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Periodontics I > Etiology > Flashcards

Etiology Flashcards

1
Q

Can you cure periodontal disease?

A

No- you can treat it and reduce chance of progression though

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2
Q

Periodontal pathogenesis involves:

A
  1. environmental factors
  2. host factors
  3. microbial factors
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3
Q

Regarding periodontal pathogenesis smoking would be considered:

A

an environmental factor

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4
Q

Regarding periodontal pathogenesis, immune system/immune factors would be considered:

A

host factors

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5
Q

Regarding periodontal pathogenesis, plaque/biofilm would be considered:

A

microbial factors

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6
Q

When overgrowth of gram positive bacteria in susceptible individuals leads to gingival inflammation this is considered:

A

gingivitis

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7
Q

Gingivitis is a reaction limited to:

A

soft tissue area

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8
Q

The gingival inflammation in gingivitis alters:

A

subgingival microenvironment

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9
Q

What occurs in patients with gingivitis, when the gingival inflammation alters the subgingival microenvironment?

A

Overgrowth of “periodontal pathogens” in biofilm

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10
Q

When plaque causes a host immune inflammation reactions together with genetic predisposition and environmental influences are able to “contain” infection:

A

gingivitis

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11
Q

When plaque causes host immune and inflammatory reactions together with genetic predisposition and environmental influences are unable to “contain” infection:

A

Periodontitis

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12
Q

If gingivitis progresses to causing attachment loss or bone loss it is considered:

A

Periodontitis

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13
Q

If you are unable to see if there is dental plaque or not, what should you do?

A

Have patient use disclosing agent

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14
Q

The structurally and functionally organized, species-rich microbial biofilms that form on teeth:

A

dental plaque

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15
Q

Dental plaque is the main etiologic agent for:

A
  1. Periodontal disease
  2. Dental caries
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16
Q

-White cheesecake accumulation
-A soft accumulation of salivary proteins, bacteria, desquamated epithelial cells, and food debris
-No organized structure
-Easily displaced with a water spray

A

Materia Alba

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17
Q

What components comprise materia alba?

A

Accumulation of:

  1. salivary proteins
  2. bacteria
  3. desquamated epithelial cells
  4. food debris
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18
Q

Describe the structural makeup of materia alba:

A

NOT organized

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19
Q

Describe the removal of materia alba:

A

easily displaced with a water spray

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20
Q

-Resilient clear to yellow-grayish substance
-Primarily composed of bacteria in a matrix of salivary glycoproteins and bacterial products
-Considered to be a biofilm
-Impossible to remove by rinsing or spraying

A

Dental plaque

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21
Q

What components comprise dental plaque?

A

Bacteria in a matrix of salivary glycoproteins and bacterial products

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22
Q

Describe the structural makeup of dental plaque:

A

a biofilm

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23
Q

Describe the removal of dental plaque:

A

Impossible to remove by rinsing or spraying- requires mechanical removal

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24
Q
  • mineralized dental plaque forms the hard deposit
  • generally covered by a layer of unmineralized dental plaque
A

Calculus

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25
Q

Describe the structural makeup of calculus:

A

mineralized

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26
Q

Composition of dental plaque:

A
  • water
  • microorganisms
  • intracellular matrix
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27
Q

What percentage of dental plaque is comprised of water?

A

70%

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28
Q

What makes up the “dry weight” of dental plaque?

A

Microorganisms & intracellular matrix

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29
Q

What makes up the ORGANIC component of intracellular matrix?

A
  1. polysaccharides
  2. proteins
  3. glycoproteins
  4. lipids
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30
Q

What makes up the INORGANIC components of intracellular matrix?

A
  1. calcium
  2. phoshphorus
    (main components)
  3. other minerals
  4. sodium
  5. potassium
  6. fluoride
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31
Q

What are the main two components that make up the inorganic portion of dental plaque?

