Etiology Flashcards
1
Q
Can you cure periodontal disease?
A
No- you can treat it and reduce its chance of progression but not cure it
2
Q
Periodontal pathogenesis involve:
A
- environmental factors
- host factors
- microbial factors
3
Q
Regarding periodontal pathogenesis, smoking would be considered:
A
an environmental factor
4
Q
Regarding periodontal pathogenesis, immune system/immune factors would be considered:
A
Host factors
5
Q
Regarding periodontal pathogenesis, plaque/biofilm would be considered:
A
microbial factors
6
Q
When overgrowth of gram positive bacteria in susceptible individuals leads to gingival inflammation:
A
gingivitis
7
Q
Gingivitis is a reaction limited to:
A
soft tissue area
8
Q
The gingival inflammation ini gingivitis alters:
A
subgingival microenvironment
9
Q
What occurs in patients with gingivitis when the gingival inflammation alters the subgingival microenvironment?
A
Overgrowth of “perriodontal pathogens” in the biofilm which may stay at gingivitis or progress to periodontitis
10
Q
When plaque causes a host immune and inflammatory reactions together with genetic predisposition and environmental influences are able to “contain” infection:
A
gingivitis
11
Q
When plaque causes a host immune and inflammatory reactions together with genetic predispositions and environmental influences unable to “contain” infection:
A
periodontitis
12
Q
If gingivitis progresses to causing attachment loss or bone loss it is considered:
A
periodontitis
13
Q
If you are unable to see if there is plaque or not, what should you do?
A
have patient use disclosing agent
14
Q
The structurally and functionally organized, species-rich microbial biofilms that form on teeth:
A
Dental plaque
15
Q
Main etiologic agent for periodontal disease and dental caries:
A
dental plaque
16
Q
Dental plaque is the man etiologic agent for:
A
- periodontal disease
- dental caries
17
Q
- White cheeselike accumulation
- a soft accumulation of salivary proteins, bacteria, desquamate epithelial cells, and food
- No organized structure
- easily displaced with a water spray:
A
Materia alba
18
Q
What components comprise materia alba?
A
accumulation of
1. salivary proteins
2. bacteria
3. desquamated
4. epithelial cells
5. food debris
19
Q
Describe the structural makeup of material alba:
A
NOT organized
20
Q
Describe the removal or materia alba:
A
easily displaced with a water spray
21
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 and spraying
A
dental plaque
22
Q
What components comprise dental plaque?
A
bacteria in a matrix of salivary glycoproteins and bacterial products
23
Q
Describe the structural makeup of dental plaque:
A
a biofilm
24
Q
Describe the removal of dental plaque:
A
impossible to remove by rinsing or spraying- requires mechanical removal
25
- mineralized dental plaque forms the hard deposit
- generally covered by a layer of unmineralized dental plaque
calculus
26
Describe the structural makeup of calculus:
mineralized
27
Composition of dental plaque:
- water
- microorganisms
- intracellular matrix
28
What percentage of dental plaque is comprised of water?
70%
29
What makes up the "dry weight" of dental plaque?
microorganisms & intracellular matrix
30
What makes up the ORGANIC component of intracellular matrix?
1. polysaccharides
2. proteins
3. glycoproteins
4. lipids
31
What makes up the INORGANIC component of dental plaque?
1. Calcium
2. Phosphorus
(main components)
3. other minerals
4. sodium
5. potassium
6. fluoride
32
What are the main two components that make up the inorganic portion of dental plaque?
calcium & phosphorus
33
___ grams of dental plaque contain approximately 10^11 bacteria (and the human body has approximately 10^12 bacteria)
1 gram
34
More than ___ distance microbial species can be identified in dental plaque with highly sensitive molecular techniques
500
35
What is dental plaque?
a- it is a 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 the hard deposit on teeth surface with 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
B
36
Sites of plaque accumulation in the oral cavity include: (4)
- gingival thirds
- cracks, pits, fissures
- under overhanging restorations
- around maligned teeth
37
Why does plaque accumulate in:
- gingival thirds
- cracks, pits, fissures
- under overhanging restorations
- around maligned teeth
because these areas are harder to keep Clea with brushing and flossing
38
Dental plaque classification is based on:
position on the tooth surface (toward the gingival margin)
39
What are the three classifications (based on location) of dental plaque?
