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Restorative dentistry > Gingival and periodontal disease > Flashcards

Gingival and periodontal disease Flashcards

1
Q

What is periodontology

A

The study of the periodontal tissues in health and disease; including the causes, prevention and treatment of diseases of the periodontal tissues.

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2
Q

What is the periodontium

A

Gingivae
Periodontal ligament
Root cementum
Alveolar bone

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3
Q

What are the two subsections of alveolar bone

A

Alveolar bone proper
Alveolar process

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4
Q

What is the name of the thin plate of bone immediately adjacent to the periodontal ligament

A

Alveolar bone proper

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5
Q

What does CEJ stand for

A

Cemnetoenamel junction

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6
Q

What determines periodontal health

A

The outcome of the bacteria of the dental plaque and the host immune system

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7
Q

What are periodontal diseases

A

A group of diseases affecting the periodontal tissues, representing an immune reaction (innate and adaptive) to adjacent microbial plaque

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8
Q

What are two periodontal diseases

A

Gingivitis
Periodontitis

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9
Q

Does Gingivitis always progress to periodontitis

A

No

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10
Q

What is inflammation

A

A Biological response to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process.

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11
Q

What are cardinal signs of inflammation

A

Pain - dolor
Heat - calor
Redness - rubor
Swelling - tumor
Loss of function - functio laesa

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12
Q

What is the resolution of inflammation in periodontitis

A

There is none

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13
Q

In relation to internal vessels and cells what occurs to cause inflammation

A

-Dilatation of blood vessels​
-Increased permeability of vessel walls​
-Inflammatory exudate​
-Emigration of white blood cells from​ blood vessels into the connective tissue​

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14
Q

Periodontal disease is a multifactorial condition depending on general health conditions but what is the main factor at play

A

The function of the host immune system and its interplay with the bacteria of the plaque

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15
Q

How can general health lead to periodontal disease

A

Stress
Fatigue
Smoking
Diet
Medications
Hygienic habits

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16
Q

What are some local risk factors of developing periodontal disease

A

Acquired: plaque, calculus, overhanging and poorly contoured restorations ​

Anatomical: malpositioned teeth, root groves, concavities and furcations, enamel pearls​

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17
Q

What are the systemic risk factors for periodontal disease

A

Non-modifiable: aging, genetic factors​

Modifiable: smoking, poorly controlled diabetes, stress, medications, hormonal changes, poor nutrition, socioeconomic status ​

18
Q

What were the multiple theories behind periodontal disease over the years

A

Non-specific plaque
Specific plaque
Ecological plaque
Polymicrobial dysbiosis
(Keystone-Pathogen hypothesis)

19
Q

Who developed the non-specific plaque theory

A

1884 Black
1899 Miller

20
Q

What does the specific plaque theory conclude

A

Few species of the total microflora are actively involved in disease

21
Q

What is the ecological plaque theory

A

Combines key concepts of the earlier two hypotheses adding that changes in environment like pH, redox potentially lead to favourable growth certain species of bacteria​

1994 Marsh​
“everything is everywhere but environment selects”​

Composition of the dental plaque depends on environment​

22
Q

What is a biofilm

A

An aggregate of microorganisms in which cells adhere to each other on a surface. These adherent cells are embedded within a self-produced matrix of extracellular polymeric substance (EPS) – DNA, proteins, polysaccharide.
Resistance to antibiotics, antibacterial agents, hidden from immune system of the host.

23
Q

Where may biofilms form

A

Biofilms may form on living or non-living surfaces and can be prevalent in natural, industrial and hospital settings: Biofilms can form inside water and sewage pipes​

24
Q

Is dental plaque a type of biofilm

A

Yes

25
Q

What are the steps to formation of biofilm

A

Pellicle
Association adhesion
Growth
Mature

26
Q

What occurs during the growth stage of biofilm

A

Microcolonies - production of polysaccharide matrix

27
Q

When do microcolonies transition into metaboli8c complexes in biofilm formation

A

Maturation stage

28
Q

What is association adhesion

A

Trailblazing bacteria ‘streptococcus, actinomyces’ posses adhesion molecules

29
Q

What is keystone bacteria theory

A

Certain low-abundance microbial pathogens can cause inflammatory disease by increasing the quantity of the normal microbiota and by changing its composition and by interfering with the host immune system ​

30
Q

What bacterium is the keystone pathogen hypothesis based on

A

‘red complex’
Porphyromonas gingivalis

31
Q

What disrupts the homeostasis between the bacteria of the biofilm and the immune system

A

1) Genetic conditions associated with the impairment of immune system:​
Papillon-Lefevre syndrome, Chediak-Higashi syndrome, LAS syndrome, Down’s syndrome, chronic granulomatous disease​

2) Diseases leading to impairment of immune system: Leukaemia, agranulocytosis, neutropenia, HIV infection

32
Q

What produces calculus

A

Calcification of dental plaque

33
Q

Signs of gingivitis

A

Erythema (redness)
Swelling
Bleeding on gentle probing

34
Q

When might pain occur with periodontitis

A

Pain occurs very rarely mostly in necrotising ulcerative periodontal disease​

35
Q

What are clinical examination signs of periodontitis

A

Bleeding on gentle probing​

Erythema, fibrosis, loss of Knife edge Margin​

Halitosis​

Swelling – falls pocket formation​

Bone loss​

Increase clinical probing depths - True pocket formation​

Recession​

Mobility​

Purulence​

36
Q

What indicates a true pocket

A

Loss of attachment

37
Q

What could produce a false pocket

A

Gingival swelling

38
Q

Why cant antibiotics be prescribed to resolve periodontitis

A

Biofilm protects the bacteria from antibiotic and mouthwash and chemicals

39
Q

What must be done before prescribing antibiotics or chemical agents to remove bacteria in biofilm

A

Disrupt the biofilm first before use of substance

40
Q

What is the difference between biofilm and dental plaque

A

Dental plaque is a type of biofilm

Restorative dentistry (6 decks)

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