(3) Histology of periodontal Disease - Advanced Lesion Flashcards
Is this periodontitis?
Yes
Transition from gingivitis to periodontistis
Bone loss
What location is the inflammation?
Extension of the inflammation into the supra-alveolar connective tissue
Periodontal ligament and alveolar bone
Where does the destruction of the collagen fibres extend to?
Periodontal ligament
What is the effect of the destruction of collagen fibres and the periodontal ligament
Lead to loss of attachment to the cementum and/or bone
What happens once there is less of attachment of the periodontal ligament to cementum/bone?
Apical migration of the JE
What type of pocket forms in the advanced lesion?
True pocket
Due to to bone loss and apical migration of the je
Where do neutrophils infiltrate?
The Pocket
Where do plasma cells infiltrate?
Connective tissue
Adaptive immune response
What is the effect of ROS production?
Activate osteoclasts and resorption
Apoptosis of fibroblasts
Destruction of collagen fibres
= ulceration and destruction of tissues
Why does inflammation not go away on its own?
The patient cannot remove the plaque themselves and need to be removed by a dentists
If it is above 3.5mm below the gingival margin
Name structure A-C
A = dentin
B = cementum
C = enamel space
What is noticeable about the JE here?
Passes the CEJ, apical along the root
And much thicker
What shows the inflammatory infiltrate here?
The white lines show infiltrate
Where do the immune cells lie?
All the dots adjacent to the sulcular and junctional epithelium
What side is the deeper pocket on?
Left
What bone is involved at the advanced lesion stage?
Alveolar Bone
Osteoclasts resorption of the bone
Is there variation in pocket size for the same tooth?
Yes variation at different sites
Where is the gingival margin/gun line in this histogram?
What do the dark cells represent here?
Inflammatory cells
Where is the plaque and calculus in this histogram?
Where is the proliferative epithelium in this histogram?
Does this show serve pockets?
Yes
Does this how severe pockets?
Shows pockets but not too severe
What are the 2 types of bone loss?
Vertical bone loss
Horizontal pattern of Bone loss
What does vertical bone loss lead to?
Infra-bone pockets
What does horizontal pattern of Bone loss lead to?
Supra-bony pockets
What type of bone loss is shown here?
Supra-bony pocket
Horizontal bone loss
What type of bone loss is shown here?
Infra-bony pocket
Vertical bone loss
How do you measure loss of attachment?
Go from the cemento-enamel junction to the pocket floor (junctional epithelium)
What type of pocket is shown here?
Supra-bony pocket
Name A-E
What do you call the gingiva between 2 teeth?
Interdental papilla
What antibodies are present?
IgG
IgA
More IgM than the established lesion
