Etiology of Periodontal Diseases Flashcards
1
Q
gingival health:
A
- coral pink
- free from inflammation/edema
- firm and resilient
- scalloped gingival margin that envelops the teeth
- peaked and pointed interdental papilla
- stippled surface texture
- no bleeding upon probing
- consistent with good oral hygiene
2
Q
how is gingival health achieved
A
- plaque free tooth surfaces (brushing, flossing)
- healthy diet
- regular dental visits
3
Q
primary factor for gingival disease in a susceptible host
A
plaque
4
Q
lingering biofilm on a clean tooth results in
A
inflammatory process
5
Q
local inflammation persists as long as biofilm is
A
present around gingival tissues
6
Q
inflammation resolves after
A
after removal of biofilm
7
Q
inflammation of gingival tissues
A
gingivitis
8
Q
gingivitis affects ___% of adult population
A
82%
9
Q
____is primary etiologic factor
A
plaque
10
Q
this is characterized by inflammation of gingival margins and interdental papilla, redness, bleeding on probing
A
gingivitis
11
Q
attachment loss with gingivitis?
A
NO
12
Q
most common form of gingival disease
A
dental plaque-induced gingival disease
13
Q
is gingivitis reverisble?
A
yes
14
Q
this disease may occur without attachment loss or on a reduced periodontium
A
dental plaque-induced gingival disease
15
Q
gingivitis associated with what only
A
dental plaque
16
Q
does dental plaque-induced gingival diseases (is/isnt) associated with attachment loss
A
isnt
17
Q
result of microbial challenge between bacteria in plaque biofilm and host response
A
gingivitis associated with dental plaque only
18
Q
-cessation of oral hygiene leads to gingivitis within
A
2-3 weeks in healthy adults
19
Q
gingivitis histologically characterized by
A
- dense infiltrate of lymphocytes
- mononnuclear cells fibroblast alterations
- increased vascular permeability
- continuing loss of collagen in response to the microbial challenge
20
Q
severity /duration of inflammatory response can be altered by
A
modifying local or systemic factors
21
Q
is gingivitis reversible?
A
fully in healthy persons once local factors and decrease of the microbial load around teeth reduced
22
Q
gingivitis occurs rapidly in cases of generalized or localized:
A
inefficient plaque removal
23
Q
gingival diseases modified by systemic factors such as:
A
- endocrine changes (puberty, menstrual cycle, pregnancy, diabetes)
- results from effects of systemic conditions on host’s cellular and immunologic functions
- primary etiology is still plaque
24
Q
gingivitis occurs in _____% of pregancies
A
30-100%
25
the severity/duration of inflammatory response for gingivitis can be altered by modifying
local or systemic factors
26
_____of gingival tissues is associated with pregnancy
acute inflammation
27
what are the characteristics with pregnancy and gingivitis
characterized by:
erythema, edema, hyperplasia, increased bleeding;
histologically, same description as gingivitis
28
some pregancies result in the presence of__________ (pregnancy tumors/pregancy epulis)
pyogenic granulomas
.2-9.6% of pregnancies
29
pyogenic granulomas appear most offten during when of pregnancy
2nd or 3rd month
30
these bleed easily and become hyperplastic or nodular:
occur in pregnant women
pyogenic granulomas
31
pyogenic granulomas occur in areas of
gingivitis and is associated with poor oral hygiene and calc
32
gingivitis from pregnancy is accompanied by increases in steroid hormones in:
which dramatically increase:
steroid hormones in crevicular fluid and dramatic increases in levels of P. intermedia, which uses the steroids as growth factors
33
when pyogenic granulomas are excised(cut off), what happens?
lesion usually does not leave large defect
34
gingival diseases modified by medications: anticonvulsant drugs
1. gingival overgrowth (hyperplasia or hypertrophy)
35
1. gingival overgrowth (hyperplasia or hypertrophy) caused by
1. Anticonvulsant drugs:
-Phenytoin
-Sodium valproate
2. Immunosuppressive drugs:
cyclosporine
3. Calcium channel blockers:
-Nifedipine
-Verepamil
-diltiazem
36
gingival diseases by malnutrition:
1. bright, red, swollen, bleeding gingival associated with VITAMIN C deficiency
37
gingival overgrowth development and severity may be influenced by:
controlled plaque levels as well as elevated hormone levels
38
-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
good: antioxidants
bad: high levels of refined carbohydrates
[gingival diseases by malnutrition]
39
increased carbohydrate intake has implications on ____ and occurrence of ______.
