9. Influence of Systemic Conditions on the Periodontium Flashcards
3
What explains the differences in disease severity?
4
____ and ____ factors can alter periodontal tissues and host immune response.
4
Do systemic diseases initiate periodontitis, or do they predispose or accelerate periodontal disease?
6
What is the second most frequent factor as a modifiable contributor to systemic inflammatory burder? What is the first?
7
Periodontal disease allows ____ to enter the bloodstream.
7
LPS triggers the release of pro-inflammatory cytokines: ____, ___, and _____. These cytokines along with other molecules like ____ and _____ contribute to systemic inflammation.
7
What are two systemic effects due to Fibrinogen?
7
What is a systemic effect due to C-reactive protein (CRP)?
8
Periodontal disease has a role in _____ in distant vessels. Periodontal pathogens are found in _____.
8
Periodontitis may contribute directly to pathogenesis of _____ through persistent bacterial challenge to aterial endothelial, leading to inflammation, which may cause _____.
9
What is the inflammatory mechanism hypothesis for periodontitis and Alzheimer;s disease?
9
What is the bacterial mechanism hypothesis for periodontitis and Alzheimer’s?
9
What are 4 bacteria that may be involved in periodontal disease as well as Alzheimer’s?
10
What systemic disease is periodontitis associated with?
12
What are 6 complications of diabetes?
13
What effect does poorly controlled diabetes have on periodontal pockets and bone loss?
13
What abscesses are frequently seen in someone with poorly controlled diabetes?
14
What are the effects of diabetes on attachment loss? What about bleeding on probing? Tooth mobility? 15
15
What is the etiology of periodontitis as it relates to diabetes? (3 things)
16
What effect does diabetes have on collagen metabolism?
16
Does diabetes increase or decrease collagenase activity? What about collagen synthesis?
16
What are the effects of Advanced Glycation End Products on collagen?
20
Uncontrolled diabetics have a _____ response to periodontal therapy.
20
What kind of surgery should be avoided on an uncontrolled diabetic patient?
20
What is the HbA1c for uncontrolled diabetic?
21
What is the HbA1C test used to monitor?
21
What percent HbA1C is used to diagnose Diabetes Mellitus?
21
Binding of glucose to hemoglobin remains stable for _____.
22
What is the HbA1C level for prediabetes?
22
What is the Estimated Average Glucose? What is the formula for it?
25
There is improved glycemic control following scaling and root planing, finding a ____% reduction in HbA1c levels.
26
What 2 inflammatory mediators are decreased in the GCF after scaling and root planing in diabetics?
28
What is the criteria for metabolic syndrome?
29
Adipose tissue dysfunction in obese people shows increased proinflammatory cytokine production of ___ and ____.
32
What is the respone to plaque in puberty and pregnancy?
32
Do puberty and pregnancy cause gingivitis?
32
How do you treat gingivitis in puberty and pregnancy?
34
What bacteria may increase during pregnancy?
34
Prevotella intermedia substitutes Estradiol and Progesterone for _____, which is an essential growth factor for P. intermedia.
35
Hyperparathyroidism leads to generalized ____ of skeleton. It also leads to proliferation of _____ in enlarged marrow space.
35
Hyperparathyroidism causes what disease of bone?
35
What effect does hyperparathyroidism have on tooth mobility?
35
What effect does hyperparathyroidism have on the PDL?
35
What effect does hyperparathyroidism have on the lamina dura?
35
What kind of tumors are seen in oral with hyperparathyroidism?
37
What are 6 hematologic disorders associated with periodontitis?
38
What is neutropenia?
38
How may neutropenia affect the periodontium?
39
What effect does cyclic neutropenia have on the gingiva?
41
What is the criteria for Agranulocytosis?
42
What are three oral manifestations of leukemia?
42
Bleeding in the absence of gingivitis in leukemia is caused by _____.
44
What is thrombocytopenia purpura?
44
What does thrombocytopenia purpura result in?
44
The gingiva in someone with thrombocytopenia purpura is ____ and _____.
46
Do people with acquired immunodeficiency syndrome have an increased susceptibility to periodontitis?
48
What three things are affected in Chediak-Higashi Syndrome? What three things does this lead to?
48
Chediak-Higashi syndrome leads to impaired killing of microorganisms by _____.
49
Leukocyte adhesion deficiency is a failure to express _____ necessary for leukocyte adhesion to vessel wall at site of infection, so there is no _____ migration.
49
Leukocyte adhesion deficiency leads to an absence of ______ in gingival tissues.
50
What is the syndrome that is autosomal recessive and causes kyperkeratotic skin lesions on the palms, soles, knees, and elbows?
49
What effect does leukocyte adhesion deficiency have on periodontal bone?
50
What effect does Papillon-Lefevre Syndrome have on periodontium, osteoclastic activity, and cementum?
50
Does Papillon-Lefevre Syndrome cause early tooth loss of primary and permanent dentition?
53
What is the prevalence of periodontal disease in those with Down Syndrome?
54
What is Agammaglobulinemia?
56
Can stress and depression potentiate periodontal breakdown?
58
Do nutritional deficiencues cause gingivitis of periodontitis?
59
What effect does a Vitamin C deficiency have on gingiva?
59
Is gingivitis caused by a Vitamin C deficiency?
62
What are four bisphosphonates used for osteoporosis / osteopenia?
63
What are 2 IV bisphosphonates for bone cancers?
64
What is the criteria for medication related osteonecrosis of the jaw?
66
Is osteonecrosis of the jaw from oral bisphosphonates different from osteonecrosis of the jaw from IV bisphosphonates?
66
Does oral or IV bisphosphonates require longer periods of exposure?
66
Is more or less bone exposed in oral bisphosphonates compared to IV?
66
Discontinuation of _____ bisphosphonate may lead to improvement and spontaneous healing.
67
Risk of medication related ONJ is related to the ____ and ___ of the drug.
67
The most potent IV, IV Zoledronate may expose bone in ____ months. Alendronate (oral) may take ____ years.
68
Continuous use of oral bisphosphonates for ______ is associated with an increased risk of ONJ.
69
What drug for osteoporosis and bone metastases is linked to ONJ?
69
What is the mechanism of action for Denosumab?
70
What are the relative levels of RANKL and OPG is sites with active periodontitis?
72
Osteopenia and Osteoporosis are associated with _____.
72
Estrogen Deficiency and Osteopenia have what affect on attachment loss, crestal bone density loss, and bone loss when combined with smoking?
