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Perio I Supplemental Cards > Etiology > Flashcards

Etiology Flashcards

1
Q

name 6 common infections in the oral cavity

A
  • caries
  • periapical lesions
  • fungal
  • viral
  • abcesses
  • periodontal
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2
Q

periodontal disease is an ___ disease process that involves ___

A
  • infectious
  • inflammation
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3
Q

what is plaque associated periodontal disease?

A

an inclusive term describing any disease of the periodontium with two basic forms:

  1. gingivitis
  2. periodontitis
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4
Q

inflammation due to periodontal disease involves structures of the ___, resulting in loss of tissue attachment and destruction of ___

A
  • periodontium
  • alveolar bone
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5
Q

describe clinical periodontal health

A

a state in which the tissues are free from clinical inflammation

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6
Q

describe gingivitis

A
  • an inflammatory process confined to the gingival tissues
    • caused by nonspecific accumulation of plaque
    • usually is reversible
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7
Q

describe periodontitis

A
  • inflammation not confined to the gingiva, but involves the attachment apparatus: cementum, periodontal ligament, alveolar bone, and soft tissues
    • starts as gingivitis, but progresses to destroy the bone and soft tissues that support the tooth
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8
Q

describe characteristics of healthy teeth and gums

A
  • pink gums
  • no bleeding gums with flossing and brushing
  • fresh breath
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9
Q

describe characteristics of gingivitis

A
  • red swollen gums
  • bleeding gums with flossing and brushing
  • possible bad breath or taste
  • no bone loss
  • no tooth mobility
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10
Q

describe characteristics of early periodontitis

A
  • red swollen gums
  • bleeding gums with flossing and brushing
  • persistent bad breath or taste
  • slight bone loss
  • possible tooth mobility
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11
Q

describe characteristics of moderate periodontitis

A
  • red swollen gums
  • bleeding gums with flossing and brushing
  • persistent bad breath or taste
  • moderage bone loss
  • tooth mobility and root exposure
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12
Q

describe characteristics of advanced periodontitis

A
  • red swollen gums
  • bleeding gums with flossing and brushing
  • persistent bad breath or taste
  • severe bone loss
  • severe tooth mobility and root exposure
  • possible tooth loss
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13
Q

the most elementary distinction to be made during periodontal diagnosis is the differentiation between ___, ___, and ___

A

health, gingivitis, and periodontitis

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14
Q

what 3 major factors are required for periodontal disease?

A
  • microbial plaque
  • genetics/host factors
  • acquired/environmental factors

by altering one or more of these factors, periodontal disease can be prevented/stopped

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15
Q

what were the major results of the 2009-2010 NHANES study on periodontitis?

A

half of all americans suffer from periodontitis

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16
Q

according to Koch’s postulates, what are 4 requirements in identifying the causative agents of infectious disease?

A
  1. microorganism or pathogen msut be present in all cases of the disease
  2. pathogen can be isolated from the diseased host and grown in pure culture
  3. pathogen from the pure culture must cause the disease when inoculated into a healthy, susceptible laboratory animal
  4. pathogen must be re-isolated from the new host and shown to be the same as the originally inoculated pathogen
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17
Q

describe how the classic danish study (Loe) on gingivitis was conducted

A
  • prep period: intensive plaque control program, plaque free, healthy gingiva produced, ensuring that subjects started study in a state of periodontal health
  • period of no plaque control: the disease-free subjects stopped all hygiene procedures. as plaque accumulated, the onset and disease severity was monitored. period of plaque control resumed.
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18
Q

describe the 3 major findings of the Loe study

A
  1. the time necessary for clinical gingivitis to occur varied from 10-21 days
  2. re-institution of oral hygiene resulted in resolution of gingival inflammation in about 1 week
  3. the appearance of gram negative flora preceded the onset of clinically detectable gingivitis by 3-10 days
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19
Q

what were the 2 major results of the Loe study?

A
  1. gingivitis could be experimentally produced in humans by allowing plaque to accumulate
  2. reversal of gingivitis can be accomplished
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20
Q

what is the non-specific plaque hypothesis?

