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PATIENT CARE III > Etiology of Periodontal Diseases > Flashcards

Etiology of Periodontal Diseases Flashcards

1
Q

gingival health:

A
  1. coral pink
  2. free from inflammation/edema
  3. firm and resilient
  4. scalloped gingival margin that envelops the teeth
  5. peaked and pointed interdental papilla
  6. stippled surface texture
  7. no bleeding upon probing
  8. consistent with good oral hygiene
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2
Q

how is gingival health achieved

A
  1. plaque free tooth surfaces (brushing, flossing)
  2. healthy diet
  3. regular dental visits
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3
Q

primary factor for gingival disease in a susceptible host

A

plaque

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4
Q

lingering biofilm on a clean tooth results in

A

inflammatory process

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5
Q

local inflammation persists as long as biofilm is

A

present around gingival tissues

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6
Q

inflammation resolves after

A

after removal of biofilm

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7
Q

inflammation of gingival tissues

A

gingivitis

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8
Q

gingivitis affects ___% of adult population

A

82%

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9
Q

____is primary etiologic factor

A

plaque

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10
Q

this is characterized by inflammation of gingival margins and interdental papilla, redness, bleeding on probing

A

gingivitis

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11
Q

attachment loss with gingivitis?

A

NO

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12
Q

most common form of gingival disease

A

dental plaque-induced gingival disease

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13
Q

is gingivitis reverisble?

A

yes

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14
Q

this disease may occur without attachment loss or on a reduced periodontium

A

dental plaque-induced gingival disease

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15
Q

gingivitis associated with what only

A

dental plaque

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16
Q

does dental plaque-induced gingival diseases (is/isnt) associated with attachment loss

A

isnt

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17
Q

result of microbial challenge between bacteria in plaque biofilm and host response

A

gingivitis associated with dental plaque only

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18
Q

-cessation of oral hygiene leads to gingivitis within

A

2-3 weeks in healthy adults

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19
Q

gingivitis histologically characterized by

A
  1. dense infiltrate of lymphocytes
  2. mononnuclear cells fibroblast alterations
  3. increased vascular permeability
  4. continuing loss of collagen in response to the microbial challenge
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20
Q

severity /duration of inflammatory response can be altered by

A

modifying local or systemic factors

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21
Q

is gingivitis reversible?

A

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

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22
Q

gingivitis occurs rapidly in cases of generalized or localized:

A

inefficient plaque removal

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23
Q

gingival diseases modified by systemic factors such as:

A
  1. endocrine changes (puberty, menstrual cycle, pregnancy, diabetes)
  2. results from effects of systemic conditions on host’s cellular and immunologic functions
  3. primary etiology is still plaque
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24
Q

gingivitis occurs in _____% of pregancies

A

30-100%

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25
Q

the severity/duration of inflammatory response for gingivitis can be altered by modifying

A

local or systemic factors

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26
Q

_____of gingival tissues is associated with pregnancy

A

acute inflammation

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27
Q

what are the characteristics with pregnancy and gingivitis

A

characterized by:
erythema, edema, hyperplasia, increased bleeding;
histologically, same description as gingivitis

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28
Q

some pregancies result in the presence of__________ (pregnancy tumors/pregancy epulis)

A

pyogenic granulomas
.2-9.6% of pregnancies

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29
Q

pyogenic granulomas appear most offten during when of pregnancy

A

2nd or 3rd month

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30
Q

these bleed easily and become hyperplastic or nodular:
occur in pregnant women

A

pyogenic granulomas

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31
Q

pyogenic granulomas occur in areas of

A

gingivitis and is associated with poor oral hygiene and calc

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32
Q

gingivitis from pregnancy is accompanied by increases in steroid hormones in:
which dramatically increase:

A

steroid hormones in crevicular fluid and dramatic increases in levels of P. intermedia, which uses the steroids as growth factors

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33
Q

when pyogenic granulomas are excised(cut off), what happens?