1. supragingival plaque
2. marginal plaque
3. subgingibal plaque
40
Describe subgingival plaque: (3)
1. tooth attached plaque
2. unattached plaque
3. epithelial associated plaque
41
How may unattached plaque be removed?
by brushing
42
What type of bacteria make up supra gingival plaque?
gram + cocci and short rods
43
What is the oxygen requirement for supra gingival plaque (bacteria comprising = gram + cocci and short rods)?
aerobic environment
44
Describe the diversity of the bacteria comprising supra gingival plaque:
Slight diversity
45
What type of bacteria comprise subgingival plaque?
gram - rods and sprirochete
46
What is the oxygen requirement for subgingival plaque (bacteria comprising = gram - rods and spirochetes)?
anaerobic environment
47
Describe the diversity of the bacteria comprising subgingival plaque:
greater diversity
48
Type of plaque associated with calculus formation & root caries:
supragingival plaque
49
Type of plaque that is in direct contact with the gingival margin and associated with the initiation and development of gingivitis:
marginal plaque
50
Type of plaque that is associated with tissue destruction:
subgingival plaque
(made of spirochetes that can swim from subgingival space and into the tissue)
51
Steps involved in the formation of dental plaque (3):
1. formation of the pellicle
2. initial colonization of bacteria
3. secondary colonization and plaque maturation
52
What type of attachment is seen with formation of the pellicle (Step 1) in dental plaque formation?
reversible attachment
53
What type of attachment is seen with initial colonization of bacteria (Step 2) in dental plaque formation?
irreversible, specific, short range
54
How do the secondary colonizer attach to the primary colonizers in dental plaque formation?
co-adhesion
(initial colonizers used adhesion receptor attachments, and these guys use co-adhesion)
55
List some of the processes that occur during the secondary colonization and plaque maturation (Step 3) of dental plaque formation: (6)
1. metabolic interactions
2. environment modification
3. gradient formation
4. matrix synthesis
5. cell-cell signaling
6. bacterial growth
56
List the 6 steps of formation of the dental plaque (further broken down steps 1-3):
1. pellicle formation
2a. passive transport
2b. reversible attachment
3. adhesin-receptor (primary colonizers)
4. co-adhesion (secondary colonizers)
5. biofilm maturation
6. detachment
57
Adsorption of a conditioning film:
acquired pellicle
58
An organic material layer coated on all surfaces in the oral cavity, including hard and soft tissues:
acquired pellicle
59
The acquire pellicle is a ___ layer coated on ___ surfaces in the oral cavity, including ____ tissues
organic; all; hard & soft
60
Components of the acquired pellicle are derived from:
saliva and crevicular fluid
61
What type of bacteria are involved with the formation of the acquired pellicle?
gram + facultative microorganisms
62
What is considered the INITIAL stage of development of the plaque?
formation of acquired pellicle
63
During formation of the pellicle, there is reversible adhesion between the ____ and the ___.
microbial cell surface (adhesins); conditioning film (receptors)
64
During formation of the pellicle, there is ____ adhesion between microbial cell surface (adhesins) and the conditioning film (receptors)
reversible
65
The reversible adhesion between the microbial cell surface (adhesins) and the conditioning film (receptors) alters the charged and the free energy of the surface which:
increase efficiency of bacterial adhesion
66
During initial colonization, the primary colonizers and secondary colonizers attach via:
co-adhesion
67
During initial colonization after co-adheison of the primary & secondary colonizers, there is alteration in the:
oxygen gradient
68
Describe the alterations in the oxygen gradient seen during the initial colonization after co-adhesion of the primary and secondary colonizers:
anaerobic conditions emerge in the deeper layers of deposits
69
List the bacterial species that are considered PRIMARY colonizers in the formation of dental plaque:
1. Streptococcus spp.
2. Hemophilus spp.
3. Neisseria spp.
4. Actinomyces spp.
5. Veillonella spp.
70
List the bacterial species that are considered SECONDARY colonizers in the formation of dental plaque:
1. Prevotella intermedia
2. Capnocytophaga spp.
3. Fusobacterium nucelatum
4. Porphyromonas gingivialis
71
What the term for secondary colonizers adhering to the bacteria that are already in the plaque mass during formation of dental plaque?