A

calcium & phosphate

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32
Q

______ grams of plaque contains approximately 10^11 bacteria (and the human body has approximately 10^12 bacteria)

A

1 gram

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33
Q

More than _____ distinct microbial species can be identified in dental plaque with highly sensitive molecular techniques

A

500

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34
Q

What is dental plaque?

a) it is non organized structure with soft accumulation of salivary proteins, bacteria, desquamated epithelial cells, and food debris

b) it is the structurally and functionally organized, species-rich microbial biofilm that form on teeth

c) it is he hard deposit on the teeth surface which can be formed by the mineralization of the matrix of salivary glycoproteins and bacterial products

d) it is the ornamental tablet in commemoration of the contribution of dentistry

A

b

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35
Q

Sites of plaque accumulation include: (4)

A
  • gingival thirds
    -cracks, pits and fissures
    -under overhanging restorations
    -around maligned teeth
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36
Q

Why does plaque often accumulate on:
- gingival thirds
-cracks, pits and fissures
-under overhanging restorations
-around maligned teeth

A

Because these areas are harder to keep clean with brushing and flossing

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37
Q

Dental plaque classification is based on:

A

position on the tooth surface (toward the gingival margin)

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38
Q

Name the three classifications of dental plaque:

A
  1. supragingival plaque
  2. marginal plaque
  3. subgingival plaque
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39
Q

Describe subgingival plaque: (3)

A
  1. tooth attached plaque
  2. unattached plaque
  3. epithelial associated plaque
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40
Q

How may unattached plaque be removed?

A

by brushing

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41
Q

What type of bacteria makeup suprgingival plaque?

A

Gram + cocci and short rods

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42
Q

What is the oxygen requirement for supragingival plaque (bacteria comprising = gram + cocci and short rods)

A

aerobic environment

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43
Q

Describe the diversity of the bacteria comprising supragingival plaque:

A

slight diversity

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44
Q

What type of bacteria comprise subgingival plaque?

A

gram - rods & spirochetes

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45
Q

What is the oxygen requirement for subgingival plaque (bacteria comprising = gram - rods & spirochetes):

A

anaerobic environment

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46
Q

Describe the diversity of the bacteria comprising subgingival plaque:

A

greater diversity

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47
Q

Type of plaque associated with calculus formation & root caries:

A

supragingival plaque

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48
Q

Type of plaque that is in direct contact with gingival margin and associated with the initiation & development of gingivitis:

A

marginal plaque

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49
Q

Type of plaque associated with tissue destruction:

A

Subgingival plaque

(made of spirochetes that can swim from subgingival space into the tissue)

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50
Q

Steps involved in the formation of dental plaque: (3)

A

Step 1: formation of the pellicle
Step 2: initial colonization of bacteria
Step 3: secondary colonization and plaque maturation

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51
Q

What type of attachment is seen with formation of the pellicle (step 1) in dental plaque formation?

A

Reversible attachment

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52
Q

What type of attachment is seen with initial colonization of bacteria (step 2) in dental plaque formation?

A

Irreversible, specific, short range

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53
Q

How doe the secondary colonizers attach to the primary colonizers in dental plaque formation?

A

Co-adhesion

(initial colonizers used adhesion-receptor attachments)

54
Q

List some of the processes that occur during the secondary colonization & plaque maturation (Step 3) of dental plaque formation:

A
  1. metabolic interactions
  2. environment modification
  3. gradient formation
  4. matrix synthesis
  5. cell-cell signaling
  6. bacterial growth
55
Q

List the 6 steps of formation of dental plaque (further broken down steps 1-3):

A
  1. pellicle formation
    2a. passive transport
    2b. reversible attachment
  2. adhesion-receptor (primary colonizers)
  3. co-adhesion (secondary colonizers)
  4. biofilm maturation
  5. detachment
56
Q

Adsorption of a conditioning film:

A

acquired pellicle

57
Q

An organic material layer coated on all surfaces in the oral cavity, including hard and soft tissues:

A

acquired pellicle

58
Q

The acquired pellicle is a ____ layer coated on ______ surfaces in the oral cavity, including ______ tissues

A

organic; all; hard & soft

59
Q

Components of the acquired pellicle are derived from:

A

saliva & crevicular fluid

60
Q

What type of bacteria are involved with the formation of the acquired pellicle?