______compose majority of plaque matrix, thereby making plaque biofilm more difficult to remove
gingivitis and occurrence of dental caries
polysaccharides
40
less common that plaque induced gingivitis
non-plaque induced gingivitis
41
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
non-plaque induced gingivitis
42
confined to the gingiva of single tooth or group of teeth affecting <30% of remaining teeth
localized gingivitis
43
involves more than 30% of remaining teeth
generalized gingivitis
44
involves the gingival margin
marginal gingivitis
45
involves the interdental papillae, often extending into adjacent portion of gingival margin
*earliest signs of gingivitis often occur here
papillary gingivitis
46
affects gingival margin, attached gingiva, and interdental papillae
diffuse gingivitis
47
earliest sign of gingival inflammation that precede established gingivitis are:
1. increase gingival crevicular fluid
2. increase bleeding from the gingival sulcus on gentle probing
48
BOP occurs because of
ulceration of the sulcular epithelium due to engorgement of capillaries that are close to the surface of the thinned-out connective tissue
49
easily detectable/valuable for realy diagnosis and prevention of advanced gingivitis
BOP
50
BOP appears earlier than _________with signs of inflammation
change in color or other visual signs
51
BOP indicates:
inflammation lesion in the epithelium and connective tissue
52
BOP is used to measure:
and what is desired/why
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
cigarette smoking does what with BOP
suppresses gingival inflammatory response, thus decreasing presence of BOP
54
these medications increase bleeding tendencies of gingival tissue
antiplatelet:
1. aspirin
anticoagulants (blood thinners)
1. warfarin
2. eloquis
oral contraceptives
55
mouth breathers can have gingivitis noted where
max anterior teeth around facial aspect of gingiva
-gingiva appears red, shiny, caused by dehydration
56
hyperplasia:
increase in number of cells in tissues resulting in increase tissue volume
57
hypertrophy
increase tissue size and volume resulting from increase cell size
58
pathologic process in which disrupted wound healing is associated with defective cell proliferation
fibrosis
59
gingivitis or periodontitis?
inflammatory response only affecting gingiva
gingivitis
60
gingivitis or periodontitis?
follows gingivitis
periodontitis
61
gingivitis or periodontitis?
occurs because of biofilm (plaque) accumulation that is not removed
gingivitis
62
gingivitis or periodontitis?
not reversible
periodontitis
63
gingivitis or periodontitis?
reversible
gingivitis
64
gingivitis or periodontitis?
inflammatory process extends to affect the PDL and alveolar bone, resulting in clinical attachment loss (CAL)
periodontitis
65
precedes periodontitis but does not always progress to periodontitis
gingivitis
66
can be stabilized and maintained with gingival health on a reduced periodontium (bone doesnt grow back)
gingivitis or periodontitis?
periodontitis
67
chronic inflammation of the gingival tissues resulting in breakdown of surrounding periodontal tissues
periodontitis
68
periodontitis is initiated by a _____ of biofilm and modulated by the host response
dybiosis
(imbalance between bacteria in person)
69
periodontitis is characterized by:
1
2
1. bone loss
2. apical migration of the junctional epithelium
70
what are the 4 steps involved in transitioning from gingival health to periodontitis
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
4 histologic stages of gingivitis and periodontitis key features:
1. initial lesion
2. early lesion
3. established lesion
4. advanced lesion
72
1. initial lesion:
-clinically healthy tissues
-develops within 2-4 days of accumulation of plaque
73
2. early lesion:
-early gingivitis that is clinically evident
-develops approx. 1-2 weeks of continued plaque accumulation
74
3. established lesion:
-established chronic gingivitis
-progression to this stage dependent on many factors
75
4. adv lesions:
-transition from gingivitis to periodontitis
-progression to this stage dependent on many factors
76
healthy is to sulcus
as not healthy is to
periodontal pocket
77
acts as physical barrier against plaque bacteria
-higher permeability to cells and fluid.
-high rate of cellular proliferation and turnover
junctional epithelium
78
JE is stratified squamous _____in nature
nonkeratinized
79
JE is attached to tooth by :
and connective tissue by:
internal basal lamina and to connective tissue by external basal lamina
80
pocket caused by bone loss associated with apical migration of the junctional epithelium
periodontal pocket
81
bottom of pocket is coronal to the crest of the alveolar bone:
bottom of pocket is apical to crest of alveolar bone:
suprabony
infrabony
82
pesudopockets are always (supra/infra)bony
supra
83
complete periodontal assessment requires:
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
plaque in a susceptible host
(causative factors of periodontal disease)
primary etiology
85
local/environment factors
(causative factors of periodontal disease)
secondary etiology
86
large list of local contributing factors to periodontal disease:
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
systemic factors:
1. medications
2. stress
3. diabetes
4. obesity
5. cardiovascular disease
6. immuno-compromised
7. smoking
8. nutritional deficiencies
9. age
10. genetics
88
oral microbiota with ____when going from a health in the periodontium to disease
shift
89
following microbial shifts can be identified as health progresses to disease
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
5 primary bacteria associated with periodontitis
1. Aa
2. P. gingivalis
3. P. intermedia
4. T. forsythia
5. T. denticola
91
periodontal disease adversely affects pregnancy outcomes with the potential of leading to:
preterm, low birth weight infants and increasing the mother's chances of experencing more attachment loss of periodontium
92
what are the 4 organism associated with mature plaque and progression of periodontitis in women who has low birth weight infacts
1. T. forsythia
2. P. gingivalis
3. Aa (A. actinomycetemcomitans)
4. T. denticola
93
in order to be identified as a risk factor, the exposure must occur:
before disease onset
94
-well established risk factor for periodontitis
-direct relationship with prevalence of periodontal disease
-smoking has negative impact on the response to therapy
tabacco smoking
95
diabetes:
risk factor for periodontal disease
96
people with _____diabetes have higher severity of periodontitis than those without. why you would want to control your diabetes
type I and II
97
its not the ____of the plaque, but rather the ______of the complex plaque biofilm that is important
quantity
quality or composition
98
5 risk determinants for peridontal disease
1. genetic factors
2. age (increase with age)
3. gender (males)
4. socioeconomics status (lower status more risk)
5. stress (interfere)
99
primary etiologic factor:
plaque in a susceptible host!!
100
secondary etiologic factors:
1. local factors:
calc, caries, tooth position, anatomical features, trauma
3. systemic factors:
smoking habit, health, diet, obesity, hormone changes