A

increased plaque mass directly related to increased severity of disease

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21
Q

what 6 characteristics were used in the 1970s model of periodontal disease?

A
  • poor oral hygiene
  • bacterial plaque formation
  • calculus formation
  • periodontal pockets
  • alveolar bone loss
  • tooth loss
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22
Q

what are 3 issues that arise from alveolar bone loss?

A
  • overhanging margins
  • marginal ridge discrepancies
  • occlusal trauma
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23
Q

according to the 1970s model of periodontal disease, all bacterial on the tooth surface are ___

A

harmful

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24
Q

according to the 1970s model of periodontal disease, host response is important and protective against ___

A

bacteria

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25
according to the 1970s model of periodontal disease, gingivitis progresses to periodontitis with ___ and \_\_\_
bone and tooth loss
26
according to the 1970s model of periodontal disease, untreated periodontitis progresses ___ and ___ in a linear fashion with time
slowly and steadily
27
T or F: according to the 1970s model of periodontal disease, only certain individuals are susceptible
false: all individuals and all teeth within an individual are susceptible
28
according to the 1970s model of periodontal disease, what are 2 major risk factors for the disease?
oral hygiene and age as age increases, risk for periodontitis increases
29
what is the specific plaque hypothesis?
a single or limited number of periodontopathic organisms are responsible for disease and severity of disease
30
both the specific and non-specific plaque hypotheses are dependent on what?
the potential direct pathologic effects of dental plaque
31
what are bacterial histolytic enzymes? name 7 of them.
cause tissue destruction 1. collagenase 2. hyaluroniase 3. chondroitin sulfatase 4. proteases 5. deoxyribonuclease 6. ribonuclease 7. neuroaminidase
32
what are cytotoxic agents? name 7 of them.
metabolites of bacteria that cause cell death in tissue culture 1. exotoxin of actinobacillus 2. endotoxin (gram negative) 3. mucopeptides (gram positive) 4. ammonia 5. hydrogen sulfide 6. toxic amines 7. organic acids
33
describe findings of Loe and Goodsen studies
* Loe: * sri lanka data * not all individuals get periodontitis * Goodson: * recurrent acute episodes followed by remission, independent of site activity
34
describe the modern plaque hypothesis
* periodontopathic flora necessary but not sufficient for disease * periodontal diseases are specific mixed infections which cause periodontal destruction in the appropriately susceptible host
35
what are 5 types of microbial plaque?
* bacteria * fungus * protozoa * virus * mycoplasm
36
name 7 acquired and environmental factors related to periodontal disease
1. poor oral hygiene 2. age 3. medications 4. tobacco/smoking 5. stress 6. acquired immune defects, endocrine diseases, inflammatory diseases 7. nutritional deficiencies
37
name 7 innate risk factors related to periodontal disease
1. race 2. sex 3. genetic factors/inheritance 4. congenital immunodeficiencies 5. phagocytic dysfunction 6. down's syndrome 7. papillon-lefevre/ehlers-dantos syndrome
38
what is the etiologic factor that causes periodontal disease?
dental plaque
39
what is dental calculus' role in the development of periodontal disease?
provides a surface for the plaque to attach * supragingival calculus * subgingival calculus
40
describe the 7 basic biofilm properties
1. cooperating community of various types of microorganisms 2. microorganisms are arranged in microcolonies with channels between the microcolonies 3. microcolonies are surrounded by protective matrix 4. differing environments within the microcolonies in the biofilm 5. microorganisms have a primitive communication system 6. microbial gene expression differs when microorganisms are in a biofilm (quorum sensing) 7. microorganisms in biofilm are resistant to antibiotics, antimicrobials, and host response
41
describe microbial co-aggregation
bacterial receptors allow bacteria to attach to the pellicle and to attach to each other synergistically
42