A

gram + facultative microorganisms

61
Q

What is considered the INITIAL stage of development of the plaque?

A

formation of acquired pellicle

62
Q

During formation of the pellicle, there is reversible adhesion between the _____ and the _____.

A

microbial cell surface (adhesins); conditioning film (receptors)

63
Q

During formation of the pellicle, there is ____ adhesion between microbial cell surface (adhesions) and the conditioning film (receptors)

A

reversible

64
Q

The reversible adhesion between the microbial cell surface (adhesins) and the conditioning film (receptors) alters the charge and free energy of the surface which:

A

increases efficiency of the bacterial adhesion

65
Q

During initial colonization, the primary colonizers and secondary colonizers attach via:

A

co-adhesion

66
Q

During the initial colonization after co-adhesion of the primary & secondary colonizers, there is an alteration in the:

A

oxygen gradient

67
Q

Describe the alterations in the oxygen gradient seen during the initial colonization after co-adhesion of the primary & secondary colonizers:

A

Anaerobic conditions emerge in the deeper layers of deposits

68
Q

List the bacterial species that are considered PRIMARY colonizers in the formation of dental plaque:

A
  1. Streptococcus spp.
  2. Hemophilus spp.
  3. Neisseria spp.
  4. Actinomyces spp.
  5. Veillonella spp.
69
Q

List the bacterial species that are considered SECONDARY colonizers in the formation of dental plaque:

A
  1. Prevotella intermedia
  2. Capnocytophaga spp.
  3. Fusobacterium nucleatum
  4. Porphyromonas gingivalis
70
Q

What is the term for secondary colonizers adhering to the bacteria that are already in the plaque mass during the formation of dental plaque?

A

Coaggregation

71
Q

T/F: Coaggregation with the secondary colonizers adhering to the bacteria that are already in the plaque mass can be seen by the naked eye

A

True

72
Q

Following colonization this process occurs through further colonization and growth of additional species during the formation of dental plaque:

A

Maturation

73
Q

During maturation in the formation of dental plaque, bacteria use quorum sensing (cell-cell signaling) to:

A
  1. modify the environment
  2. metabolic interactions
74
Q

Regarding the structure of the dental plaque:

  1. Open _____ running through plaque mass
  2. Distance ____ produced by matrix (steep chemical gradients)
  3. Quorum sensing results in _____
A
  1. fluid-filled channels
  2. microenvironment
  3. bacterial resistance
75
Q

In periodontal microbiology what results in “corn-cob formation”:

A

Coccal-shaped cells attaching to tip of gram negative filamentous organisms

76
Q

in periodontal microbiology “corn-cob formation” is an example:

A

Interbacterial adherence or congregation

77
Q

List the microbiologic specificity hypothesis for the time period given:

a) 1900s
b) 1960s
c) 1990s

A

a) Nonspecific plaque hypothesis
b) Specific plaque hypothesis
c) Ecologic plaque hypothesis

78
Q

Hypothesis that states “Direct relationship between the total amount of plaque and the amplitude of the pathogenic effect”:

A

Nonspecific plaque hypothesis

79
Q

According to the nonspecific plaque hypothesis, the control of periodontal disease depends on:

A

control of plaque accumulation

80
Q

According to the nonspecific plaque hypothesis what standard of care was developed?

