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Patient Care 3 > Etiology of Periodontal Diseases > Flashcards

Etiology of Periodontal Diseases Flashcards

1
Q

describe gingival health

A
  • coral pink in color
  • free from inflammation/edema
  • firm and resilient
  • scalloped gingival margin that envelopes the teeth
  • peaked and pointed interdental papilla
  • stippled surface texture
  • no bleeding upon probing
  • consistent with good oral hygiene
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2
Q

how is gingival health achieved

A
  • plaque free tooth surfaces
  • healthy diet
  • regular dental visits
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3
Q

what is plaque biofilm’s affect on healthy gingiva

A
  • lingering biofilm on a clean tooth results in inflammatory process
  • local inflammation persists as long as biofilm is present around gingival tissues
  • inflammation resolves after removal of biofilm
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4
Q

describe gingivitis

A

-inflammation of the gingival tisues
- reversible

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5
Q

what is the primary etiologic factor of gingivitis

A

plaque

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6
Q

what percentage of the population is affected by plaque

A

more than 82% of adult population

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7
Q

what is gingivitis characterized by

A

-inflammation of gingival margins and interdental papilla, redness, bleeding on probing
- no attachment loss
- healthy bone levels

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8
Q

what is the most common form of gingival disease

A

dental plaque induced gingival disease

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9
Q

describe dental plaque induced gingival disease

A
  • may occur without attachment loss or on a reduced periodontium
  • inflammatory lesion is within the gingiva
  • not associated with progressive attachment loss
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10
Q

what is gingivitis associated with dental plaque only a result of

A

microbial challenge between bacteria in plaque biofilm and host responses

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11
Q

how long does it take for gingivitis to ensue with cessation of oral hygiene

A

2-3 weeks

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12
Q

what is gingivitis associated with dental plaque histologically characterized by

A
  • dense infiltrate of lymphocytes
  • mononuclear cells fibroblast alterations
  • increased vascular permeability
  • continuing loss of collagen in response to the microbial challenge
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13
Q

what is the primary etiologic factor for gingivitis

A

plaque

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14
Q

how is the severity and duration of inflammatory response of gingivitis altered

A

modifying local or systemic factors

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15
Q

how is gingivitis reversible

A

in healthy people once local factors and decrease of the microbial load around teeth reduced

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16
Q

what systemic factors effect gingival diseases

A
  • endocrine changes: puberty, menstrual cycle, pregnancy, diabetes
  • results from effects of systemic conditions on host’s cellular and immunologic functions
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17
Q

what percentage of pregnancies get gingivitis

A

more than 30% of pregnancies

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18
Q

what is gingivitis in pregnancy characterized by

A

mild to severe gingival inflammation and pain
- some can have significant hyperplasia and bleeding

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19
Q

what bacteria is increased in pregnancy and why

A

P. intermedia because progesterone causes its growth

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20
Q

how long does gingivitis with pregnancy last

A

resolves itself after delivery

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21
Q

what drugs cause gingival enlargement

A
  • phenytoin
  • immunosuppressive drugs (cyclosporin)
  • calcium channel blockers: nifedipine, verapamil, dilitiazem, sodium valproate
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22
Q

what does vitamin C deficiency cause

A
  • bright red, swollen, bleeding gingiva
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23
Q

what part of the diet increases gingivitis

A

increased carbohydrate intake

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24
Q

what do non - plaque induced gingival diseases encompass

A

lesions of autoimmune or idiopathic etiology manifesting on the gingiva

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25
Q

what are examples of non plaque induced gingival diseases

A

benign mucous membrane pemphigoid

26
Q

what viral diseases can cause gingivitis

A

gonorhhea
synphilis
herpetic stomatitis

27
Q

what fungal diseases can cause gingivitis

A

candidiasis

28
Q

what systemic diseases can cause gingival enlarment

A

DM or allergies

29
Q

what traumatic origin can cause gingivitis

A

toothbrush or flossing trauma, fingernail biting

30
Q

what is localized gingivitis

A

confined to the gingiva of single tooth or group of teeth affecting less than 30% of remaining teeth

31
Q

what is generalized gingivitis

A

more than 30% of remaining teeth

32
Q

what is marginal gingivitis

A

involves the gingival margin

33
Q

what is papillary gingivitis

A

involves interdental papillae, often extending into adjacent portion of gingival margin

