9. Influence of Systemic Conditions on the Periodontium

Question 1

3

What explains the differences in disease severity?

Question 2

4

____ and ____ factors can alter periodontal tissues and host immune response.

Question 3

4

Do systemic diseases initiate periodontitis, or do they predispose or accelerate periodontal disease?

Question 4

6

What is the second most frequent factor as a modifiable contributor to systemic inflammatory burder? What is the first?

Question 5

7

Periodontal disease allows ____ to enter the bloodstream.

Question 6

7

LPS triggers the release of pro-inflammatory cytokines: ____, ___, and _____. These cytokines along with other molecules like ____ and _____ contribute to systemic inflammation.

Question 7

7

What are two systemic effects due to Fibrinogen?

Question 8

7

What is a systemic effect due to C-reactive protein (CRP)?

Question 9

8

Periodontal disease has a role in _____ in distant vessels. Periodontal pathogens are found in _____.

Question 10

8

Periodontitis may contribute directly to pathogenesis of _____ through persistent bacterial challenge to aterial endothelial, leading to inflammation, which may cause _____.

Question 11

9

What is the inflammatory mechanism hypothesis for periodontitis and Alzheimer;s disease?

Question 12

9

What is the bacterial mechanism hypothesis for periodontitis and Alzheimer’s?

Question 13

9

What are 4 bacteria that may be involved in periodontal disease as well as Alzheimer’s?

Question 14

10

What systemic disease is periodontitis associated with?

Question 15

12

What are 6 complications of diabetes?

Question 16

13

What effect does poorly controlled diabetes have on periodontal pockets and bone loss?

Question 17

13

What abscesses are frequently seen in someone with poorly controlled diabetes?

Question 18

14

What are the effects of diabetes on attachment loss? What about bleeding on probing? Tooth mobility? 15

Question 19

15

What is the etiology of periodontitis as it relates to diabetes? (3 things)

Question 20

16

What effect does diabetes have on collagen metabolism?

Question 21

16

Does diabetes increase or decrease collagenase activity? What about collagen synthesis?

Question 22

16

What are the effects of Advanced Glycation End Products on collagen?

Question 23

20

Uncontrolled diabetics have a _____ response to periodontal therapy.

Question 24

20

What kind of surgery should be avoided on an uncontrolled diabetic patient?

Question 25

20

What is the HbA1c for uncontrolled diabetic?

Question 26

21

What is the HbA1C test used to monitor?

Question 27

21

What percent HbA1C is used to diagnose Diabetes Mellitus?

Question 28

21

Binding of glucose to hemoglobin remains stable for _____.

Question 29

22

What is the HbA1C level for prediabetes?

Question 30

22

What is the Estimated Average Glucose? What is the formula for it?

Question 31

25

There is improved glycemic control following scaling and root planing, finding a ____% reduction in HbA1c levels.

Question 32

26

What 2 inflammatory mediators are decreased in the GCF after scaling and root planing in diabetics?

Question 33

28

What is the criteria for metabolic syndrome?

Question 34

29

Adipose tissue dysfunction in obese people shows increased proinflammatory cytokine production of ___ and ____.

Question 35

32

What is the respone to plaque in puberty and pregnancy?

Question 36

32

Do puberty and pregnancy cause gingivitis?

Question 37

32

How do you treat gingivitis in puberty and pregnancy?

Question 38

34

What bacteria may increase during pregnancy?

Question 39

34

Prevotella intermedia substitutes Estradiol and Progesterone for _____, which is an essential growth factor for P. intermedia.

Question 40

35

Hyperparathyroidism leads to generalized ____ of skeleton. It also leads to proliferation of _____ in enlarged marrow space.

Question 41

35

Hyperparathyroidism causes what disease of bone?

Question 42

35

What effect does hyperparathyroidism have on tooth mobility?

Question 43

35

What effect does hyperparathyroidism have on the PDL?

Question 44

35

What effect does hyperparathyroidism have on the lamina dura?

Question 45

35

What kind of tumors are seen in oral with hyperparathyroidism?

Question 46

37

What are 6 hematologic disorders associated with periodontitis?

Question 47

38

What is neutropenia?

Question 48

38

How may neutropenia affect the periodontium?

Question 49

39

What effect does cyclic neutropenia have on the gingiva?

Question 50

41

What is the criteria for Agranulocytosis?

Question 51

42

What are three oral manifestations of leukemia?

Question 52

42

Bleeding in the absence of gingivitis in leukemia is caused by _____.

Question 53

44

What is thrombocytopenia purpura?

Question 54

44

What does thrombocytopenia purpura result in?

Question 55

44

The gingiva in someone with thrombocytopenia purpura is ____ and _____.

Question 56

46

Do people with acquired immunodeficiency syndrome have an increased susceptibility to periodontitis?

Question 57

48

What three things are affected in Chediak-Higashi Syndrome? What three things does this lead to?

Question 58

48

Chediak-Higashi syndrome leads to impaired killing of microorganisms by _____.

Question 59

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.

Question 60

49

Leukocyte adhesion deficiency leads to an absence of ______ in gingival tissues.

Question 61

50

What is the syndrome that is autosomal recessive and causes kyperkeratotic skin lesions on the palms, soles, knees, and elbows?

Question 61

49

What effect does leukocyte adhesion deficiency have on periodontal bone?

Question 61

50

What effect does Papillon-Lefevre Syndrome have on periodontium, osteoclastic activity, and cementum?

Question 62

50

Does Papillon-Lefevre Syndrome cause early tooth loss of primary and permanent dentition?

Question 63

53

What is the prevalence of periodontal disease in those with Down Syndrome?

Question 64

54

What is Agammaglobulinemia?

Question 65

56

Can stress and depression potentiate periodontal breakdown?

Question 66

58

Do nutritional deficiencues cause gingivitis of periodontitis?

Question 67

59

What effect does a Vitamin C deficiency have on gingiva?

Question 68

59

Is gingivitis caused by a Vitamin C deficiency?

Question 69

62

What are four bisphosphonates used for osteoporosis / osteopenia?

Question 70

63

What are 2 IV bisphosphonates for bone cancers?

Question 71

64

What is the criteria for medication related osteonecrosis of the jaw?

Question 72

66

Is osteonecrosis of the jaw from oral bisphosphonates different from osteonecrosis of the jaw from IV bisphosphonates?

Question 73

66

Does oral or IV bisphosphonates require longer periods of exposure?

Question 74

66

Is more or less bone exposed in oral bisphosphonates compared to IV?

Question 75

66

Discontinuation of _____ bisphosphonate may lead to improvement and spontaneous healing.

Question 76

67

Risk of medication related ONJ is related to the ____ and ___ of the drug.

Question 77

67

The most potent IV, IV Zoledronate may expose bone in ____ months. Alendronate (oral) may take ____ years.

Question 78

68

Continuous use of oral bisphosphonates for ______ is associated with an increased risk of ONJ.

Question 79

69

What drug for osteoporosis and bone metastases is linked to ONJ?

Question 80

69

What is the mechanism of action for Denosumab?

Question 81

70

What are the relative levels of RANKL and OPG is sites with active periodontitis?

Question 82

72

Osteopenia and Osteoporosis are associated with _____.

Question 83

72

Estrogen Deficiency and Osteopenia have what affect on attachment loss, crestal bone density loss, and bone loss when combined with smoking?