A

-oral hygiene measures
-nonsurgical/surgical debridement

81
Q

The nonspecific plaque hypothesis states that all plaque are:

A

NOT equally pathogenic

82
Q

According to the nonspecific plaque hypothesis “not all plaque are equally pathogenic”

Describe what this means regarding gingivitis:

A

Not all gingivitis develop into destructive periodontitis

83
Q

T/F: The specific plaque hypothesis states that not all gingivitis develops into destructive periodontitis

A

False- this is what the nonspecific plaque hypothesis states

84
Q

According to the nonspecific plaque hypothesis “not all plaque are equally pathogenic”

_____ in the pattern of disease was demonstrated in some individuals with periodontitis

A

site specificity

85
Q

Hypothesis that states “the pathogenicity depends on the presence of or increase in specific microorganisms”

A

Specific plaque hypothesis

86
Q

The Specific plaque hypothesis states that the pathogenicity depends on the presence of or increase in:

A

specific microorganisms

87
Q

According to the specific plaque hypothesis _______ is localized in aggressive periodontitis

A

A. Actinomicetemcomitans

88
Q

What was developed from the information of the Specific plaque hypothesis?

A

Targeted treatment strategies

89
Q

Strategies that aim to control or eliminate the particular pathogenic organisms (Specific plaque hypothesis)

A

Targeted treatment

90
Q

T/F: Pathogens may be present at the absence of disease

A

True

91
Q

According to the Specific plaque hypothesis what bacterial species are found in the “yellow complex”:

A
  1. S. mitis
  2. S. oralis
  3. S. sanguis
92
Q

According to the Specific plaque hypothesis what bacterial species are found in the “purple complex”:

A
  1. V. parvula
  2. A. odontolyticus
93
Q

According to the Specific plaque hypothesis what bacterial species are found in the “orange complex”:

A
  1. P. intermedia
94
Q

According to the Specific plaque hypothesis what bacterial species are found in the “red complex”:

A
  1. P. gingivalis
  2. B. forsythus
  3. T. denticola
95
Q

According to the Specific plaque hypothesis what bacterial species are found in the “green complex”:

A
  1. E. corrodens
  2. C. gingivalis
  3. C. sputigena
  4. C. ochracea
  5. C. concisus
  6. A. actino. A
96
Q

Hypothesis that states “both the total amount of dental plaque and the specific microbial composition of plaque may contribute”

A

Ecologic plaque hypothesis

97
Q

The ecologic plaque hypothesis describes ______ meaning the state of the dynamic equilibrium

A

Microbial homeostasis

98
Q

What criteria for identification of periodopathogens was formed during the nonspecific plaque hypothesis (1900s):

A

Kochs postulates

99
Q

What criteria for identification of periodontopathogens was formed during the ecologic plaque hypothesis (1990s):

A

Socransky’s criteria

100
Q

What criteria for identification of periodontopathogens is being described below?

-Be routinely isolated from diseased individuals
-Be grown in pure culture in lab
-Produce a similar disease when inoculated into susceptible lab animals
-Be recovered from lesions in diseased lab animals

A

Kochs Postulates

101
Q

What criteria for identification of periodontopathogens is being described below?

-Be associated with disease
-Be eliminated or decreased in sites that demonstrate clinical resolution
-Demonstrate an alteration in host cellular or immune response
-Be capable of causing disease in experimental models
-Demonstrate virulence factors

A

Socranksky’s Criteria

102
Q

P. gingivalis is known as a notorious periodontal pathogen. Which complex does it belong to?

A

Red complex

103
Q

What are the virulence factors of bacteria that contribute to microbiologic specificity:

A
  1. toxins & enzymes
  2. Adhesins
  3. Evading mechanisms
104
Q

Bacterial products that promote tissue destruction:

A

Toxins & enzymes

105
Q

What are some specific toxins and enzymes that serve as virulence factors:

A

-LPS
-leuktotoxin
-gingipains
-collagenase
-protease

106
Q

Factors that promote colonization:

A

Adhesins

107
Q

List some specific adhesins:

A

-fimbria
-gingipains

108
Q

The production of an extracellular capsule is an example of:

A

evading mechanism

109
Q

What evading mechanisms functions in proteolytic degradation of host immunity components?

