
50% are uncultivable
What bacterial flora in abscess
Gram - rods
What are the red complex bacteria
- T Forsythia
- T Denticola
- P Gingivalis
What are the virulence factor of Actinobacillus actinomycetemcomitans (Aa)? (6)
- Polysaccharide / LPS
- Leukotoxin
- Extracellular proteins
- GroEl heat shock protein
- Fimbriae
- Other membrane proteins
What are the Virulence Factors in T Denticola?
- LPS
- Flagellum
- Extracellular Proteolytic Enzyme
What are the Virulence Factors in T Forsythia
- LPS
2. Extracellular proteolytic enzymes
What are the 6 Virulence Factors in P Gingivalis
- Capsule
- LPS
- Fimbriae
- GroEl heat shock proteins
- Extracellular proteolytic enzymes
- Haemaglutin’s
Smoking is a systemic risk factor for what
- COPD
- MI
- Stroke
- CVD
- Cancer
What study identifies smoking as a risk factor
Grossi
How does smoking increase risk for perio dx
Toxins Immunosuppression Increased bacterial adhesion Reduced oxygen tension Vasoconstriction Increased cytokines Reduced fibroblast proliferation
CONFIT BV
What effect does smoking have on Non Surgical Treatment? (4)
- Increased residual pocket
- Less reduction in PD
- Reduced wound healing
- Less pathogen reduction
What effect does smoking have on surgical treatment (5)
- Reduces wound healing
- Reduces grafting success
- Reduced CAL gain
- Reduced PD reduction
- Reduced root coverage
What effect does smoking have on implant success?
No statistical difference
What effect does smoking have on maintenance and retreatment
Reduced success
Increased refractory
Graded response
What are the 5 A’s of smoking cessation
a. Ask
b. Advise
c. Assess
d. Assist
e. Arrange
Why do Koch postulates not apply
Can’t grow some bacteria in media
What are Kochs Postulates
- Organism found in the lesion
- Must be isolated and grown in culture on artificial media
- Inoculation causes similar lesions
- Micro Organism isolated from the lesion
What are the alternatives to Kochs postulates
- Assoc with the disease
- Elimination of the organism
- Host Response
- Animal pathogenicity
- Mechanism of pathogenicity
How does P Ginigvalis cause increased clotting
Proteolytic enzymes produced by P Ging activate prothrombin
What does CRP do and why is it important
Binds to damaged cells, that opsonizes bacteria and facilitates complement fixation
Activates Neutrophils