A

lesion usually does not leave large defect

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34
Q

gingival diseases modified by medications: anticonvulsant drugs

A
  1. gingival overgrowth (hyperplasia or hypertrophy)
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35
Q
  1. gingival overgrowth (hyperplasia or hypertrophy) caused by
A
  1. Anticonvulsant drugs:
    -Phenytoin
    -Sodium valproate
  2. Immunosuppressive drugs:
    cyclosporine
  3. Calcium channel blockers:
    -Nifedipine
    -Verepamil
    -diltiazem
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36
Q

gingival diseases by malnutrition:

A
  1. bright, red, swollen, bleeding gingival associated with VITAMIN C deficiency
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37
Q

gingival overgrowth development and severity may be influenced by:

A

controlled plaque levels as well as elevated hormone levels

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38
Q

-general nutrition may be related to the presence of absence of inflammation of the gingival tissues.

diets that contain food rich in _____are beneficial

foods that contain high levels of ______ are detrimental to the inflammatory process

A

good: antioxidants
bad: high levels of refined carbohydrates
[gingival diseases by malnutrition]

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39
Q

increased carbohydrate intake has implications on ____ and occurrence of ______.
______compose majority of plaque matrix, thereby making plaque biofilm more difficult to remove

A

gingivitis and occurrence of dental caries
polysaccharides

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40
Q

less common that plaque induced gingivitis

A

non-plaque induced gingivitis

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41
Q

category encompasses lesions of autoimmune or idiopathic etiology manifesting on the gingiva
-gingival diseases of bacterial, viral, fungal, genetic, systemic, foreign body or traumatic origins

A

non-plaque induced gingivitis

42
Q

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

A

localized gingivitis

43
Q

involves more than 30% of remaining teeth

A

generalized gingivitis

44
Q

involves the gingival margin

A

marginal gingivitis

45
Q

involves the interdental papillae, often extending into adjacent portion of gingival margin
*earliest signs of gingivitis often occur here

A

papillary gingivitis

46
Q

affects gingival margin, attached gingiva, and interdental papillae

A

diffuse gingivitis

47
Q

earliest sign of gingival inflammation that precede established gingivitis are:

A
  1. increase gingival crevicular fluid
  2. increase bleeding from the gingival sulcus on gentle probing
48
Q

BOP occurs because of

A

ulceration of the sulcular epithelium due to engorgement of capillaries that are close to the surface of the thinned-out connective tissue

49
Q

easily detectable/valuable for realy diagnosis and prevention of advanced gingivitis

A

BOP

50
Q

BOP appears earlier than _________with signs of inflammation

A

change in color or other visual signs

51
Q

BOP indicates:

A

inflammation lesion in the epithelium and connective tissue

52
Q

BOP is used to measure:
and what is desired/why

A
  1. used to measure homecare
  2. absence of BOP want which means low risk of attachment loss
  3. BOP more objective sign for examiner
53
Q

cigarette smoking does what with BOP

A

suppresses gingival inflammatory response, thus decreasing presence of BOP

54
Q

these medications increase bleeding tendencies of gingival tissue

A

antiplatelet:
1. aspirin

anticoagulants (blood thinners)
1. warfarin
2. eloquis

oral contraceptives

55
Q

mouth breathers can have gingivitis noted where

A

max anterior teeth around facial aspect of gingiva
-gingiva appears red, shiny, caused by dehydration

56
Q

hyperplasia:

A

increase in number of cells in tissues resulting in increase tissue volume

57
Q

hypertrophy

A

increase tissue size and volume resulting from increase cell size

58
Q

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

A

fibrosis

59
Q

gingivitis or periodontitis?
inflammatory response only affecting gingiva

A

gingivitis

60
Q

gingivitis or periodontitis?
follows gingivitis

A

periodontitis

61
Q

gingivitis or periodontitis?
occurs because of biofilm (plaque) accumulation that is not removed

A

gingivitis

62
Q

gingivitis or periodontitis?
not reversible

A

periodontitis

63
Q

gingivitis or periodontitis?
reversible

A

gingivitis

64
Q

gingivitis or periodontitis?
inflammatory process extends to affect the PDL and alveolar bone, resulting in clinical attachment loss (CAL)

A

periodontitis

65
Q

precedes periodontitis but does not always progress to periodontitis

A

gingivitis

66
Q

can be stabilized and maintained with gingival health on a reduced periodontium (bone doesnt grow back)
gingivitis or periodontitis?