A

Gingipains

110
Q

Modulating the host response via binding serum components on the bacterial cell surface is an example of:

A

evading mechanism

111
Q

Evading mechanism that contributes to the invasion of gingival epithelial cells:

A

LPS

112
Q

Specific bacteria of gingivitis: (8)

A
  1. Actinomyces spp.
  2. Capnocytophaga spp.
  3. Campylobacter spp.
  4. Streptococcus spp.
  5. Parvimonas micra
  6. Fusobacterium nucleatum
  7. Prevotella intermedia
  8. Treponema spp.
113
Q
  1. Actinomyces spp.
  2. Capnocytophaga spp.
  3. Campylobacter spp.
  4. Streptococcus spp.
  5. Parvimonas micra
  6. Fusobacterium nucleatum
  7. Prevotella intermedia
  8. Treponema spp.

These bacteria are assocated with:

A

Gingivitis

114
Q

Specific bacteria of periodontitis: (8)

A
  1. Aggregatibacter actinomycetemcomitans (Type B)
  2. Porphyromonas gingivalis
  3. Prevotella intermedia
  4. Parvimonas micra
  5. Fusobacterium nucelatum
  6. Tanerella forsythia
  7. Treponema denticola
  8. Spirochetes
115
Q
  1. Aggregatibacter actinomycetemcomitans (Type B)
  2. Porphyromonas gingivalis
  3. Prevotella intermedia
  4. Parvimonas micra
  5. Fusobacterium nucelatum
  6. Tanerella forsythia
  7. Treponema denticola
  8. Spirochetes

These bacteria are associated with:

A

Periodontitis

116
Q

Specific bacteria of necrotizing periodontal disease: (4)

A
  1. Fusobacterium nucleatum
  2. Prevotella intermedia
  3. Treponema spp.
  4. Spirochetes
117
Q
  1. Fusobacterium nucleatum
  2. Prevotella intermedia
  3. Treponema spp.
  4. Spirochetes

These bacteria are associated with:

A

Necrotizing periodontal disease

118
Q

Specific bacteria associated with pregnancy & puberty: (2)

A
  1. prevotella intermedia
  2. capnocytophaga spp.
119
Q
  1. prevotella intermedia
  2. capnocytophaga spp.

These bacteria are associated with:

A

pregnancy & puberty

120
Q

Specific bacteria associated with periodontal abscesses: (5)

A
  1. Fusobacterium nucleatum
  2. Parvimonas micra
  3. Prevotella intermedium
  4. Porphyromonas gingivalis
  5. Spirochetes
121
Q
  1. Fusobacterium nucleatum
  2. Parvimonas micra
  3. Prevotella intermedium
  4. Porphyromonas gingivalis
  5. Spirochetes

These bacteria are associated with:

A

Periodontal abscesses

122
Q

Specific bacteria of peri-implantitis is comparable to:

A

Microbiota to that of periodontitis

123
Q

In a healthy site we see gram ____ bacteria; in a diseased site we see gram ____ bacteria

A

Healthy: positive
Diseased: negative

124
Q

In a healthy site we see ____ bacteria shape; in a diseased site we see ____ bacteria shape

A

Healthy: cocci
Diseased: rod

125
Q

In a healthy site we see ____ bacteria; In a diseased site we see ____ bacteria

(movement)

A

Healthy: nonmotile
Diseased: motile

126
Q

The oxygen requirement of bacteria seen in a healthy site is ______ while the oxygen requirement of bacteria seen in a diseased site is ______

A

Healthy: facultative anaerobe
Diseased: Obligate anaerobe

127
Q

Fermenting bacteria are seen in ____ sites, while proteolytic bacteria are seen in ____ sites

A

healthy; diseased

128
Q

Which one is correct for the specific bacteria observed in correlated periodontal disease?

a) in diseased sites, more gram positive, nonmotile cocci are observed

b) in healthy sites, more orange and red complex bacteria are observed

c) A. actinomycetemcomitans and P. Gingivalis are highly related to periodontitis

d) Capmocytophaga spp. is usually found in periodontal abscess

A

C

129
Q

The donor-recipient transmission of periodontal pathogens:

A
  1. Parent to child
  2. Spouse to spouse
130
Q

T/F: Periodontal pathogens are communicable but not readily transmissible

A

True

131
Q
A

Periodontics I (17 decks)

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