coaggregation
72
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
true
73
Following colonization, this process occurs through further colonizations and growth of additional species during formation of dental plaque:
maturation
74
During maturation in the formation of dental plaque, bacteria use quorum sensing (cell-cell signaling) to:
1. modify the environment
2. metabolic interactions
75
Regarding the structure of dental plaque:
1. Open ____ running through plaque mass
2. Distinct ___ produced by matrix (steep chemical gradients)
3. Quorum sensing results in ___.
1. fluid-filled channels
2. microenvironment
3. bacterial resistance
76
In periodontal microbiology, what results in "Corn-cob formation"?
coccal-shaped cells attach along the tip of gram negative filamentous organisms
77
In periodontal microbiology, "corn-cob formation" is an example of:
inter-bacterial adherence or coaggregation
78
List the microbiologic specificity hypothesis' for the time period given:
A) 1900s
B) 1960s
C) 1990s
A) non-specific plaque hypothesis
B) specific plaque hypothesis
C) ecologic plaque hypothesis
79
Hypothesis that states "direct relationship between the total amount of plaque and the amplitude of the pathogenic effect"
Non-specific plaque hypothesis
80
According to the non-specific plaque hypothesis, the control of periodontal disease depends on:
control of plaque accumulation
81
According to the non-specific plaque hypothesis, what standard of care was developed?
- Oral hygeine measures
- non-surgical/ surgical debridement
82
The non-specific plaque hypothesis states that all plaque are:
Not equally pathogenic
83
According to the non-specific plaque hypothesis "not all plaque are equally pathogenic"
Describe what this means regarding gingivitis:
Not all gingivitis develop into destructive periodontitis
84
T/F: The specific plaque hypothesis states that not all gingivitis develops into destructive periodontitis
false- this is what the non-specific hypothesis states
85
According to the non-specific plaque hypothesis "not all plaque are equally pathogenic"
_____ in the pattern of disease was demonstrated in some individuals with periodontitis
site specificity
86
The hypothesis that states "the pathogenicity depends on the presence of or increase in specific microorganisms"
Specific plaque hypothesis
87
The Specific plaque hypothesis states that the pathogenicity depends on the presence of or increase in:
specific microorganisms
88
According to specific plaque hypothesis, _____ is localized in aggressive periodontisis
A. Actinomicetemcomitans
89
What was developed from the information of specific plaque hypothesis?
Targeted treatment
90
Strategies that aim to control or eliminate the particular pathogenic organisms (Specific plaque hypothesis)
targeted treatment
91
T/F: Pathogens may be presence at the absence of disease
true
92
According to the Specific plaque hypothesis, what bacteria are found in the "yellow complex"?
1. S. mitis
2. S. oralis
3. S. sanguis
93
According to the Specific plaque hypothesis, what bacteria are found in the "purple complex"?
1. V. parvula
2. A. odontolyticus
94
According to the Specific plaque hypothesis, what bacteria are found in the "orange complex"?
P. intermedia
95
According to the Specific plaque hypothesis, what bacteria are found in the "red complex"?
1. P. gingivalis
2. B. forsythus
3. T. denticola
96
According to the Specific plaque hypothesis, what bacteria are found in the "green complex"?
1. E. corrodens
2. C. gingivalis
3. C. sputigena
4. C. ochracea
5. C. condcisus
6. A. actino. a
97
Hypothesis that states "both the total amount of dental plaque and the specific microbial composition of plaque may contribute:
Ecologic plaque hypothesis
98
The ecologic plaque hypothesis describes ____ meaning the state of the dynamic equilibrium
Microbial homeostasis
99
What criteria for identification of periodontopathogens was formed during the nonspecific plaque hypothesis (1900s)
Kochs postulates
100
What criterial for identification of periodontopathogens was formed during the ecologic plaque hypothesis (1990s)
Socransky's Criteria
101
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
Kochs Postulates
102
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
Socransky's Criteria
102
P. gingivalis is known as a notorious periodontal pathogen. Which complex of color does it belong to?
Red complex
103
What are the virulence factors of bacteria that contribute to microbiologic specificity?
