Aggressive Periodontitis Flashcards

1
Q

What are four important features of aggressive periodontitis?

A
  • Patient is otherwise HEALTHY clinically
  • Characteristic RAPID bone and attachment loss
  • INCONSISTENCY with plaque and calculus
  • FAMILIAL aggregation
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2
Q

What are the two sub-classifications of Aggressive Periodontitis?

A

Localized Aggressive

Generalized Aggressive

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3
Q

LAP most frequently occurs in patients between _____ and _____ years old.

A

puberty–>20 years old

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4
Q

GAP affects patients under the age of _______ but may occur in older patients also.

A

30

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5
Q

In localized aggressive periodontitis, at least ______ _____ must be affected and no more than two teeth other than _____ and _____.

A

at least one first molar

no more than 2 other teeth besides molars/incisors

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6
Q

In GAP, there must be at least _____ permanent teeth other than ______ and ______ that are affected.

A

at least 3 teeth other than first molars and incisors

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7
Q

Which form of aggressive periodontitis (LAP or GAP) is characterized by a robust serum antibody response?

A

LAP = serum antibody response

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8
Q

True or False: GAP has a moderate serum antibody response.

A

False…POOR serum antibody response

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9
Q

Which form of aggressive periodontitis is characterized by intense gingival inflammation and which has relatively less gingival inflammation?

A

Intense inflammation: GAP (“inflammation causes gaps”)

Less inflammation: LAP

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10
Q

True or False: Localized Aggressive Periodontitis is characterized by episodic destruction of attachment and bone.

A

False, GAP has episodic nature

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11
Q

How do you determine rate of bone loss?

A

Comparison of serial radiographs (aggressive is 3-4 times faster than chronic)

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12
Q

True or False: Prevalence of Aggressive Periodontitis in the primary dentition is 0.9% to 4.5%

A

True

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13
Q

True or False: Prevalence of Aggressive Periodontitis in the United States is 5%

A

False, below 1% in the U.S.

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14
Q

True or False: Both types of Aggressive Periodontitis are more prevalent among African Americans (2.6%)

A

True

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15
Q

There is a direct link between ______ ______ microbes and localized aggressive periodontitis.

A

A.a

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16
Q

A.a and, more particularly, the _____ clone or serotype ____ is highly associated with LAP.

A
JP2 clone  (high in African American populations)
serotype B
17
Q

True or False: A.a is motile.

A

False

18
Q

True or False: A.a in anaerobic.

A

False, it’s a facultative anaerobe

19
Q

What are the 4 virulence factors associated with A.a?

A
  1. Leukotoxins
  2. LPS
  3. Collagenase
  4. Immunosuppressive Factors
20
Q

A.a will translocate across the _____ and invade the _____.

A

junctional epithelium

connective tissue

21
Q

What is the action of leukotoxin?

A

kills PMNs and macrophages

22
Q

Which two host responses are suppressed by A.a’s immunosuppressive factors?

A

Lymphocytes

Chemotaxis

23
Q

P.gingivalis is a gram___ microbe that is ______ and _______. P.gingivalis is associated with _____ aggressive periodontitis.

A

negative
anaerobic
nonmotile
generalized

24
Q

What are the three virulence factors associated with P.gingivalis?

A
  1. Proteinase (gingipains and collagenase)
  2. LPS (activates PGs, TNFalpha, and IL-1beta)
  3. Inhibition of IL-8 (decreases chemotaxis of PMNs)

=inhibition of host responses

25
Q

True or False: LAP is most likely a genetic polymorphism.

A

True

26
Q

What is the proposed inheritance mode for LAP?

A

autosomal dominant

27
Q

There are significantly higher levels of _______ in gingival crevicular fluid in patients with LAP

A

prostaglandin E2

28
Q

True or False: There are high titers and high avidity of IgA in localized aggressive periodontitis.

A

False, high titers of IgG2

29
Q

True or False: GAP patients have high levels of antibodies against P.gingivalis.

A

False, LOW levels of antibodies against P.g

30
Q

LAP is associated with impaired ______ function.

A

neutrophil

31
Q

Diagnosing AP: If there is high A.a? If there is high P.g?

A
A.a = LAP
P.g = GAP
32
Q

Diagnosing AP: High crevicular PGE2 levels? High titers of IgG? Low levels of P.g antibody?

A

high PGE2 = LAP
high IgG2 = LAP
low P.g Ab = GAP

33
Q

Levels of antibody against A.a are higher in ______ than in blood.

A

sulcular fluid > peripheral blood

34
Q

What are the two antibiotic cocktails that are prescribed for aggressive periodontitis?

A

Amoxicillin + Metranidazole (500mg 3x per day)

Ciprofloxacin + Metranidazole

35
Q

Metranidazole is effective against ______ but not _____ when used on its own.

A
  • P.g

(not) A.a