Etiology Periodontics Flashcards by Camilo G

Whats in microbial plaque

Bacteria
Fungus
Protozoa
Virus
Mycoplasm

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What is the etiologic factor that casues periodontal disease

Dental PLaque

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Dental Calculus provides what for plaque

A surface to attach

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Dental calculus provides a surface for the plaque to attach what
2

Supragingival calculus

Subgingival Calculus

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What 3 bacteria are red complex

1) Porphyromonas gingivalis
2) Bacteroides forsythus
3) Treponema denticola

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Bacteria grabs unto what?

The pellicle

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Microbial Co-Aggregation is what?

Bacterial receptros allow bacteria to attach to pellicle and each other

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Two regulatory compnents in quorum sensing?

Transcriptional Activator protein (R protein)

Al molecule produced by sutoinducer synthase

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Is the ability to adhere a virulence factor?

YES!!

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How can bacteria in mouth enter host?

ulcerations in epithelium

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Alternate name for actinobacillus

Aggregatibacter

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Pelicle definition

Thin bacteria free layer of salivary proteins

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What constitutes supragingival plaque

Coronal Paque

Marginal Plaque

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What are the common infections in the oral cavity

Caries
periapical
Fungal
Viral
Abcesses
Periodontal

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Periodontal health def

State in which there is no clinical inflammation

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GIngivitis def

Inflammatory process in the gingival tissues

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Periodontitis

Inflammation not confined to the gingiva. Invlolves attachment apparatus.. Cementum, PDL, Alveolar bone, and soft tissues

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Whats the name of organization that handles public health that Winkler has on slide show

NHANES

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Kich’s postulates to identify causative agent of infectious disease
4

1) Microorganism present in all cases of disease
2) Pathogen can be isolated from host and cultured
3) Pathogen from culture must cause the disease when inoculated into a healthy host
4) Pathogen must be re-isolated from new host and shown to be same pathogen as originally innoculated

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Gingivitis takes this long to occur

10-21 days

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Once hygine start, gingival inflammation goes away in how many days

1 week

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Gram negative flora shows up when?

3-10 days afte rinflammation

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How can gingivitis be reversed?

By plaque removal!!

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Main points of modern plaque hypothesis

1) Periodontopathic flora necessary but not suciffient for disease
2) Periodontal diseases are specific mixed infection that cause periodontal destruction in the host

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Is stress an aquired and environmental risk factor for plaque

No | Jk, yes!

Biofilm properties | 3

1) There are different micro-colonies 2) Microcolonies surrounded by protective matrix 3) Microorganisms in biofilm are resitant to antibiotics, antimicrobias and host response

What color complex is a.a.?

Green

Is the green complex an early or late colonizer

Early

Steps in formation of plaque biofilm | 6

1) Association 2) Adhesion 3) Proliferation 4) Micro-colonies 5) Biofilm formation 6) Growth/maturation

Association def

Pellicle forms on tooth

Adhesion def

bacteria bind to pellicle

how long does it take bacteria to bind to pellicle

hours

Growth/maturation def

The biofilm develops a primitive circulatory system

Biofilm formation def

Microcolonies form complex groups with metabolic advantages

Places in mouth that have the most plaque

Most to least: - Distal>Mid-buccal>Lingua - Posterior>Anterior

Whats the relation b/w poor oral hygine and gingivitis?

Strong relation

Whats the relation b/w poor oral hygine and risk for developing periodontitis

Not as strong as Poor oral hygine and gingivitis

Is all periodontitis preceded by gingivitis?

Yes

Does all gingivitis lead to periodontitis?

Fimbrae mechanism of action

1) Attachemnt | 2) Prevention of phagocytosis

Capsule mechanism of action

1) Attachment | 2) Prevent phagocytosis

Endotoxin mechanism of action

1) Activation of inflammatory response | 2) Bone resorption

Initial colonizers attach to what?

Pellicle! Not the tooth

By attaching, bacteria avoids displacement by what?

Gingival Crevicular FLuid

What percentage of Americans suffer from gingivitis? | Periodontitis?