1. Toxins & Enzymes
2. Adhesins
3. Evading mechanisms
104
Bacterial products that promote tissue destruction:
Toxins and enzymes
105
What are some specific toxins and enzymes that serve as virulence factors?
- LPS
- Leukotoxin
- Gingipains
- Collagenase
- Protease
106
Factors that promote colonization:
Adhesins
107
List some specific adhesins:
- fimbria
- gingipains
108
The production of an extracellular capsule is an example of:
Evading mechanism
109
What evading mechanisms is functions in proteolytic degradation of host immunity components?
gingipains
110
Modulating the host response via binding serum components on the bacterial cell surface is an example of:
Evading mechanism
111
Evading mechanisms that contributes to the invasion of gingival epithelial cells:
LPS
112
Specific bacteria of gingivitis (8):
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
The following bacteria are associated with:
1. Actinomyces spp.
2. Capnocytophaga spp.
3. Campylobacter spp.
4. Streptococcus spp.
5. Parvimonas micra
6. Fusobacterium nucleatum
7. Prevotella intermedia
8. Treponema spp.
Gingivitis
114
Specific bacteria of periodontitis (8):
1. Agreggatibacter actinomycetemcomitans (type B)
2. Porphyromonas gingivalis
3. Prevotella intermedia
4. Parvimonas micra
5. Fusobacterium nucleatum
6. Tannerella forsythia
7. Treponema denticola
8. Spirochetes
115
The following bacteria are associated with:
1. Agreggatibacter actinomycetemcomitans (type B)
2. Porphyromonas gingivalis
3. Prevotella intermedia
4. Parvimonas micra
5. Fusobacterium nucleatum
6. Tannerella forsythia
7. Treponema denticola
8. Spirochetes
Periodontitis
116
Specific bacteria of necrotizing periodontal disease: (4)
1. Fusobacterium nucleatum
2. Prevotella intermedia
3. Treponema spp.
4. Spirochetes
117
The following bacteria are associated with:
1. Fusobacterium nucleatum
2. Prevotella intermedia
3. Treponema spp.
4. Spirochetes
Necrotizing Periodontal Disease
118
Specific bacteria associated with pregnancy and puberty: (2)
1. Prevotella intermedia
2. Capnocytophaga spp.
119
The following bacteria are associated with:
1. Prevotella intermedia
2. Capnocytophaga spp.
pregnancy & puberty
120
Specific bacteria associated with periodontal abscesses: (5)
1. Fusobacterium nucleatum
2. Parvimonas micra
3. Prevotella intermedia
4. Pophyromonas gingibalis
5. Spirochetes
121
The following bacteria are associated with:
1. Fusobacterium nucleatum
2. Parvimonas micra
3. Prevotella intermedia
4. Pophyromonas gingibalis
5. Spirochetes
periodontal abscesses
122
Specific bacteria of peri-implantitis is comparable to:
microbiota to that of periodontitis
123
In a healthy site we see gram ___ bacteria; In a diseased site we see gram ___ bacteria
health: positive
disease: negative
124
In a healthy site we see ___ bacteria; In a diseased site we see ___ bacteria (shape)
health: cocci
disease: rod
125
In a healthy site we see ___ bacteria; In a diseased site we see ___ bacteria (movement)
health: nonmotile
disease: motile
126
In a healthy site we see ___ ; In a diseased site we see ___ (oxygen requirement)
health: facultative anaerobes
disease: obligate anaerobes
127
Fermenting bacteria are in ____ sites; while proteolytic bacteria are seen in ___ sites
healthy; diseased
128
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) Capnocytophaga spp. is usually found in periodontal abscess
C
129
List the donor to recipient transmission of periodontal pathogens:
1. parent-to-child
2. spouse-to-spouse
130
T/F: Periodontal pathogens are communicable but not readily transmissible
True
131