34
Q

where do earliest signs of gingivitis occur

A

in the papillae

35
Q

what is diffuse gingivitis

A

affects gingival margin, attached gingiva and interdental papillae

36
Q

what are the 2 earliest signs of gingival inflammatino that precede established gingivitis

A
  • increased GCF
  • increased bleeding from the gingival sulcus on gentle probing
37
Q

what appears earlier BOP or color change or visual signs of inflammation

A

BOP

38
Q

what does BOP indicate

A

inflammatory lesion in the epithelium and connective tissue

39
Q

what type of sign is BOP

A

objective

40
Q

what does absence of BOP imply

A

low risk of attachment loss

41
Q

how does cigarette smoke affect BOP

A

supressess gingival inflammation and BOP

42
Q

what medications affect gingival bleeding

A

antiplatelet medications (aspirin)
- anticoagulatns (warfarin, eloquis)
- oral contraceptives

43
Q

where is gingivitis common in mouth breathers

A

in maxillary buccal area

44
Q

what does gingiva look like in mouth breathers

A

red, shiny, edematous

45
Q

what is fibrosis

A

pathologic process in which disrupted wound healing is associated with defective cell proliferation

46
Q

describe gingivitis compared to periodontitis

A
  • inflammatory response only affecting gingiva
  • occurs becuase of biofilm accumulatino that is not removed
  • reversible
    -precedes periodontitis but does not always progress to periodontitis
47
Q

describe periodontitis compared to gingivitis

A
  • follows gingivitis
  • not reversible
  • inflammatory process extends to affect the PDL and alveolar bone, resulting in clinical attachment loss
  • can be stabilizied and maintained with gingival health on a reduced periodontium
48
Q

describe periodontitis

A
  • chronic inflammation of the gingival tissues resulting in breakdown of surrounding periodontal tissues
  • complex and multifactorial
  • initiated by a dysbiosis of biofilm and modulated by the host response
49
Q

what is periodontitis characterized by

A
  • bone loss
  • apical migration of the JE
50
Q

what are the steps involved in transitioning from gingival health to periodontitis

A
  • plaque around gingival tissues cause microbial challenge for healtghy tissues
  • inflammatory change of the gingival sulucs begins
  • cellular and fluid inflammatory exudate causes degeneration of surrounding connective tissues including gingival fibers
  • apical to JE, collagen fibers are destroyed and area if occupied by inflammatory cells and edema
51
Q

what are the stages of periodontitis and decribe each

A

1: initial lesion: clinically healthy gingival tissues, develops within 2-4 days of accumulation of plaque
2: early lesion: early gingivitis, develops 1-2 weeks of continued plaque accumulation
3: established lesion: established chronic gingivitis, progression to this stage dependent on many factors
4: advanced lesion: transition from gingivitis to periodontitis, progression to this stage dependent on many factors

52
Q

what are the features of the JE

A
  • acts as physical barrier against plaque bacteria
  • stratified squamous nonkeratinized in nature
  • attached to the tooth by internal basal lamina and to the CT by external basal lamina
  • exhibits higher permeability to cells, gingival fluid and host defense molecules to flow through
  • high rate of cellular proliferatino and turnover
53
Q

what is a periodontal pocket cause dby

A

bone loss associated with apical migration of the JE

54
Q

what is a suprabony perio pocket

A

bottom of pocket is coronal to the crest of the alveolar bone

55
Q

what is a infrabony pocket

A

bottom of pocket is apical to the crest of the alveolar bone

56
Q

pseudo pockets are always”

A

suprabony

57
Q

complete periodontal assessment requires:

A
  • description of the clinical appearance of the soft tissues
  • probing depths
  • plaque and bleeding index
  • recession/CAL
  • radiographs
58
Q

what are the causative factors for periodontal disease

A

primary etiology: plaque in a susceptible host
- secondary etiology: local/environmental factors

59
Q

what are the local factors contributing to perio

A
  • calculus
  • carious lesions
  • overhands
  • malpositioned teeth
  • xerostomia
  • furcations
  • food impaction
  • occlusal truama
  • orthodontics
  • poor crown margins
60
Q

what are the systemic factors with perio

A
  • medication
  • stress
  • diabetes
  • obesity
  • CVD
  • immunocompromised
    -smoking
  • nutrional deficiencies
  • age
  • genetics
61
Q

what are the primary bacteria associated with periodontitis

A
  • Aa
  • P. gingivalis
  • P. intermedia
  • T. forsythia
  • T. denticola
62
Q
A

Patient Care 3 (22 decks)

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