Exam 1 C

Question 1

What do T-lymphocytes and B-lymphocytes do in pockets?

Answer 1

T-cell = lymphokines and delayed hypersensitivity
B-cell = turn into plasma cells to make antibodies

Question 2

Describe pathogenesis initial?

Answer 2

2-4 days, acute inflammation, vasculitis, PMNs, macrophages, subclinical (no gingivitis), increased flow of gingival crevicular fluid

Question 3

Describe pathogenesis early?

Answer 3

4-7 days, T-cell lesion, clinical signs of gingivitis, redness, bleeding, edema

Question 4

Describe pathogenesis established?

Answer 4

2-3 weeks, B-cell lesion; plasma cells, chronic gingivitis

Question 5

Describe pathogenesis advanced?

Answer 5

undetermined time, bone loss, pocket formation, B-cell lesion, periodontitis

Question 6

What cytokine causes bone resorption?

Answer 6

IL-1 beta

TNF-alpha (with PGE2)

Question 7

Cytokine IL-1 beta associated with what?

Answer 7

polymorphisms that do not cause disease, but makes individual response more severe

Question 8

What proteinase breaks down collagen and is found with cytokines?

Answer 8

MMP (1&8)

Question 9

What cells are involved in advanced lesions of Paige and Schroder?

Answer 9

B-cells/plasma cells

Question 10

How does smoking affect PD treatment?

Answer 10

less clinical inflammation (decrease immune response)
increases pathogens
decreased response to Tx
greater recurrence risk
more tooth loss

Question 11

What does smoking cause?

Answer 11

localized attachment loss

leathery gingiva

Question 12

How much does smoking raise PD risk?

Answer 12

4x more for current smokers

1.6x more for former smokers

Question 13

True/False Smoking has a huge effect on rate of plaque accumulation?

Answer 13

False - no effect

Question 14

What is smoker recurrence?

Answer 14

relapse

Question 15

What is smoker refractory?

Answer 15

non-responsive to Tx modalities

Question 16

Smokers are good candidates for what?

Answer 16

PerioStat drug therapty (antibiotics)

Question 17

What is host modulatory therapy?

Answer 17

normal host response does a significant portion of damage seen in PD

Question 18

How does host modulatory response work?

Answer 18

MMPs break down collagen
Prostaglandins produce bone resorption
Osteoclasts produce bone resorption

Question 19

Types of host modulation with Tx?

Answer 19

stop smoking, improve oral hygiene, reduce stress, control systemic disease

Question 20

Host modulation by Tx?

Answer 20

PerioStat which inhibits MMP

Question 21

When we collect data, what is most important in all the data we collect when diagnosing PD?

Answer 21

CAL

Question 22

How can we tell PD is continuing?

Answer 22

CAL and probing depth increasing

Question 23

What does healthy gingiva look like?

Answer 23

scalloped gingival margin
knife-like papillas
pink (salmon) color

Question 24

What does diseased gingiva look like?

Answer 24

blunted/bulbous/rounded interproximally
engorged vasculature
red color
bleeding by probing
CAL
fibrotic tissue - if smoker

Question 25

Cementum can be what?

Answer 25

overlapped (most common(, butted, or exposed dentin at CEJ

Question 26

Cementum dimensions?

Answer 26

16-60 microns coronal

150+ microns apical

Question 27

What happens to cementum with age?

Answer 27

apical, furcal, and distal surfaces increase

width also increases