>90% gingivitis | 50% Perio

Formula for periodontal disease

Pathogenic flora+ Lack of beneficial flora+susceptible host = Periodontal disease

What are the beneficial flora in mouth? | 5

``` Actinomyces sp. Strep mitis Strep snaguis Capnocytophaga sp V. parvula ```

Characteristic of susceptible host that's not common sense

LPS responsiveness

What constitutes subgingival plaque

Attached plaque | Unnatached plaque

Attached plaque means attached where

Tooth Epithelium CT

What type of plaque is considered panktonic

Unnatached plaque

In order from most superficial to most deep, whats the order at the bottom of a pocket

1) Calculus 2) Attached plaque 3) Unnatached Plaque 4) JE 5) Partially lysed CT fibers 6) Intact CT fibers

Attached subgingival plaque def

Zone directly attached to pellicle or calculus in the sulcus and pocket

Unattached Subgingival plaque def | 2

1) Zone of subgingival plaque not directly attached to pellicle 2) In direct contact with both JE and sulcular epithelium 3) Located b/w outer position of attached plaque and sulcular epithelium

Young supragingival plaque def

Mainly gram + cocci and rods. | Some gram - cocci and rods

Aged supragingival plaque def

An increase in gram - anaerobic bacteria

Tooth plaque is aka

Attached plaque

Epithelial plaque is aka

Unattached plaque

supragingival plaque has this matrix percentage

50%

Supragingival flora is mostly this gram stain

Gram +

Oxygen requirement of most of supragingival plaque

Aerobic

Metabolism of most of supragingival plaque

Carbohydrate

Matrix percentage of subgingival plaque

very little

Flora of subgingival plaque overall mostly gram stainned

Gram -

Metabolism of subgingival mostly

protein

Does the toot-associated plaque extend to the JE?

NO!

Does the Epithelium associated plaque extend to the JE?

YES!

What type of subgingival plaque is associated with calculus formation and root caries?

Tooth associated plaque

What type of subgingival plaque is associated with gingivitis and periodontitis?

Epithelium associated plaque

Gram stain of bacteria in Epithelium associated subgingival plaque

Gram + And Gram -

Bacteria very strongly associated with Periodontal disease | 3

A.a. Porphyromonase Gingivalis Tanner Forsythia

Abcess of periodontium casued by 5 bacteria

- Fusobacterium Nucleatum - Prevotella Intermedia - Bacterioides forsythus - Porphyromonas gingivalis - Peptostreptococcus micros

Bacteria associated with LAP

aa Prevotella intermedia porphyromonas gingivalis

Bacteria associated with Refractory disease

T. forsythia P. gingivalis P. intermedia C. recta

bacteria associated with ANUG

P. intermedia | medium spirochetes

bacteria associated with HIV-associated gingivitis

``` Candida albicans P. gingivalis P. intermedia F. nucleatum aa C. recta ```

``` AA oxygen requirement gram stain metabolism motility shape ```

``` Facultative anaerobe Gram - Saccharolytic non- motile Coccobacillus ```

colonies with a star center are

what bacteria has a prevalence of 90% in LAP

what has a prevalecence of 30-50% in severe adult periodontitis

Doeas aa have ability to invade epithelial host cells

ew, yes

what exotoxin does aa have?

leukotoxin

Leukotoxin from aa does what?

kill PMNs and monocytes

Is leukotoxin endo or exotoxin

exotoxin

Effect of LPS release?

bone resorption

LPS is a endo or exotoxin

endotoxin

LPS is characteristic of what type of bacteria

Gram -

``` Porphyromonas gingivalis Gram stain Oxygen requirement motility metabolism shape Color What cells doe sit invade ```

``` Gram - anaerobic non-motile asaccharolytic (proteins) Bacillus Black pigmented Invades epithelial cells ```

Porphyromonas gingivalis 5 beneficial characteristics

``` can grow at high pH THick capsue LPS FImbriae Proteinases ```

Tannarella forsythia gram stain oxygen requirement shape

Gram - anaerobic spindle-shaped/pleomorphic

Growth of t. forsythia enhanced by what other organism

F. nucleatum

What does T. forsythia invade?

Epithelial cells

``` Prevotella inermedia Gram stain oxugen req shape Color ```

Gram negative Anaerobiv Rod Black

What pathogens is elevated in ANUG

1) Prevotella intermedia | 2) SPirochetes

Fusobacterium nucleatum gram stain oxygen req shape

Gram neg anaerobic spindle-shaped rod

What is the most common isolate from sub-gingival samples

Fusobacterium nucleatum

Campylobacter rectus gram stain oxygen req motility

gram neg anaerobc motile!

What pathogen forms convex spreading colonies on blood agar plates?

Campylobacter rectus

Does C. rectus make leukotoxin

yes!

``` Peptostreptococcus micros gram stain oxygen req shape metabolism ```

Gram POSITIVE anaerobic coccus asaccharolytic

Spirochetes gram stain oxygen req shape

Gram - anaerobic helical shape