name the 6 ways in which koch's postulates were modified for periodontics
1. putative pathogens must be found in large numbers in diseased sites 2. the absence of pathogens in health 3. must be able to demonstrate immune response to putative pathogens 4. virulence factors can often be demonstrated 5. animal models should simulate human disease 6. elimination of these organisms should result in clinical improvement
43
which bacterial complexes are early colonizers? which are late colonizers?
* early colonizers: blue, purple, green, and yellow complexes * late colonizers: orange and red complexes
44
describe the two major components of biofilm fluid flow
* fluid flow: fluid channels conduct the flow of nutrients, waste products, enzymes, metabolites, and oxygen * bacterial communication: bacteria in the biofilm communicate with each other by sending out chemical signals
45
does does the plaque biofilm help keep inhabitants safe?
makes host defense mechanisms difficult to penetrate the environment and resist the effects of antimicrobials and antibiotics
46
describe the etiology, initiation, and progression of periodontitis
* etiology: microbial plaque * initiation: non-specific plaque accumulation * progression: gram negative bacteria and susceptible host
47
describe common plaque distribution on the surfaces of the teeth
* distal \> mid-buccal * mid-buccal \> lingual * posterior \> anterior
48
T or F: any tooth brush, regardless of the brushing method, does not completely remove interndental plaque, even for patients with wide-open dental embrasures
true
49
the majority of dental and periodontal diseases originate in \_\_\_, and ___ removal is necessary
* interproximal areas * interdental plaque
50
not all gingivitis progresses to \_\_\_, but all ___ is preceded by gingivitis
* preiodontitis * periodontitis
51
what are virulence factors?
properties that enable the bacterium to cause disease
52
describe the mechanism of action for the following virulence factors: fimbrea, pili, fibrillae capsule endotoxin
* fimbrea, pili, fibrillae: bacterial attachment, prevention of phagocytosis * capsule: protection, attachment, prevent phagocytosis * endotoxin: activation of inflammatory response, cytokine production, bone resorption
53
in colonization and invasion, what happens after initial colonizers attach to the pellicle or saliva-coated tooth surface?
co-aggregation takes place
54
in bacterial adherence, what must bacteria be able to attach to?
* available surfaces * enamel * cementum * epithelial cells * connective tissues, or * existing plaque
55
what is the significance of bacteria attaching to available surfaces during bacterial adherence?
by attaching, the bacteria avoids displacement by the gingival crevicular fluid
56
the ability of a bacteria to adhere is a ___ factor
virulence factor
57
in what 2 ways can bacteria enter the host?
* ulceration in the epithelium * direct penetration into the host tissues (less common)
58
what is the formula for periodontal disease?
pathogenic flora + lack of beneficial bacteria + susceptible host = periodontal disease
59
name the 7 pathogens whose presence can contribute to periodontal disease
1. aggregatibacter actinomycetemcomitans (formerly actinobacillus actinomycetemcomitans) 2. porphyromonas gingivalis 3. prevotella intermedia 4. peptostreptococcus micros 5. tannerella forsythia (formerly b. forsythus) 6. fusobacterium nucleatum 7. campylobacter rectus
60
the absence of which 5 beneficial bacterial species can contribute to periodontal disease?
1. actinomyces spp. 2. strep mitis 3. strep sanguis 4. capnocytophaga spp. 5. v. parvula
61
name 7 factors that can contribute to a susceptible host
1. impaired neutrophils 2. inadequate immune response 3. LPS responsiveness 4. AIDS 5. diabetes 6. smoking 7. drugs
62
plaque formation forms via pellicle formation and attachment. describe this.
1. pellicle formation: a thin, bacteria-free layer of salivary proteins attach to the tooth surface within minutes of a professional cleaning 2. attachment: within hours, bacteria begin to attach to the outer surface of the pellicle via fimbriae on bacteria
63
describe supragingival plaque and subgingival plaque
* supragingival plaque * coronal plaque * marginal plaque * subgingival plaque * attached plaque (tooth, epithelium, connective tissue) * unattached plaque