A

periodontitis

67
Q

chronic inflammation of the gingival tissues resulting in breakdown of surrounding periodontal tissues

A

periodontitis

68
Q

periodontitis is initiated by a _____ of biofilm and modulated by the host response

A

dybiosis

(imbalance between bacteria in person)

69
Q

periodontitis is characterized by:
1
2

A
  1. bone loss
  2. apical migration of the junctional epithelium
70
Q

what are the 4 steps involved in transitioning from gingival health to periodontitis

A
  1. plaque around gingival tissue causes microbial challenge to healthy tissue
  2. inflammatory change of gingival sulcus begins (gingivitis)
  3. cellular and fluid inflammatory exudate causes degeneration of surrounding connective tissues, including gingival fibers
  4. apical to JE, collagen fibers are destroyed and area if occupied by inflammatory cells and edema
71
Q

4 histologic stages of gingivitis and periodontitis key features:

A
  1. initial lesion
  2. early lesion
  3. established lesion
  4. advanced lesion
72
Q
  1. initial lesion:
A

-clinically healthy tissues
-develops within 2-4 days of accumulation of plaque

73
Q
  1. early lesion:
A

-early gingivitis that is clinically evident
-develops approx. 1-2 weeks of continued plaque accumulation

74
Q
  1. established lesion:
A

-established chronic gingivitis
-progression to this stage dependent on many factors

75
Q
  1. adv lesions:
A

-transition from gingivitis to periodontitis
-progression to this stage dependent on many factors

76
Q

healthy is to sulcus
as not healthy is to

A

periodontal pocket

77
Q

acts as physical barrier against plaque bacteria
-higher permeability to cells and fluid.
-high rate of cellular proliferation and turnover

A

junctional epithelium

78
Q

JE is stratified squamous _____in nature

A

nonkeratinized

79
Q

JE is attached to tooth by :
and connective tissue by:

A

internal basal lamina and to connective tissue by external basal lamina

80
Q

pocket caused by bone loss associated with apical migration of the junctional epithelium

A

periodontal pocket

81
Q

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

bottom of pocket is apical to crest of alveolar bone:

A

suprabony

infrabony

82
Q

pesudopockets are always (supra/infra)bony

A

supra

83
Q

complete periodontal assessment requires:

A
  1. description of the clinical appearance of the soft tissues
  2. probing depths
  3. plaque and bleeding index
  4. recession/clinical attachment loss (CAL)
  5. radiographs
84
Q

plaque in a susceptible host

(causative factors of periodontal disease)

A

primary etiology

85
Q

local/environment factors

(causative factors of periodontal disease)

A

secondary etiology

86
Q

large list of local contributing factors to periodontal disease:

A
  1. calc
  2. carious lesions
  3. overhangs
  4. malpositioned teeth
  5. xerostomia
  6. furcations
  7. food impaction
  8. occlusal trauma
  9. orthodontics
  10. poor crown margins
87
Q

systemic factors:

A
  1. medications
  2. stress
  3. diabetes
  4. obesity
  5. cardiovascular disease
  6. immuno-compromised
  7. smoking
  8. nutritional deficiencies
  9. age
  10. genetics
88
Q

oral microbiota with ____when going from a health in the periodontium to disease

A

shift

89
Q

following microbial shifts can be identified as health progresses to disease

A
  1. from gram + to gram -
  2. from cocci to rods
  3. from nonmotile to motile
  4. from facultative anaerobes to obligate anaerobes
  5. from fermenting to proteolytic species
90
Q

5 primary bacteria associated with periodontitis

A
  1. Aa
  2. P. gingivalis
  3. P. intermedia
  4. T. forsythia
  5. T. denticola
91
Q

periodontal disease adversely affects pregnancy outcomes with the potential of leading to:

A

preterm, low birth weight infants and increasing the mother’s chances of experencing more attachment loss of periodontium

92
Q

what are the 4 organism associated with mature plaque and progression of periodontitis in women who has low birth weight infacts

A
  1. T. forsythia
  2. P. gingivalis
  3. Aa (A. actinomycetemcomitans)
  4. T. denticola
93
Q

in order to be identified as a risk factor, the exposure must occur:

A

before disease onset

94
Q

-well established risk factor for periodontitis
-direct relationship with prevalence of periodontal disease
-smoking has negative impact on the response to therapy

A

tabacco smoking

95
Q

diabetes:

A

risk factor for periodontal disease

96
Q

people with _____diabetes have higher severity of periodontitis than those without. why you would want to control your diabetes

A

type I and II

97
Q

its not the ____of the plaque, but rather the ______of the complex plaque biofilm that is important

A

quantity

quality or composition

98
Q

5 risk determinants for peridontal disease

A
  1. genetic factors
  2. age (increase with age)
  3. gender (males)
  4. socioeconomics status (lower status more risk)
  5. stress (interfere)
99
Q

primary etiologic factor:

A

plaque in a susceptible host!!

100
Q

secondary etiologic factors:

A
  1. local factors:
    calc, caries, tooth position, anatomical features, trauma
  2. systemic factors:
    smoking habit, health, diet, obesity, hormone changes

PATIENT CARE III (7 decks)

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