Exam 2; Periodontitis and the Risk of Systemic Disease Flashcards
What is the focal infection concept
that the spread of bacteria from the oral cavity causes many chronic diseases
What are three problems with the focal infection theory
extracting teeth didn’t necessarily cure the disease
people with good oral health and no infection still developed systemic diseases
people with no teeth still developed systemic diseases
This is the mechanism by which periodontitis could potentially influence systemic diseases
acute-phase reaction cascade
What are the four components of the acute phase reaction cascade
triggering factors → local reaction → mediators → secondary systemic reaction
What are some examples of triggering factors in the APRC
infection necrosis surgery neoplasia radiation
What are some examples of location reaction molecules in the APRC
marcophages
fibroblasts
endothelial and other cells
What are some examples of mediators in the APRC
production and release of cytokines
TNF
IL
IFN
What are some examples of secondary systemic reactions in the APRC
fever and leukocytosis
complement
serum glucocorticoids increased
altered synthesis of acute phase proteins
This risk factor is when there are several studies with similar results
consistency of association
This risk factor is when the potential factor precedes the occurrence of the disease
correct time sequence
this risk factor is when if a given factor is related to other diseases, its association with the disease is less likely to be interpreted as casual
specificity of associations
This risk factor is when the risk of developing the disease should be related to the degrees of exposure to the factor
degree of exposure
This risk factor is when the association must make sense in light of known biological mechanisms and pathways
biological plausibility
This risk factor is when induction of the disease in animals exposed to the risk factor
support from experimental evidence
What are your major factors in studies of association of periodontitis and AVD
smoking
age
diabetes
educational and socioeconomic status
What are three pathways that explain the link between periodontitis and cardiovascular disease
effect of periodontal bacteria on platelets
invasion of endothelial cells and macrophages on periodontal bacteria
endocrine-like effects of pro-inflammatory mediators
Studied have shown that these two things are elevated in periodontally diseased subjects
c-reactive proteins and fibrinogen
Studies have shown that this can reduce the correlation of heart issues (via decreasing CRP, decreased arterial thickness, etc.)
periodontal therapy; SRP
What are the characteristics behind the strength of studies involving the link of periodontitis and AVD (strength of evidence)
the association between periodontitis and AVD is not a false finding
the strength reported is modest due to inconsistencies between studies
What has several studies shown between the degrees of exposure and the correlation between AVD and periodontitis (strength of evidence)
several studies suggest that there is a higher cumulative frequency of occurrence of coronary artery disease and increasing periodontal severity
What are three biological plausibility strength of evidence between AVD and periodontitis
periodontal pathogens have been isolated from human carotid thermos
P. gingivalis can induce platelet aggregation
Systemic pro-inflammatory mediators CRP and fibrinogen are elevated in subjects with periodontitis
What is the experimental strengths of evidence between AVD and periodontitis
animal models have supported the plausibility and identified biological pathways that might mediate the linkage; however the models were overly simplistic
What is the specificity as a strength of evidence toward AVD and periodontitis
periodontitis does not fully meet the criterion of specificity
What is the main association between peridontitis and adverse pregnancy outcomes
preterm low birth weight (PLBW)
What are two other associations between periodontitis and adverse pregnancy outcomes
preterm birth
intrauterine growth restriction
How can periodontitis be associated with preterm birth and low birth weight
it can result in the translocation of bacteria and endotoxin into the systemic circulation
inflamed periodontal tissues produce significant quantities of inflammatory mediators; these can have systemic effects
Did periodontal therapy in pregnant women with periodontitis lower the incidence of PLBW
Yes (kinda) studies have shown that treatment, such as scaling and root planing decreased the likelihood of delivering preterm or with a low birth weight
ALTHOUGH THESE FINDINGS ARE NOT SIGNIFICANT
Poorly controlled this tend to have more periodontal attachment loss than healthy individuals
diabetics; both types
Reduction of this has a clinical impact similar to adding a second drug to the diabetes treatment regime
reduction of HbA1c by SRP
These can colonize dental plaque and serve as a source of subsequent infection, resulting in hospital-acquired pneumonia
respiratory pathogens
It is possible that plaque can serve as a receiver for what
bacteria that cause hospital-acquired pneumonia
oral hygiene is likely to become an important consideration for hospitalized patients at risk for pneumonia
Individuals with poor oral hygiene have an increased risk of developing what
chronic respiratory disorders (COPD)
Patients with a history of COPD have significantly more what
attachment loss than subjects without COPD