64
describe the ecology and characteristics of unattached subgingival plaque
* the zone of subgingival plaque not directly attached to the tooth surface * mostly consists of gram negative, motile bacteria and resides between the outer position of the attached plaque and sulcular epithelium * in direct contact with both the junctional and sulcular epithelium
65
what are the differences between "young" supra-gingival plaque and "aged" supra-gingival plaque?
* young * mainly gram positive cocci and rods * some gram negative cocci and rods * aged * an increase in gram negative anaerobic bacteria
66
what are the 7 bacteria associated with chronic periodontitis?
1. p. gingivalis 2. p. intermedia 3. f. nucleatum 4. a.a. 5. c. recta 6. t. forsythia 7. treponema spp., e. corrodens
67
which 3 bacteria are associated with localized aggressive periodontitis?
1. a.a. 2. p. intermedia 3. p. gingivalis
68
which 2 bacteria are associated with acute necrotizing ulcerative gingivitis?
p. intermedia and intermediate sized spirochetes
69
which 6 bacteria are associated with HIV-associated gingivitis?
* candida albicans * p. gingivalis * p. intermedia * f. nucleatum * a.a. * c. recta
70
describe aggregatibacter actinomycetemcomitans (a.a.)
* small, non-motile * gram negative * facultative anaerobe * saccharolytic * coccobacillus * small convex colonies with a star shaped center
71
describe characteristics of a.a. relative to periodontitis
* increased frequency in aggressive cases * prevalence: nearly 90% in localized aggressive periodontitis and 30-50% in severe chronic adult periodontitis * many serotypes, some more pathogenic than others
72
does a.a. have the ability to invade host epithelial cells?
yes
73
what are exotoxins? name 6 examples
* extracellular substances produced by bacteria which are toxic to certain cells or tissues of the body * ex. botulinin, tetanus, diphtheria, erythrogenic toxins, leukotoxin, and several enterotoxins
74
describe the leukotoxin produced by a.a.
* it is an exotoxin * is thought to kill PMNs and monocytes from blood, and PMNs from the pocket
75
what is LPS?
* lipopolysaccharide is a virulence factor associated with many gram negative bugs * unlike exotoxins, LPS is an integral part of the outer membrane * once released, the cell can exert a variety of activities that promote tissue damage
76
describe LPS release
* cytotoxic effects * complement activation * bone resortpion (direct or indirect)
77
describe characteristics of porphyromonas gingivalis
* gram negative * anaerobic * non-motile * asaccharolytic * rod shaped (bacillus) * "black pigmented bacteroides" * invades epithelial cells * forms dark brown-black colonies
78
what is an advantages for p. gingivalis?
* it is able to grow at an elevated pH
79
describe virulence factors for p. gingivalis
* virulence factors include a thick capsule, which helps resist phagocytosis * LPS - stimulates cytokine secretion in monocytes and macrophages * fimbriae - responsible for binding the bacterium to host tissues, production and delivery of selected toxins and colonization antigens * proteinases - include collagenase * toxic products
80
describe characteristics of tanerella forsythia
* gram negative * anaerobic * spindle-shaped * pleomorphic * growth shown to be enhanced by co-cultivation with f. nucleatum * formerly known as bacteroides forsythus and tanerella forsythensus * invades epithelial cells
81
describe characteristics of prevotella intermedia
* "black pigmented bacteroides" * gram negative * anaerobic * short, round ended rod * elevated in acute necrotizing ulcerative gingivitis
82
describe characteristics of fusobacterium nucleatum
* gram negative * anaerobic * spindle shaped rod * _most common isolate from subgingival samples_
83
describe characteristics of campylobacter rectus
* gram negative * anaerobic * short, motile vibrio * forms small convex "spreading" or "corroding" colonies on blood agar plates * produces a leukotoxin
84
describe characteristics of peptostreptococcus micros
* gram positive * anaerobic * small coccus * asaccharolytic
85
describe characteristics of spirochetes
* gram negative * anaerobic * helical shaped * related to necrotizing ulcerative gingivitis (ANUG)

Perio I Supplemental Cards (7 decks)

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